bluuebunny/crossref_metadata_2025 huggingface dataset:
The Durability of Relaxation Training in Pediatric Headache Management
Authors: Engel Joyce M. , Rapoff Michael A. , Pressman Alice Rogot
Published: December 2014

The long-term effects of relaxation training for pediatric headache disorders was determined for all four original participants from a multiple baseline across subjects design. Long-term follow-up data were collected at a mean of 81 months post-treatment.

All participants reported some increases in headache activity from 12-month to long-term follow-up, but at relatively low levels compared with baseline. Headache-free days were 51% to 86% fewer. Headache severity was 81% to 94% better, and headache duration was 75% to 94% better than baseline levels. Medication used was limited to over-the-counter analgesics on an as-needed basis for all subjects.

Three subjects (75%) stated that they would recommend relaxation training to other individuals experiencing headaches. The results of this study support the conclusion that relaxation training is an effective longterm treatment for migraine, tension, and mixed headache disorders originating in childhood or adolescence.
Environmental Problems in Homes of Elders with Disabilities
Authors: Mann William C. , Hurren Dianne , Tomita Machiko , Bengali Minoo , Steinfeld Edward
Published: December 2014

Reporting on results from the University at Buffalo Consumer Assessments Study, this paper examines environmental problems in the homes of elderly persons with disabilities. For the study, 127 persons over the age of 60 were interviewed; all had received, or were currently receiving, services from a senior services agency or hospital rehabilitation program. An average of almost four problems per home were identified. Problems are grouped into categories by room and by area such as ‘lighting’ and ‘steps’ and described in more detail. Since all subjects had been referred to the project through an agency or hospital providing services, the results suggest that the home environment needs of elders are not adequately addressed by these service providers. An environmental interventions model, developed following an analysis of study results, is presented to guide service providers in setting priorities for recommending home modifications. Occupational therapists are qualified to provide home assessments, and must play a greater role in ensuring that these assessments and interventions are provided for non-institutionalized older persons with disabilities.
An Evaluation of the Soft Splint in the Acute Management of Elbow Hypertonicity
Authors: Wallen Margaret , Mackay Suzanne
Published: December 2014

This paper presents an evaluation of the Soft Splint used in the management of hypertonicity at the elbow. An “A1,B1,A2,B2” single system design was used with elbow range of motion, measured with a standard goniometer, as the dependent variable. Visual analysis of the data and the two standard deviation band method of data analysis indicated that the Soft Splint is highly effective in the management of hypertonicity. Elbow range of motion improved significantly during the intervention phases. During the A2 (non-intervention) phase the measurements returned to the baseline level. The findings support the continuing use of the Soft Splint in reducing hypertonicity at the elbow. Replication of this design is required to generalize the results of this study.
Effectiveness of an Intervention to Improve Occupational Performance in Dementia
Authors: Josephsson Staffan , Bäckman Lars , Borell Lena , Nygård Louise , Bernspång Birgitta
Published: December 2014

The Model of Human Occupation was used as a conceptual model for an intervention program to support performance of activities of daily living in four patients with dementia at varying stages of development. The program focused on relatively well preserved functions in dementia (e.g., motor skills, procedural memory). Other important features included (a) the provision of environmental support, and (b) the consideration of subjects' habits and motivation. Intervention-related gains were evaluated using parts of the Assessment of Motor and Process Skills (AMPS) instrument and an assessment of the amount of support required for task performance. The results showed some intervention-related gains in three of four patients. The gains were parallelled by a decrease in the amout of support required for task performance. The results support the notion that performance of everyday activities in dementia may be enhanced with proper intervention.
Responding to Patients' Nonverbal Communication of Affect
Authors: Svidén Gunilla
Published: December 2014

The purpose of this study was to analyze the ways in which occupational therapy students (n=13) say they would respond to patients' nonverbal communication of affect. Students viewed three silent videotapes of patients in treatment on two occasions: at the beginning of their occupational therapy education and after one and a half years of study. The results indicate that after having been active in a new social context, occupational therapy education, students' comments showed evidence of change: This change may be regarded as cognitive in nature because comments became more differentiated and organized. Whether this structural development is related to development from a functional point of view, i.e., comments reflecting a more sensitive adaptation to the patient's feelings, is analyzed based on Burleson's model for the production of comforting strategies. Educational implications are discussed.
Inter-Rater Reliability of Assessments Administered by Individuals with and without a Background in Health Care
Authors: Edwards Mary , Feightner John , Goldsmith C. H.
Published: December 2014

As part of a randomized controlled trial, a pilot study was conducted to determine the inter-rater reliability of four assessments administered by individuals with and without a background in health care. The assessments included in the study were the Barthel Index (Mahoney & Barthel, 1965), the Mini Mental Status Examination (Folstein, Folstein, & McHugh, 1975), the Philadelphia Geriatric Center Morale Scale (Lawton, 1975), and the Instrumental Activities of Daily Living Scale (Lawton & Brody, 1969).

