Purpose: This thesis focuses on the development of occupational therapy competencies to enable executive occupational performance with school-aged children and youth. Methods: Three studies were structured according to the knowledge inquiry, synthesis, and product stages of the Knowledge To Action cycle (Graham et al., 2006). A scoping review in Phase One explored how executive functioning is described in the occupational therapy literature. In Phase Two, a qualitative study was conducted to determine how occupational therapists who have worked with children and youth perceive executive functioning to be understood and addressed. Phase Three used established competency development processes to produce an occupational therapy competency model and framework for enabling executive occupational performance. Results: Although there is little consensus on how executive functioning is understood, literature reviewed in Phase One demonstrated its pervasive effect on performance of complex, novel, and goal-directed occupations. Emerging themes suggest that assessment requires occupational, dynamic, and performance-based approaches, with interventions rooted in metacognitive frameworks. The Phase Two qualitative study suggested that, although there are challenges to being able to “see” executive functioning, it is necessary to explicitly and systematically consider executive functioning during clinical reasoning. Learning to “see” through the executive functioning lens is a complex process. The competency framework development process utilized in Phase Three yielded the Competencies in Context Model. Responding to series of contextual challenges related to system, client, and occupational therapist factors, professional assessment, intervention, iii knowledge acquisition, and knowledge translation competencies are used to organize 16 specific occupational therapy practice competencies. Conclusion: Points of tension within the literature and the field have implications for occupational therapy curricula, research, practice, and professional development. Executive functioning issues have wide reaching effects on occupational performance of children and youth that have not been adequately recognized or explored in the occupational therapy literature. The competency model and framework developed through this research make a substantive contribution to the field in beginning to redress the dearth of occupational therapy-specific models, resources, and tools designed to support occupational therapists’ acquisition or implementation of the executive functioning perspective. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2012-08-26 22:27:09.05

Purpose: To appraise and synthesize the available evidence from previous systematic reviews concerning the impacts of goal setting on engagement in the rehabilitation process and on outcomes of participation and occupational performance for individuals with acquired brain injury (ABI). Material and method: Systematic review of systematic reviews. From a total of 175 hits in the search which was conducted in two parts, 16 full text articles were assessed for eligibility, from which four were selected to be included in the review. Results: Four systematic reviews of moderate quality consisting of variety of methodologies were included. The empirical evidence was limited but supportive that goal directed interventions may contribute to better engagement in rehabilitation and better outcomes of occupational performance. Limited evidence suggested that goal setting improved adherence to the treatment regimens and that patient’s active participation in goal setting had positive impact on patients and their engagement in the process. Findings suggested that goal-directed interventions, particularly in outpatient rehabilitation, may improve patients’ occupational performance. Findings related to participation outcomes were minimal. Conclusion: Goal setting is a complex and multidimensional process. Goal setting may contribute to improved engagement in rehabilitation and occupational performance outcomes for patients with ABI. / <p>Presentation was completed via Adobe Connect</p>

Executive function (EF) skills impact a broad range of functional developmental outcomes including academic success, social integration, motor coordination, independence in self-care, and community engagement, and are at the core of many challenges for children seen by pediatric occupational therapists (OTs). Yet limited evidence of an integrative OT framework addressing EF skills exists. While EF challenges are ubiquitous in pediatric practice, OTs still do not routinely incorporate EF into assessment or treatment. In response to this gap in therapeutic programming, this author developed the QUEST program. QUEST, or QUESTION, EXECUTIVE FUNCTION, SELF-REGULATION THERAPY, is an innovative occupational therapy intervention designed for children three years and older that addresses regulatory and EF challenges in an integrative manner. QUEST combines Bandura’s Social Cognitive Theory, Zelazo’s Iterative Reprocessing Model, and Embodied Cognition to formulate a powerful change model for better outcomes. It is an evidence-based, non-academic learning program that works with the banded nature of the cognitive and regulatory systems, using discovery-oriented games and problem-solving tasks to help children learn to learn. Organized activity protocols direct therapeutic programs for ease of application while caregiver guidelines assist with transfer to the natural environment. QUEST will be disseminated to pediatric OTs via a 2-part continuing education course, initially launched in the San Francisco Bay Area and later disseminated via webinar to a national audience. Both program evaluation and in-depth single-subject research will be carried out to ensure best practice. Through the dissemination of this course, OTs will see improved awareness of the impact of EF in underlying performance challenges, higher levels of integrative programming amongst pediatric OTs, and improved pediatric outcomes.

