bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic pain as a disease
Authors: Sullivan Mark D. , Ballantyne Jane C. 
Published: January 2023

Abstract
This chapter argues that changes in our values about pain and opioids were much more important than increases in the prevalence of chronic pain in creating the opioid epidemic. Central to these changes was the argument that chronic pain is not just a symptom of disease, but also a disease itself that deserves its own treatment. Pain intensity measurement was used to determine the need for pain treatment and the success of that treatment. This assessment strategy was joined with the titrate-to-effect treatment strategy first utilized in cancer pain treatment that declared that the proper opioid dose is the dose that significantly reduces the pain intensity score. The pain-as-disease model is intended to increase the scientific and clinical legitimacy of chronic pain, but it tends to exclude the patient from the process of treatment and recovery and may produce iatrogenic harm.
Anxiety Disorders
Authors: McFarland Daniel , Pirl William , Watson Maggie 
Published: January 2023

Abstract
Pathological anxiety is common in cancer patients receiving palliative and end-of-life care and may extend to family members and those close to the patient. For patients, fear of death can be severe and physical comorbidities challenging. Anxiety makes it difficult to cope with impending death. Therefore, the management of anxiety disorders is an important part of end-of-life care. In this chapter, the characteristics, symptoms, and manifestations of anxiety disorders are described, along with information on how to make an accurate diagnosis. Once the symptoms are assessed, a plan to alleviate anxiety can be formed. Evidence-based methods, for individuals with advanced cancer and their extended family and social network, are briefly described. Professional issues, as they relate to anxiety management, are covered so that clinicians may follow clear pathways of care within the medicolegal structures in which they work. High-quality psychosocial care is the primary aim since alleviating anxiety disorders in the dying and their family members is a priority.
Adjustment Disorder and Demoralization
Authors: Kissane David W. , Grassi Luigi , Fang Chun-Kai 
Published: January 2023

Abstract
The diagnosis of metastatic cancer and subsequent disease progression, despite available treatment regimens, can signal closeness to the end of life. This can challenge coping and adaptation, resulting in the development of adjustment disorder and what has become known as demoralization. This chapter covers background models of adjustment disorder and demoralization, the way they overlap, and the notion that demoralization can be a richer diagnostic framework for palliative care because of its inclusion of key existential symptoms. The prevalence of adjustment disorder with demoralization is in the range of 15% to 25% of palliative care patients. Core symptoms include a sense of poor coping with low morale, entrapment by the illness, hopelessness, pointlessness, poor functioning, and the potential for suicidal thinking. The diagnosis requires differentiation from clinical states of anxiety and depression, and assessment may be aided by use of the Psycho-Existential Symptom Assessment Scale or short forms of the Demoralization Scale. Management is tailored to severity of presentation and includes psychoeducational, supportive, and meaning-centered therapies. Psychotropic medication will assist severe presentations. There are communication challenges in discussing existential symptoms and ethical concerns about decision-making toward the end of life. Much service development is still needed to optimize care delivery.
Diagnosing Dying and Assessing Death Wishes
Authors: Monforte-Royo Cristina , Porta-Sales Josep , Balaguer Albert 
Published: January 2023

Abstract
Recognizing the signs and symptoms of dying, especially in the days near death (i.e., imminent death), is key to tailoring treatments toward goals of care and avoiding futile interventions. In accompanying the dying, the palliative care team provides symptom management and support to sustain living until death intervenes. This chapter covers prognostic tools evaluating clinical signs such as functional status, anorexia-cachexia, dyspnea, cognitive decline, or delirium. Nevertheless, nothing can replace whether professionals are trained in diagnosis, with skills to control symptoms and effective communication. It is not uncommon for patients with advanced illness to experience a wish to hasten death (WTHD) (~25% in some studies). The WTHD is regarded as a response to suffering of multifactor origin (physical, emotional, spiritual, and social), and hence it may reflect a wish to put an end to this suffering rather than a genuine wish to die. The proactive exploration of a possible WTHD is therefore an opportunity to identify hidden sources of suffering and to address these as best one can. Faced with a patient who expresses a WTHD, health professionals have an ethical duty to listen and to do what they can to relieve the person’s suffering. Before interpreting the WTHD as a deliberate expression of personal autonomy, it is essential to rule out depression, demoralization, and other forms of existential distress, lack of social support, and uncontrolled symptoms, and to explore the roots of a patient’s suffering, both present and foreseen.
Spiritually Sensitive Care in Palliative and End of Life Settings
Authors: Deodar Jayita , Park Crystal , Lazenby Mark 
Published: January 2023