The scores of three assessors, one senior occupational therapist, and two research assistants were examined. The research assistants were trained to administer the assessments by the occupational therapist but had no previous background in health care.

Inter-rater reliability for the measures varied from .97 to 1.00 indicating that, with adequate training, research assistants with no health care background could administer the assessments in a consistent manner.
Assessment of the Evaluation Procedures of Drivers with Disabilities
Authors: Sprigle Stephen , Morris Belinda O. , Nowachek George , Karg Patricia E.
Published: December 2014

Surveys were sent to 403 driver evaluators and trainers throughout the United States whose clientele includes persons with disabilities, and 138 responses (35%) were received from 44 states. Most of the respondents were experienced evaluators, and 62% were occupational therapists. They were asked to report on the methods, equipment, and criteria used when assessing an individual's ability to drive. The measurement of specific driving characteristics (i.e., brake reaction time, steering force) was reported as being more important than measuring nonspecific physical characteristics (i.e., range of motion, grip strength), yet only one half of the respondents measured most of the defined driving characteristics. Most characteristics were measured through observation or a functional test rather than by using equipment. The overwhelming majority of evaluators used subjective criteria or no criteria when judging the findings of a test. Despite these results, two thirds of the evaluators reported being satisfied with their current evaluation equipment.
Qual-OT: A Quality of Life Assessment Tool
Authors: Robnett Regula H. , Gliner Jeffrey A.
Published: December 2014

The “Qual-OT” is an assessment tool that was developed to help define quality of life for the field of occupational therapy. The questionnaire was given to practicing occupational therapists (n — 194), people with spinal cord injuries (n = 78), and people with multiple sclerosis (n = 133). The information derived was used to test the premise that quality of life can be described uniformly, and that it is a construct about which therapists and clients have the same general idea. Factor analyses of the original questions yielded seven distinct factors. Single factor ANOVAs revealed that there were differences among the diagnostic groups on these factors. These differences showed that, for the most part, practicing occupational therapists obtained higher scores on the seven factors than the other two groups.
Motor Free Visual Perceptual Test: Impact of Vertical Answer Cards Position on Performance of Adults with Hemispatial Visual Neglect
Authors: Merrier Louisette , Hébert Réjean , Gauthier Louise
Published: December 2014

Patients who have hemispatial visual neglect (HVN) have difficulty directing their attention toward the visual field contralateral to the side of the lesion. This affects their performance on perceptual assessment tests and masks related visual perceptual deficits. The aim of this study was to verify whether a vertical position of the answer cards of the Motor Free Visual Perceptual Test (MVPT) could overcome this problem. Three groups of subjects were involved in the study: 15 healthy subjects, 15 subjects who had right brain damage without HVN, and 9 subjects who had right brain damage with HVN. The presence of HVN was established by positive test results for at least one of the two tests used, the Albert Test and the Bells Test. The subjects performed the MVPT twice—once in its standard version, and once in a modified version in which the answer cards were presented in a vertical position. The equivalence between the two forms was confirmed with healthy subjects and subjects with right brain damage without HVN. Tor the subjects who had HVN, the vertical positioning of the answer cards caused significantly less interference (p < .05). The test-retest reliability coefficient for the two versions of the MVPT was 0.92–0.94.
The Impact of Child Characteristics on Mothers' Sleep Patterns
Authors: Crowe Terry K. , Clark Lynne , Quails Clifford
Published: December 2014

The sleep patterns of 45 mothers of children with moderate to severe multiple disabilities, 45 mothers of children with Down syndrome, and 45 mothers of typically developing children were compared by means of a 7-day diary. The children ranged in age from 6 months to 5 years. The Caregiver's Activity and Recording of Events (CARE) Inventory was completed by each subject to record mothers' activities in half-hour segments throughout a 24-hour day. Activities were coded into nine categories including rest/sleep. The three groups of mothers were compared on total hours of rest/sleep per day, number of sleep interruptions, reason for sleep interruptions, influences of siblings of target children, and number of times the father attended to the target child during the night as perceived by the mother. Surprisingly, the results indicated that mothers of children with multiple disabilities reported more sleep than did mothers in the other two groups. There were no significant differences found among the groups in the following: amount of weekly daytime sleep; frequency and duration of child-related interruptions per week; number of nights of uninterrupted sleep per week; maximum number of sleep interruptions in one night; and mothers' perception of fathers' nighttime assistance. The data indicated that many mothers in all three groups experienced numerous weekly sleep interruptions, particularly mothers of infants 6 to 12 months of age. Professionals working with mothers of young children must consider the effects of shortened and interrupted sleep patterns on the day time functioning and health of mothers and the effect on the well-being of the entire family.
Perceptions of Occupational Therapists regarding Service Delivery Models in School-Based Practice
Authors: Case-Smith Jane , Cable Judy
Published: December 2014