Darbo tikslas – įvertinti, Tarptautinės funkcionavimo, negalumo ir sveikatos klasifikacijos, bei Kanadietiško veiklos atlikimo testo tinkamumą, vertinant asmenų patyrusių galvos smegenų infarktą, veiklą. Nustatyti, šių dviejų testų sąsajas ir skirtumus. Pacientus vertinant reabilitacijos laikotarpiu, po paguldymo reabilitacijos skyriuje praėjus 1-3 dienoms ir pakartotinis vertinimas atliktas po dviejų savaičių. Veiklos ir dalyvumo sutrikimų nustatymas- svarbus, paskiriant reabilitacijos specialistus ir sudarant reabilitacijos gydymo planą. / Final aim of master work - to explore International Classification for Health, Disability and Functioning (ICF) and Canadian Occupational Performance Measure (COPM) use in evaluation people’s employment after head brain infarction. To clarify these two tests conjunction and differences. Assess the patients in rehabilitation period then they come for the medical treatment in 1-3 day’s period and repeated after two weeks. Operational problems determination is important of rehabilitation professionals and the appointment of the conclusion of the rehabilitation treatment plan.

Background: Obsessive-compulsive disorder (OCD) affects 2 % of the population and leads to restrictions in many occupations, in many life domains and environments. In half of the cases the existing treatment is not enough and leads to emotional and physical exhaustion. The underlying causes behind the diagnosis is not fully clarified but methods in occupational therapy has the potential for evaluation and development in symptom management. Purpose: To identify and describe the experiences in persons with OCD regarding supporting and hindering factors in occupational performance. Method: A literature review with data from three personal blogs and one self-biography was analyzed using a qualitative content analysis leading to five categories. Result: The five categories are: Occupations are restricted or can’t be performed as preferred; Strategies are used to control occupational performance but could trigger compulsions; Meaningful occupation bridges difficult tasks and promotes occupation. The degree of anticipation controls if external stimuli inspires activity or triggers compulsions; Social support increases the ability to carry out activity. The result depicts both hindering and supporting factors affecting occupational performance. Still factors are too complex to divide because supporting strategies also are self-destructive or only work in some situations. Conclusion: Persons with OCD have supporting, hindering and paradoxical strategies and there were factors to facilitate occupational performance in preferred and necessary activities. The social support was the most prominent supporting factor for quality of life and occupational performance.

Purpose: This study aimed to understand the effects of the Cognitive Orientation to daily Occupational Performance (CO-OP) on successful engagement in desired occupations (goals), health-related quality of life, and caregiver stress for individuals with Parkinson’s Disease (PD)-related cognitive impairment and their caregivers. Methods: A mixed methods single-subject design was used. Quantitative and qualitative data were combined to gain a comprehensive understanding of results. Results: Participants successfully engaged in all three trained goals and both untrained goals, generalized CO-OP strategies to perform trained goals outside of treatment sessions, and transferred CO-OP strategies to perform untrained goals independently. Conclusions: Individuals with PD-related cognitive impairment are capable of successfully engaging in self-selected treatment goals that are trained during CO-OP sessions, generalizing CO-OP strategies they have learned in treatment in order to perform the same goals outside of treatment, and transferring CO-OP strategies in order to perform untrained goals independently. / October 2016