Abstract
This chapter describes the importance of spiritually sensitive palliative care for cancer patients. Typical symptoms and ways that patients present with spiritual distress are outlined, alongside clinical approaches to spiritual assessment and the common tools used to assist with this assessment, and the relevant differential diagnoses. The chapter reviews evidence-based psychotherapeutic and complementary therapies that address patients’ spiritual concerns. It discusses the influence of different cultural and religious traditions on decision-making and the unit of care. It considers the professional, legal, ethical, training, and service development issues that arise when clinical programs strive to deliver care that is aligned to be responsive to spiritual needs.
Staff Support
Authors: Kelly Brian , Trill Maria Die , Ntizimira Christian 
Published: January 2023

AbstractProviding end-of-life care presents a range of professional and personal challenges for clinicians. These are often balanced against the personal rewards of providing care to the dying patient and their family. Symptoms such as depression, anxiety, demoralization, and what is referred to as “burnout” can occur among clinicians when demands overwhelm the rewards. Factors that can contribute to the emotional load of such work include: cumulative grief, coping with the limitations of curative treatments, refocusing of goals, and the often clinical and ethical complexity of care. Other relevant factors include risk and protective factors at the personal level for the clinician, through to organizational, cultural, and clinical workplace factors. This chapter describes interventions to support clinicians including those that ensure clinicians are appropriately prepared with the necessary skills and supported in their role. It also covers effective mentorship and supervision, strong leadership, and teamwork that promotes support and clinician well-being, and steps to promote a sense of meaning and purpose in this work. Cultural factors, and the varying models of care relevant to different settings globally are described, including the critical role of community workers in provision of appropriate and effective end-of-life care in diverse locations.
Preventing Falls by Integrating Functional Exercise into Habitual Daily Routines
Authors: Hu Yi-Ling , Liu Chiung-ju 
Published: January 2023

Abstract
This chapter reviews a three-arm clinical trial, which compared the LiFE (Lifestyle-integrated Functional Exercise) program to structured strength and balance exercise and gentle flexibility exercise. Older adults, aged 70 years and above, who had a history of falls were recruited from the community and randomly assigned to one of the three exercise programs. Older adults in the LiFE program successfully integrated strength and balance exercises into their everyday activities. Significant improvements in favor of the LiFE condition were observed for fall rates, static balance, ankle strength, function, and participation. The study shows that the LiFE program is an effective alternative fall prevention program compared to traditional structured strength and balance exercise.
Scoping Review of Occupational Therapy Interventions for Chronic Diseases
Authors: Siebert Carol 
Published: January 2023

Abstract
Chronic diseases may result in activity limitations and may negatively impact overall health, quality of life, and self-efficacy. The body of evidence for occupational therapy (OT) interventions to address chronic conditions is emerging. This study was a scoping review of randomized controlled trials of community-based interventions to improve occupational outcomes for individuals with arthritis, heart disease, chronic obstructive pulmonary disease, and depression. Sixteen studies, published between 1998 and 2008, all involving OT either alone or as part of a multidisciplinary intervention, were reviewed. Ten studies found significant differences between intervention and control groups in activity, quality of life, and/or self-efficacy outcomes. There was mixed evidence for the impact of such interventions on physical function and health. This study supports the role of OT in improving occupational outcomes of adults with chronic conditions. It also offers a basis for additional studies to further examine and identify OT intervention with this population.
The Integration of Occupational Therapy into Primary Care
Authors: Pyatak Elizabeth A. , Padilla Vega Daniel 
Published: January 2023