School-based occupational therapists provide direct services, with the child removed from the classroom and integrated, and consultative services within the classroom, involving the teacher and members of the teaching staff. The purpose of this study was to determine the percentage of time that school-based therapists spend using direct/pull-out and integrative/consultative models of service delivery, to explore the attitudes of occupational therapists toward direct/pull-out and integrative/consultative services, and to identify variables associated with attitudes toward each. Written forced choice surveys were mailed to 321 school-based occupational therapists, and data analysis included 216 (67% of the sample).

Therapists spent 47% of the time providing pull-out services and 53% of the time in the classroom and in consultation. Although the respondents indicated that they enjoyed one-on-one interaction with students, they disagreed that children with disabilities were best served when pulled out of the classroom. Attitudes toward consultation were positive; therapists enjoyed sharing their expertise and believed that therapy should be integrated throughout the school day. Time spent using pull-out services and consultation was highly related to attitude toward that service delivery model; therapists who provided primarily consultation were significantly lower in their ratings of the importance of direct, pull-out services. Therapists who were contracted by the school used pull-out services more than did those employed in the school (58% compared with 44%).

School-based therapists appear to use a variety of service delivery models and have blended direct services with integrative/consultative services. They identified advantages to the use of both models and seem to believe that children are best served when direct services are combined with those that integrate therapy into the classroom and involve consultation with teachers.
Measuring Parent and Professional Attitudes about the Individualized Family Service Plan: A Preliminary Report
Authors: Royeen Charlotte Brasic , Cromack Ted , DeGangi Georgia , Poisson Susan , Wietlesbach Shirley
Published: December 2014

This paper is a preliminary report on the development of alternate forms of an attitude scale to assess parents' and professionals' views toward the Individualized Family Service Plan (IFSP) process (Parental Attitude Scale toward the IFSP; Professional Attitude Scale toward the IFSP), a process evolving as a result of federal regulations regarding early intervention services. Development of the set of attitude scales is unique in that (1) parents and professionals are considered as equals with different forms of the instrument having comparable content with minor changes in phrasing, and (2) alternate forms may allow for long-range, repeated measures of how attitudes change over time in response to implementation of a federal mandate, the IFSP. The item development for scale construction is reported, and the method by which six alternate forms (three for use with parents and three for use with professionals) were constructed. Continued lines of research for psychometric validation of the reliability of the instruments is identified for future research. Limitations of the research are put forth.
A Comparison of Three Occupational Forms in Rehabilitation Patients Receiving Upper Extremity Strengthening
Authors: Schmidt Cynthia L. , Nelson David L.
Published: December 2014

This study examined the differences in distance of motion (DOM) and exercise repetitions of patients performing three bilateral upper extremity exercise tasks. Participants sanded an inclined board under three different conditions: rote exercise, occupationally embedded exercise (working on a shelf), and altruistic occupationally embedded exercise (working on a rocking horse for children). It was hypothesized that differences would be observed between the conditions, with altruistic occupationally embedded exercise predicted to elicit the greatest DOM and the most repetitions, and rote exercise predicted to elicit the lowest DOM and the fewest repetitions. A counterbalanced design was used so that each subject experienced each condition on 3 consecutive days. Subjects included 9 male and 10 female inpatients, who required upper extremity strengthening, from two Ohio rehabilitation centers. Results for distance of motion were not significant and did not support the hypotheses. There also was a lack of significant differences in repetitions. Several explanations of the results are explored in the discussion.
Connecting with Patients: The Personal Experience of Professional Helping
Authors: Rosa Susan Ayres , Hasselkus Betty Risteen
Published: December 2014

In this study, we examine the nature and meaning of therapist-patient interactions from the perspective of the therapist. Qualitative analysis of phenomenologic data from interviews with occupational therapists affirmed the importance of a sense of “connecting” in these relationships, and the predominance of “helping” and “working together” in forging those connections. The nature of helping, the nature of working together, and the personal nature of these experiences in occupational therapy are examined. Findings enhance our understanding of collaboration in occupational therapy and underscore the importance of considering the personal contexts of practice.
Use of Assistive Devices for Bathing by Elderly Who are Not Institutionalized
Authors: Mann William C. , Hurren Dianne , Tomita Machiko , Charvat Barbara
Published: December 2014