Magister Scientiae (Occupational Therapy) - MSc(OT) / Historically travelling was an option only for the affluent; however, with the turn of the 20th century, travelling shifted to an important form of free-choice learning by means of discovery. Travelogues of able-bodied travellers state that travelling offers them an opportunity for constructing new identities as it broadens their perspectives of self. This caused the researcher to question if the same experiences could be prompted amongst people with disabilities. Various disciplines recognise that travelling is a valuable opportunity for growth, but no literature could be found within Occupational Therapy. This led to the research question explored in this study: what is the shared, lived experience of travelling for people with disabilities? The objectives of this study are to describe and explore the purpose and overall experiences of travelling for people with disabilities, explore how people with disabilities perceive, understand and make sense of their experiences of travelling, and lastly to explore the meaning that travelling has for people with disabilities. The theoretical framework underpinning this study is the Peron-Environment-Occupation Model and the Model of Human Occupation, with specific reference to the philosophy of occupational science. Embedded in a philosophical worldview of social constructivism, a Hermeneutical Phenomenological design was chosen using a qualitative approach. Through purposive sampling, six participants were interviewed using a semi-structured interview guide. Interpretative phenomenological analysis was applied to analyse data subsequent to cross analysis, thereby developing a composite understanding of the meaning of travelling to the participants. The findings present three themes, namely: a Double edged sword which highlights the contradictory effects that travelling can have, followed by People are part of the package, which emphasises the participants’ interpretations of the immense role that society plays in disability, and lastly the most prominent theme Pilgrimage to self-discovery. Additionally, an Integrated Model was developed which integrates two prominent models within Occupational Therapy. Conclusively this study provides insight into how travelling facilitated the participants to develop a new identity.

Syftet med studien var att beskriva föräldrars upplevelser av att ha ett barn med psykiska och/eller kognitiva svårigheter i skolan. Författarna gjorde semistrukturerade intervjuer via telefon med 10 föräldrar som har barn med svårigheter i skolan. Data analyserades enligt en kvalitativ innehållsanalys. Analysen resulterade i följande kategorier föräldrars behov av att vara spindeln i nätet, frustrationen över att inte få tillräckligt med stöd, skolmiljöns påverkan på barnen, känslan av att inte veta vad som händer samt positiva upplevelser av skolan. Resultatet av studien visade att föräldrar upplever att det finns brister i skolmiljön som påverkar barnen i deras aktivitetsutförande. Föräldrarna upplever att det saknas viktig kunskap hos pedagogerna som ger dem möjlighet att stötta deras barn på rätt sätt så barnen får samma möjligheter som de övriga barnen på skolan. Författarna i studien diskuterar resultatet utifrån vad arbetsterapeuter kan bidra med för kunskap till pedagogerna samt stödja barnen till att uppnå bästa möjliga resultat i skolarbetet. Fortsatt forskning inom ämnet skulle kunna handla om fäders upplevelse samt skolans upplevelse av att ha barn med svårigheter inom skolan. / The purpose of the study was to describe parent´s experiences of having children with mental and/or cognitive difficulties in school.The authors made semi-structured interviews by telephone with 10 parents who have children with difficulties in school. Data was analyzed according to a qualitative content analysis. The analysis resulted in the following categories  parents need to be the spider in the network, the frustration of not getting enough support, the school environment's impact on the children, the feeling of not knowing what is happening and positive experiences of the school. The result of the study showed that parents find that there are deficiencies in the school environment that affect the children in their activity performance. The parents feel that there is no important knowledge among the educators, which gives them the opportunity to support their children in the right way so that the children have the same opportunities as the other children at the school. The authors of the study discuss the results based on what occupational therapists can contribute for knowledge to the pedagogues and support the children in achieving the best possible results in schoolwork. Continued research on this subject could be about the experience of fathers and the school's experience of having children with difficulties in school.