Abstract
This chapter outlines the findings of Donnelly et al.’s article describing the integration of occupational therapy on interprofessional primary healthcare teams. A case study approach was used to identify the structures and processes that support successful integration of occupational therapy within family health teams. The findings illustrate that key factors supporting integration include developing team members’ understanding of the role of occupational therapy in primary care, creating a culture of collaboration, and developing trust and understanding among team members. The chapter outlines key findings of the Donnelly et al. article, highlights related studies evaluating the role and outcomes of occupational therapy in primary care settings, and provides a descriptive case study relating the chapter content to current occupational therapy practice.
Return to Work after Spinal Cord Injury
Authors: Sleight Alix G. 
Published: January 2023

Abstract
Individuals across a variety of chronic conditions seek rehabilitation with a goal of returning to employment. The qualitative study outlined in this chapter explored the experiences of returning to work among adults 7–11 years after spinal cord injury. This study used in-depth interviews and observations and described the nuances and challenges of returning to work for this population. This study has implications for all practitioners working with patients seeking to return to work after illness or disability. Namely, persons who have no higher education or lack viable employment may be less likely to find work, suggesting that occupational therapists and other rehabilitation practitioners must be creative and attentive to the increased needs of these individuals. In addition, this study suggests that early and timely interventions tailored to patients’ interests and competencies are critical in successful return to work, and the rehabilitation team should have a distinct coordinating role in this arena.
Personal Medicine as a Recovery Tool
Authors: Scremin Tristan , Milman Tessa Z. 
Published: January 2023

Abstract
This chapter explores how people with psychiatric disorders use personal medicine, non-pharmaceutical personal coping tools, as a mechanism for their recovery from mental illness. Personal medicine involves engaging in activities that are meaningful or activities to support self-care. The study examined how individuals use personal medicine to cope with symptoms, to improve wellness, and to bring greater meaning and purpose to their lives. The study includes narratives illustrating how individuals use personal medicine, why they often do not share these experiences with their providers, and how experiences of personal medicine intersect with use of psychiatric medications. Suggestions are provided for how providers can support recovery by eliciting information about personal medicine and supporting individuals to identify and use it.
Optimizing Arousal to Manage Aggression
Authors: McIntyre Erin 
Published: January 2023

Abstract
This chapter presents the results of a study in which sensory rooms were utilized in four inpatient mental health units as an alternative or complementary approach to de-escalation of arousal and aggression. The use of sensory modulation techniques to reduce the incidence of violence and aggression focuses on adaptive regulation of arousal and emotion, as opposed to the more traditional, dominant model, which relies on verbal and cognitive techniques for de-escalation. This study utilized narrative analysis of interview and focus group data of service users and staff, which demonstrated that by modifying the environment and introducing soothing stimuli via a sensory room, arousal can be optimized to support emotional regulation. Findings are discussed in light of recent advances in the neurophysiology of emotional regulation and the General Aggression Model, which focuses on arousal and maladaptive emotional regulation as precursors to aggression.
Somatically Based Regulation Intervention for Adolescents Who Have Experienced Complex Trauma
Authors: De Brun Jessica 
Published: January 2023

Abstract
For adolescents who have experienced complex trauma and reveal developmental disruption in self-regulation or who have the inability to utilize language-based psychotherapy, a somatic regulation treatment model may be a useful intervention. This chapter describes a pilot study using a quasi-experimental research design to evaluate the efficacy of the Sensory Motor Arousal Regulation Treatment model as opposed to treatment as usual in two residential treatment facilities. Outcomes indicated a significant reduction of internalizing symptoms on the Child Behavior Checklist and the Somatic Complaints and Anxious/Depressed subscales. The study suggests that somatic regulation can positively impact stabilization and skill-building in complex trauma treatment for adolescents.
Hyporesponsiveness to Vestibular Input and Academic Performance
Authors: Blanche Erna I. , Cermak Sharon A. 
Published: January 2023