For elderly persons with disabilities, bathing is a frequent activity that can be both pleasant and dangerous. Bathing involves using water in an environment with hard, smooth surfaces that become slippery when wet, and many falls occur in the bathroom. A variety of assistive devices are available to make bathing safer and more comfortable. Bathing devices rank as one of the most frequently used categories of assistive devices, yet many elders experience problems in the use of bathing devices. Study of bathing devices has been little beyond determination of the frequency of their use. In this article, we developed a hierarchical model for use in prescribing bathing devices related to mobility and support. This model, based on level of disability, is called the Bath Device Prescription Model (BDPM). Subjects were drawn from the University at Buffalo Consumer Assessments Study (n=319), which considers persons older than 60 years with disabilities. Subjects who reported difficulty with bathing (n=294) were divided into two groups based on mental status (Mini Mental Status Exam [MMSE] scores ⩾24 or ⩾23). This model was tested by first determining the level of disability of satisfied users of (1) bath mats, (2) grab bars in the bath area, (3) bath stools, (4) bath chairs, and (5) bath transfer benches. Level of disability was measured with the Sickness Impact Profile-physical dysfunction section (SIP-PDS), the body care and movement subsection of the SIP-PDS, the motor section of the Functional Independence Measure (FIM), and the bathing-washing and drying item of the FIM. Subjects who were having a problem with a bath device, other than installation, maintenance, or access to the bathroom, were considered. Disability scores for these dissatisfied owners of bath devices were compared with the mean score of satisfied users of each bath device. Typically, dissatisfied owners of bath devices were more disabled than satisfied users, suggesting that they would benefit from a higher level device, following the BDPM. This study represents the first reported investigation testing a model for use in the prescription of bath devices.
Pilot Study of Upper-Extremity Work and Power in Chronic Cumulative Trauma Disorders
Authors: Shackleton T.L. , Harburn K.L. , Noh S.
Published: December 2014

Research designed to increase our understanding of behavioral responses to chronic pain resulting from work-related cumulative trauma disorders (CTD) has been limited. This pilot study's main purpose was to examine the test-retest reliability of self-determined work and power during maximum and submaximum efforts in the performance of wrist flexion and extension movements of the CTD-affected extremity, using the LIDO WorkSET Simulator System. Data were collected from 22 subjects (11 men, 11 women) with chronic upper-extremity CTD, in two same-day sessions. Subjective reports of current pain in the CTD subjects were measured using a Visual Analogue Scale (VAS) and a Numerical Rating Scale (NRS). Upper-extremity work and power data were also collected on 12 healthy subjects as a control (6 men, 6 women). Pilot results included: acceptable test-retest reliability of the work and power measures in the CTD subjects; the CTD group demonstrated markedly lower (20% to 58%) maximum work, submaximum work, and maximum power values compared with the healthy group; gender variation was seen in the CTD and healthy groups with respect to work and power data, and women with CTD tended to report higher pain intensity than male cohorts. These results provide insight for future studies.
Clinician Productivity with and without Students
Authors: Paterson Margo L.
Published: December 2014

This review of clinician workload measurement system (WMS) data at two Canadian hospitals compared clinician time use when students were and were not placed with them. Using the national WMS data, time was sub-divided into direct patient care and indirect patient care. A longitudinal design allowed clinicians to serve as their own control. The findings indicated that 87% of clinicians (n=23) had no significant difference in their direct and indirect patient care time with and without students (n=71). With a larger sample, it is expected that students would actually increase time spent by a clinician on direct patient care and either make no difference or negligibly increase time spent on indirect patient care. This study demonstrated that contrary to popular opinion, having students can actually increase clinician productivity with respect to patient care.
Is There Life after Categories? Reflexivity in Qualitative Research
Authors: Frank Gelya
Published: December 2014

This article encourages occupational therapists conducting qualitative research to use disciplined self-reflection to enrich their studies. Subjective reactions infield situations should not be eliminated or ignored, but examined systematically, leading to new insights and deeper understandings.
Social Biography and Research
Authors: Crepeau Elizabeth Blesedell
Published: December 2014

This essay addresses the interrelationship between the social biography of the researcher and the research process and how each influences the other.
Variables Related to Successful School-Based Practice
Authors: Case-Smith Jane
Published: December 2014

In this ethnographic study, 13 occupational therapists who provided school-based services were interviewed. Each therapist was asked to describe an example of a student with whom she felt particularly successful and one who was challenging or frustrating. Three themes were identified in the examples through analysis that included a follow-up focus group meeting of the participants. The frame of clinical reasoning was applied to help interpret the results. Procedural reasoning was described as “Finding the key” by the participants. This theme defined their search for the underlying reasons for the child's behaviors and performance. The key, or a way to reframe the child's behaviors, then became the basis for their intervention activities and was shared with teachers, parents, and other team members. Finding the key seemed to be particularly important to helping the team design an appropriate environment-child fit that enabled the child's best performance. The second theme, “The whole child,” emphasized the importance of the child's psychosocial core and described the therapist's use of interactive and conditional reasoning to support the student's selfimage. Because the therapists valued the child's vision of a new self, they were able to help the child achieve new social roles and improved selfesteem. A third theme, “Whose success is this?,” told of the importance of a cohesive team, which included the parents, to the success of the child. The child's achievement of important life goals and success as a student seemed to be the result of a team effort to which occupational therapy contributed. Cohesive and collaborative teams seemed to be instrumental to the child's progress and goal attainment.
Fatigue and Activity Patterns of People with Chronic Fatigue Syndrome
Authors: Packer Tanya L. , Foster Dawna M. , Brouwer Brenda
Published: December 2014