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2018-07-19T13:23:08Z No. of bitstreams: 1 Camilla Oleiro da Costa.pdf: 1634217 bytes, checksum: 4f4fa51fa8a0e3057d06d806291d420d (MD5) / Made available in DSpace on 2018-07-19T13:23:08Z (GMT). No. of bitstreams: 1 Camilla Oleiro da Costa.pdf: 1634217 bytes, checksum: 4f4fa51fa8a0e3057d06d806291d420d (MD5) Previous issue date: 2017-01-17 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq# / #-2555911436985713659# / #600 / The health and children development are always relevant issues. In childhood and adolescence, the main problems related to mental health are disorders of conduct, attention, hyperactivity and emotional. Occupational performance is the ability of individuals to perform routine activities and to perform roles and tasks. The children have a smaller repertoire of occupations when compared to adults. However, with them develop, they begin to perform more complex tasks until they reach the total repertoire of activities, within their possibilities. The emotional and behavioral disorders can influence the development of children and, consequently, change their occupational performance. The perception about the occupational performance of children, then, can be related to the presence of emotional and behavioral disorders. Objective: Relate the more frequent mental health problems in the child population with the perception of caregivers of children regarding their occupational performance. Methodology: Cross-sectional study with pairs of schoolchildren of the municipal network with eight years old and their main caregivers. Instruments: A sociodemographic questionnaire was used for the sample of children. For the caregivers were used a sociodemographic questionnaire, the Strengths and Difficulties Questionnaire (SDQ) and the Canadian Occupational Performance Measure (COPM). Data analysis: Qualitative variables were described by frequency and quantitative variables by mean and standard deviation. For the comparison of the dichotomous and numerical variables, the T-test was used and for the analysis of the continuous variables the Spearman correlation coefficient was used. Values of p <0.05 were considered statistically significant. Results: The averages of occupational performance and satisfaction with the performance of the children were 5.96 (+2.2) and 5.99 (+2.93), respectively. It was found that receive social benefit (p = 0.011) and live with the mother (p = 0.048) were associated with occupational performance below average in children. The total mean SDQ was 15.5 (+8). The subscale of emotional symptoms had an average of 3.85 (+2.72) points, the subscale of conduct problems of 2.88 (+2.1) points, the subscale hyperactivity 5.3 (+2.8) points, the subscale of relationship problems with colleagues of 3.4 (+2.7) points and the subscale of pro-social behavior averaged 8.8 (+1.4) points. It was found weak correlation between the average occupational performance and the subscales and total SDQ. However, it was evidenced that the worse occupational performance, more emotional and behavioral problems the child presents. / A saúde e o desenvolvimento infantil são assuntos sempre pertinentes. Na infância e adolescência, os principais problemas relacionados à saúde mental são os transtornos de conduta, de atenção, de hiperatividade e emocionais. O desempenho ocupacional é a capacidade que os indivíduos têm de realizar atividades rotineiras e de desempenhar papeis e tarefas. As crianças têm um repertório menor de ocupações quando comparadas aos adultos. Entretanto, ao se desenvolverem, passam a executar tarefas mais complexas até atingirem o repertório total de atividades, dentro de suas possibilidades. Os transtornos emocionais e comportamentais podem influenciar o desenvolvimento das crianças e, consequentemente, alterar seu desempenho ocupacional. A percepção sobre o desempenho ocupacional de crianças, então, pode estar relacionada a presença de transtornos emocionais e comportamentais. Objetivo: Relacionar problemas de saúde mental mais frequentes na população infantil com a percepção de cuidadores de crianças a respeito do desempenho ocupacional das mesmas. Metodologia: Estudo transversal com pares de crianças escolares da rede municipal de oito anos e seus cuidadores principais. Instrumentos: Para a amostra de crianças foi utilizado um questionário sociodemográfico. Para os cuidadores foram utilizados um questionário sociodemográfico, o Strengths and Difficulties Questionnaire (SDQ) e a Medida Canadense de Desempenho Ocupacional (COPM). Análise dos dados: As variáveis qualitativas foram descritas por frequência e as variáveis quantitativas por média e desvio padrão. Para comparação das variáveis dicotômicas e numéricas foi utilizado o Teste T e para análise das variáveis contínuas foi utilizado o coeficiente de correlação de Spearman. Os valores de p<0,05 foram considerados estatisticamente significativos. Resultados: As médias de desempenho ocupacional e satisfação com o desempenho das crianças foram de 5,96 (+2,2) e 5,99 (+2,93), respectivamente. Verificou-se que receber benefício social 6 (p = 0,011) e morar com a mãe (p = 0,048) foram associados ao desempenho ocupacional abaixo da média nas crianças. A média total do SDQ foi de 15,5 (+8). A subescala de sintomas emocionais teve média de 3,85 (+2,72) pontos, a subescala de problemas de conduta de 2,88 (+2,1) pontos, a subescala de hiperatividade de 5,3 (+2,8) pontos, a subescala de problemas de relacionamento com os colegas de 3,4 (+2,7) pontos e a subescala de comportamento pró-social teve média de 8,8 (+1,4) pontos). Foi encontrada fraca correlação entre a média de desempenho ocupacional e as subescalas e total do SDQ. Todavia, evidenciou-se que quanto pior o desempenho ocupacional, mais problemas emocionais e comportamentais a criança apresenta.

Firefighting is a strenuous occupation that requires high-intensity work, resulting in prolonged periods of stress and physical exertion. The physical demand of performing firefighting tasks is augmented by the weight of personal protective equipment (PPE) worn (i.e., load carriage: LC) and the use of a self-contained breathing apparatus (SCBA). These factors have been shown to increase metabolic demand at submaximal workloads and decrease maximal aerobic capacity in laboratory settings. However, there is limited research evaluating the effects of these factors on occupational performance. Therefore, the primary purpose of this study was to quantify the detrimental effect of LC only and LC+SCBA on firefighter occupational performance. In addition, it is important to identify fitness characteristics and physiological outcomes that are correlated to the decrement in performance produced by the PPE. This information will guide practitioners in selecting appropriate training strategies to effectively prepare firefighters to perform occupational tasks in gear. Thus, a secondary aim was to evaluate the relationships between fitness and pulmonary outcomes versus the decrement in occupational performance produced by the PPE. Twenty-one male firefighter recruits (Age: 28.6 ± 4.3 yr; Height: 178.6 ± 7.2 cm; Mass: 94.1 ± 15.4; Body Fat: 17.8 ± 8.4%) participated in this study. Occupational physical ability was assessed by time to complete a simulated fire ground test (SFGT). The SFGT was composed of the following tasks: stair climb, charged hose drag, equipment carry, ladder raise, forcible entry, search, and victim rescue. The recruits participated in six testing sessions. First, two SFGT familiarization trials were performed on separate days. During the next three testing sessions, the firefighter recruits performed the following SFGT conditions in a randomized order: control condition (PT clothes), LC only condition, and PPE+SCBA (SCBA) condition. Baseline and post-SFGT pulmonary and physiological data were collected. To describe within group differences between SFGT conditions, relative difference scores were calculated as follows: % difference = (([experimental trial outcome – PT trial outcome] / PT trial outcome) x 100). Statistical differences between the SFGT conditions were assessed with repeated measures ANOVA. To evaluate the relationship between fitness outcomes versus the decrement in SFGT performance, fitness testing data were obtained from the recruit academy and included: 1.5 mile run time, maximal push-ups, maximal sit-ups, maximal pull-ups, and prone plank time. In addition, the recruits completed a battery of fitness tests in their sixth testing session. The absolute difference in time to complete the SFGT between conditions was calculated as: experimental SFGT time - PT time. Bivariate correlations were used to assess the relationship between the absolute difference in SFGT time versus fitness outcomes. The LC+SCBA trial took 44.5 ± 15.5% longer (345.9 ± 43.7 s; p < .001) and the LC only trial took 38.3 ± 12.6% longer (331.2 ± 39.3 s; p < .001) to complete the SFGT than the PT trial (241.0 ± 33.3 s). The LC+SCBA trial took longer to complete the SFGT than the LC only trial (p = .046). Post-SFGT RPE was higher in the LC+SCBA trial (6.7 ± 1.7) and LC only trial (6.3 ± 1.5) compared to the PT trial (4.6 ± 1.8; p < .001). Absolute aerobic capacity, lower body power, anaerobic power and capacity, abdominal muscular endurance, and upper body strength were significantly correlated to the decrement in SFGT performance on some tasks caused by the PPE. In summary, PPE increases the intensity of performing fire ground tasks. To enhance occupational performance, it is imperative that firefighters optimize specific physical fitness attributes to reduce the relative stress produced by the PPE.