Although fatigue is the central symptom of people with chronic fatigue syndrome (CFS), relatively few reports in the literature examine the severity of this fatigue or the activity patterns of people with CFS. Using the Fatigue Severity Scale, the Nottingham Health Profile, the Human Activity Profile, and the Activity Record, severity of fatigue, health status, and activity patterns were investigated. People with CFS reported significantly higher levels of fatigue, poorer health status, and engagement in less energy-demanding activities ( P<0.001) than people without CFS. Those with CFS spent 16.18% (standard deviation [SD]=9.62) of their time resting compared with only 2.28% (SD=3.26) of the time spent by those without CFS ( P<0.05). Time spent in productive activities (household activities and work) was also significantly different, with the CFS group less involved ( P<0.05). This severity of fatigue and limitations in activity patterns warrant further attention. Frequent rest periods and energy conservation training may benefit these clients.
Pre-Academic Skill Development in Children Who Were Full-Term Low-Birthweight Infants: Pilot Data
Authors: Tomchek Scott D. , Lane Shelly J. , Ottenbacher Kenneth
Published: December 2014

This investigation assessed pre-academic skill performance in 19 preschool-aged children with no significant disability who had been full-term low-birthweight infants. Subjects were drawn from a 1988 cohort of intensive-care nursery graduates. Mean birthweight was 2239 g, and mean gestational age was 36.7 weeks. The Miller Assessment for Preschoolers (MAP) was used to measure pre-academic skill development. The MAP scores include a total score and five index scores: foundations, coordination, verbal, nonverbal, and complex tasks. Percentile scores derived from MAP testing were analyzed to determine if scores in the study population fell below the 25th percentile, indicating risk for delays in pre-academic skill performance and warranting tracking services. Results indicated that, as a group, this full-term low-birthweight sample of preschool-aged children had adequate overall pre-academic skill development. However, closer examination of MAP indices suggests the presence of some difficulties. Forty-seven percent of the sample fell below the 25th percentile risk cut-off in the Coordination Index. Also of potential concern were findings from the Verbal Index in which 21.2% of the sample scored at risk. Parental concerns about the child's development often correctly predicted deficits in appropriate MAP indices. This finding, along with findings from the data analysis, suggests that a portion of this population of children continues to be at risk for developmental difficulties. Evaluating pre-kindergarten readiness, using both formal evaluation tools and parental input, may be important for identifying children from this “at-risk” group who may be experiencing pre-academic difficulties. Further investigation with a broader sample is recommended.
Caregiver Role: Ideas about Feeding Infants and Toddlers
Authors: Humphry Ruth , Thigpen-Beck Betty
Published: December 2014

This work represents an initial effort to describe expectations and attitudes that might contribute to variation in the caregiving role as it relates to feeding young children. The study also investigates the impact of performance contexts on attitudes about one aspect of caregiving—feeding. One hundred twenty-four primary caregivers of typically developing infants from 4 to 28 months were interviewed about their expectations for developmental milestones related to feeding and their attitudes about how a parent should respond to different meal-time behaviors of children. Reliability of the instruments was explored. Test-retest reliability of caregiver expectations for when milestones were expected, as captured on Feeding Skills Development, ranged from good (.87) to poor (not significant). Reliability of attitudes captured by the second instrument, Feeding Stories, ranged from moderate to poor. The multidimensional contributions of temporal and social contexts on the attitudes of caregivers about feeding practices were examined. The older the participant the more relaxed approach to what and when a baby ate. The pattern of association of social context and parental value was different for participants who were African American and those who were white. Results are discussed in the light of possible factors that contribute to caregivers' ideas about their young child with special needs and feeding issues. It is suggested that these thoughts might frame how the caregiver responds to feeding intervention suggestions.
Visual Scanning Patterns in an Adult Chinese Population: Preliminary Normative Data
Authors: Dawson Deirdre R. , Tanner-Cohen Carolyn
Published: December 2014

Visual neglect is routinely tested using cancellation tasks. On these tests, subjects without visual neglect are expected to use a systematic left to right search pattern and detect virtually all targets (Weintraub & Mesulam, 1985). This premise of normal scanning being systematic and left to right also provides the foundation for scanning retraining, one rehabilitation approach for neglect. However, in an increasingly multicultural society, it behooves us to investigate cultural variations in normal visual scanning patterns. The purpose of this study was to begin to investigate normal visual scanning patterns in a sample of unilingual, Mandarin-speaking adults. The study was conducted at the Anhui Medical University, Hefei, China. Twenty-nine subjects completed three cancellation tasks: the Bells Test (Gauthier, Dehaut, & Joanette, 1989) and two from the Cancellation Test (Weintraub & Mesulam, 1985). The results showed that fewer subjects than reported by Gauthier et al. (1989) started their search with a left top or left middle orientation and fewer used a systematic scanning pattern. Clinicians responsible for testing and treating visual neglect in multicultural populations should be aware that more variation may be seen in performance on routine scanning tasks.
Development of “All about Me,” a Scale That Measures Children's Perceived Motor Competence
Authors: Missiuna Cheryl
Published: December 2014

All About Me was developed in response to the concern of pediatric occupational therapists that existing measures of self-concept tend to focus on children older than 8 years of age and include very few items that measure physical competence. This instrument evaluates young children's perception of their self-efficacy in the performance of fine and gross motor activities that they encounter daily. Designed for use by pediatric therapists working with primary school children, it is a discriminative assessment that can be used to identify children who perceive themselves to be less competent motorically or to measure and encourage discussion of self-efficacy in children who have been identified as having motor difficulties. In this article, All About Me is described, and the results are reported of two studies that have pilot-tested the developmental edition. Preliminary evidence indicates that All About Me has adequate to good levels of construct, content, and concurrent validity, internal consistency, and test—retest reliability, and may be a useful tool for both discriminative and descriptive purposes.
A Life-World of Altering Meaning: Expressions of the Illness Experience of Dementia in Everyday Life over 3 Years
Authors: Nygård Louise , Borell Lena
Published: December 2014

The aim of this study was to describe the illness experiences of two participants with dementia, as expressed in their everyday lives during 3 years of disease progression. Data were collected at intervals by participant observations and conversational interviews and analyzed via a phenomenological and interpretive method. The findings describe an illness experience characterized by an altering meaning of the concretely present life-world for the participants. This was exhibited by an increasingly existential meaning of the objects and tasks of everyday life, while the perception of the life-world as taken for granted seemed to gradually decrease. Furthermore, participants experienced being threatened by a lack of order and control and uniquely responded to these experiences. Living with the changes and the threat seemed to imply insecurity and doubtful hope, diminishing social contacts, and increasing dependency, but the meaning of the consequences differed between participants. On the basis of the presented structure of the phenomena, a possible way of understanding the illness experience and its meaning in progressively dementing diseases in the occupations of everyday life was exemplified and suggested from a phenomenological point of view.
The Influence of Olfactory Intervention on Non-Nutritive Sucking Skills in a Premature Infant
Authors: Meza Carol V. , Powell Nancy J. , Covington Chandice
Published: December 2014

This single-subject research design examined the influence of maternal breast milk odor on the frequency of high amplitude non-nutritive sucking of a preterm infant during gavage feeding. The participating infant sucked on the nipple of a suckometer connected to a computerized data collection system. Analysis of the data demonstrated that when the odor of maternal breast was present, the frequency of high amplitude non-nutritive sucking was greater than when no odor was present. During the last 3 days of the 14-day study, the preterm infant demonstrated an increase in the frequency of high amplitude non-nutritive sucking consistently during the time when the odor of the mother's breast milk was introduced for a 60-second period.
The Relationship of Sensory Integrative Development to Achievement in Elementary Students: Four-Year Longitudinal Patterns
Authors: Parham L. Diane
Published: December 2014

This longitudinal investigation evaluated the relationship of sensory integrative development to achievement. It was hypothesized that perceptual abilities would be strongly related to achievement when participants were 6 to 8 years of age, but not 4 years later. Participants (32 school-identified learning handicapped children and 35 non-learning handicapped children) were administered the Sensory Integration and Praxis tests and the Kaufman Assessment Battery for Children. As predicted, sensory integrative factors were strongly related to arithmetic achievement at younger ages, and the strength of the association declined with age. The reverse pattern was found for reading: sensory integration was not significantly related to concurrent reading achievement at younger ages, but was related to later reading. An unexpected finding was the strength of the relationship of the sensory integrative factors, particularly Praxis, to arithmetic achievement.
Dynamic Seating Interface Pressures during Wheelchair Locomotion: Influence of Cushion Type
Authors: Kernozek Thomas W. , Lewin Jeff E.K.
Published: December 2014

Seat interface pressure distribution is measured statically in a clinical or research environment with the patient in a fixed position (static) if measured at all. The purpose of this study was to compare the dynamic seat interface pressures between three cushion types [2″ foam, Roho Low Profile (air), and Jay Active (gel)] during wheelchair locomotion. A total of 9 volunteer subjects (7 males, 2 females) participated in a study to determine seat interface pressure fluctuations between each of the 3 different wheelchair cushions. Seat interface pressures were measured with the Novel Pliance System, consisting of a 320×32 sensor matrix mat interfaced with a PC. Each sensor had an area of 1.5 cm2. Sampling rate was fixed at 10 Hz. Average pressures under the ischial tuberosities were determined and the average maxima and minima were calculated from 3 wheelchair locomotion cycles of 3 trials. Wheelchair locomotion speed was constant across trials and conditions (±107). A repeated measures analysis of variance (RM ANOVA) exhibited a main effect for cushion type [F(2, 16)=16.6, p < .05]. A Newman-Keuls pairwise multiple comparison found differences between the 2” foam cushion and both the air and gel cushions, but no differences between the gel and air cushions during wheelchair locomotion. It is important that clinicians and cushion designers understand the dynamic performance characteristics of specific cushion types. Cushion performance may enhance the effectiveness of seating systems in minimizing pressure fluctuations.
Development of Pencil Grip Position in Preschool Children
Authors: Tseng Mei Hui
Published: December 2014

Pencil grip is an aspect of handwriting that has been addressed by occupational therapists who treat children with handwriting difficulties. However, there has been little research investigating the developmental progression of pencil grip in Taiwanese children. Without knowledge of normal development, therapists cannot justify a diagnosis of “unusual” or “bizarre” pencil grips.

This study was designed to investigate the developmental progression in pencil grips in Taiwanese children. The subjects were 326 children aged 2.5 to 6.4 years. The type of grips each child used to perform a drawing task was videotaped. A developmental assessment of pencil grips compiled by Schneck and Henderson was used to rate children's grip positions.

A developmental pregression was noted and 14 grip patterns were identified. About half of the 3- to 3.4-year old children were able to employ a mature grip when drawing in a 7.89 cm x7 cm box. By the age of 4, about three fourths of the children were able to use mature grips to draw. For children aged 5 years and older, the percentage increased to more than 90%.

Comparison of the results with those of Schneck and Henderson (1990) suggests that Taiwanese children 3.5 to 5.9 years of age are more advanced than American children of the same age. In addition, the percentage of Taiwanese children using the lateral tripod is much higher than that of American children. Possible reasons for these differences are proposed. Implications for occupational therapy and suggestions for future studies are discussed.
A Longitudinal Study of Self-Awareness: Functional Deficits Underestimated by Persons with Brain Injury
Authors: Fleming Jennifer , Strong Jenny
Published: December 2014

A longitudinal study of 55 adults with severe traumatic brain injury (TBI) investigated the areas of function for which they lacked self-awareness of their level of competency. Data were collected at 3 and 12 months post-injury using the Patient Competency Rating Scale. Self-awareness was measured by comparing patient self-ratings with the ratings of an informant. The results were consistent with previous studies, indicating that self-awareness was most impaired for activities with a large cognitive and socioemotional component, and least impaired for basic activities of daily living, memory activities, and overt emotional responses. For most areas of function that were overestimated at 3 months post-injury, self-awareness subsequently improved during the first year after injury.
Assessment of Disabilities in Stroke Patients with Apraxia: Internal Consistency and Inter-Observer Reliability
Authors: van Heugten C.M. , Dekker J. , Deelman B.G. , Stehmann-Saris J.C. , Kinebanian A.
Published: December 2014

In this paper the internal consistency and inter-observer reliability of the assessment of disabilities in stroke patients with apraxia is presented. Disabilities were assessed by means of observation of activities of daily living (ADL). The study was conducted at occupational therapy departments in general hospitals, rehabilitation centers and nursing homes in the Netherlands. Patients (n=42) diagnosed to have had a stroke in the left hemisphere and to have apraxia as well, participated in the study (48% male, aged 39–91). Guidelines were offered for the ADL-observation and the assessment of disabilities in these activities. The internal consistency of the scales is expressed by means of Cronbach's alpha and Mokken-scale analysis. The inter-observer reliability is expressed by means of percentage of agreement between two observers, Cohen's kappa and the intra-class correlation coefficient (ICC). The internal consistency of the observations is good: alpha is high (0.94). The Mokken-analysis confirms this finding: an H-coefficient of 0.58 and corresponding rho of 0.94 indicate a strong and reliable scale composed of the set of all ADL-observations. Results indicate that the inter-observer reliability can be considered fair to good: all kappa values were higher than 0.44; the maximum kappa was 0.95. Percentages of agreement vary between 60% and 96%. The ICC range from 0.62 to 0.98. The results of this study imply that the ADL-observations can be considered an internally consistent and reliable instrument for the assessment of disabilities in stroke patients with apraxia.
Inter-Rater Reliability of a Home Fall Hazards Assessment Tool
Authors: Clemson Lindy , Fitzgerald Maureen H. , Heard Robert , Cumming Robert G.
Published: December 2014

The Westmead Home Safety Assessment provides an extensive list of potential hazards and was developed as a tool for occupational therapists to identify environmental hazards in the homes of persons who are at risk of falling. It was refined by procedures to establish content validity and by compiling an accompanying manual. Thus, the tool and its' manual offer a valid and systematic way of identifying potential environmental fall hazards in and about the home. Using the tool in home visit situations can assist the therapist to develop skills in observing fall hazards. This study examined the reliability of the refined tool when used in the context of a home visit. An inter-rater reliability study demonstrated the inter-rater reliability (all items kappa > 0.40) was improved over the earlier version (one third items kappa < 0.40). This supported the importance of training and clearly defining the domain of interest.
Meanings of ‘Research’ and ‘Researcher’—The Clinician Perspective
Authors: Cusick Anne , Franklin Alison , Rotem Arie
Published: December 2014

This study used an open-ended self-report survey to define ‘research’ and ‘researcher’ from the clinician's perspective. Seventy-five occupational therapists working in 6 acute care metropolitan hospitals in Sydney, Australia participated in this study (75% response rate). There were four key findings. First, a profile of therapist research revealed variations in levels of involvement with most (75%) having none. This was not related to postgraduate qualifications or study, years of experience, age, clinical specialty or seniority. Second, the nature of activities identified to be research by clinicians varied: project names, specific research tasks, input, output-related activities such as thinking and professional development activities. Third, research was defined in terms of its attributes, process, and outcomes. Fourth, researchers were described as being engaged in specific research tasks, other general tasks that progressed the research, and they were identified as producers of research outcomes. Differences were identified in responses between those therapists who were involved in research and those who were not.
Changes in Health, Functional and Psychosocial Status and Coping Strategies of Home-Based Older Persons with Arthritis over Three Years
Authors: Mann William C. , Tomita Machiko , Hurren Dianne , Charvat Barbara
Published: December 2014

The population of persons over 65 years of age, both in simple headcount and in proportion of the total population of the United States, has been increasing dramatically since 1900. This trend is projected to continue at least until the middle of the next century. Approximately half of persons over 65 years of age experience pain and/or activity limitation as a result of arthritis. There has been little study of the changes over time in health, functional, and psychosocial status of elders with arthritis, nor of the coping strategies they employ. Using participants from the University at Buffalo Consumer Assessments Study, we retrospectively selected 61 cognitively intact Mini Mental Status Exam (MMSE>23) elders with arthritis that impacted on activities, who were living at home at an initial interview and at a three-year follow-up interview. Using paired ṯ-tests we found significant changes at the three-year follow-up in four measures of health status: number of medications, number of chronic illnesses, pain, and vision. Functional status declined significantly as measured by the FIM (using MANOVA for six sections of the FIM), the Sickness Impact Profile, and the IADL section of the OARS (using paired ṯ-tests). No significant changes were found for psychosocial status. Using MANOVA, we found a significant increase in numbers of assistive devices owned (from an initial mean of 14.7 to a three-year follow-up mean of 20.1), and number of devices used. Satisfaction with devices was high. Environmental problems in the home showed a significant increase over the three years. While our selection of study participants did not include individuals who went to nursing homes or hospitals, or who had died, we still found significant decline in health and functional status, and clear evidence of successful coping strategies. Results suggest a strong role for occupational therapy services for elders with arthritis. There is also a need for change in policy toward home modification and occupational therapy services.
Test-Retest Reliability of the Assessment of Motor and Process Skills in Elderly Adults
Authors: Doble Susan E. , Lewis Norma , Fisk John D. , Rockwood Kenneth
Published: December 2014

We examined the test-retest reliability of the Assessment of Motor and Process Skills (AMPS) in a heterogeneous sample of 55 elderly adults. Subjects were reassessed within 1 to 10 days (M=4.0, SD=2.7 days). The subjects' Time 1 and Time 2 ability measures were highly correlated (Motor: r(55)=.88, P<.001; Process: r(55)=.86, P<.001). Measures were stable in 92% of the subjects. Significant variability occurred in only 8% (N=9) of the subjects' ability measures. Measurement error was a concern less than 2% of the time; 6% of the subjects' measures differed as a reflection of real changes in their task performances. Although some variability was attributed to fluctuations in subjects' medical conditions or motivation to adhere to the task requirements, not all of it could be attributed to a specific factor. These data provide support for the reliability of the AMPS, and serve as a reminder that not all test—retest differences represent measurement error.