Abstract
This study examined the response to sensory integration therapy (SIT) in a group of children with learning disabilities. Ninety-two children were divided into two groups of 46. The control group received special education alone. The experimental group received both SIT and special education. Children in both groups were tested with the Southern California Postrotary Nystagmus Test (SCPNT) and language and academic tests. In the experimental group, children who tested below –1.0 standard deviation in the SCPNT (hyporesponsive to vestibular input) were better responders to SIT than children who were not hyporesponders. In the control group, fewer children with hyporesponsiveness to vestibular input benefited from special education compared to those without hyporesponsiveness. Hyporesponsiveness to vestibular input was also linked to language concerns. Children who were hyperresponsive to vestibular input exhibited more generalized sensory-motor problems than children who were hyporesponsive.
Autism during Infancy
Authors: Bodison Stefanie , Lane Alison E. 
Published: January 2023

Abstract
The chapter describes a study, “Autism during Infancy: A Retrospective Video Analysis of the Sensory-Motor and Social Behaviors at 9–12 Months of Age,” that used retrospective video analysis to identify several sensory-motor and social behaviors that discriminated between children with autism, children with developmental disabilities, and neurotypical children between the ages of 9 and 12 months. There were 19 boys and 13 girls whose families had taken high-quality home videos of them. Nine categories of behaviors were identified and coded: affective expressions, looking, gaze aversion, response to name, social touch responses, anticipatory posture, motor stereotypies, object stereotypes, and sensory modulation. This was the first retrospective study to identify early sensory-motor indicators of autism in children.
Exploring the Content Validity of the Pediatric Evaluation of Disability Inventory (PEDI)
Authors: Reinoso Gustavo , Park Karen 
Published: January 2023

Abstract
This chapter explores the content validity of the Pediatric Evaluation of Disability Inventory (PEDI). Rather than concentrating on developmental items (e.g., stacking blocks) that may not be relevant to each family and child, the authors set out to explore daily-level activities and items. The authors developed and defined 20 complex activities related to mobility, self-care, toileting, and social cognition. Similarly, they provided opinions about the appropriateness on three measurement scales (functional skills/behaviors, caregiver assistance, and modifications). These items and domains were reviewed by a panel of experts in the fields of occupational therapy, physical therapy, physiatry, speech and language therapy, and special education, who were not familiar with items or domains. Results were positive, with 80% of experts rating the overall PEDI as either good or excellent on the two major content validity issues including measuring functional disability in children and determining the comprehensiveness of the item sampling.
The Importance of Family-Centered Care
Authors: Como Dominique H. , Bodison Stefanie 
Published: January 2023

Abstract
Lawlor and Mattingly utilize data collected from three different studies to illustrate the need for a model of family-centered care that addresses the challenges, or “daily dilemmas,” that arise when attempting to create family–practitioner partnerships. Two macro-categories, Situating Family-Centered Care in Cultural Contexts and Daily Dilemmas within Family-Centered Care, were identified. Practitioners often have to overcome the expert model of treatment, the dilemma of “real work,” “turf battles,” and the blurring of professional boundaries while also recognizing the efforts that parents, often mothers, have to make to engage in these partnerships. To be implemented successfully, effective family-centered care requires a radical shift in traditional power dynamics.
Lifestyle Changes and Pressure Ulcer Prevention in Adults with Spinal Cord Injury
Authors: Diaz Jesus 
Published: January 2023

Abstract
This chapter presents findings from a study analyzing occupational therapy intervention outcomes to elucidate the relationship between lifestyle changes and pressure ulcer development. The complexities of lifestyle and behavior changes contributed to different patterns which impacted the development and progression of pressure ulcers. The four identified patterns included positive pressure ulcer changes accompanied by positive lifestyle and behavior changes, negative or no pressure ulcer changes accompanied by positive lifestyle and behavior changes, positive pressure ulcer changes accompanied by minor or no lifestyle or behavior changes, and negative or no pressure ulcer changes accompanied by minor or no lifestyle changes. Community-based occupational therapy practice provides an opportunity to comprehensively address important lifestyle factors impacting pressure ulcer development.
Energy Conservation Interventions for Multiple Sclerosis
Authors: Cunningham Rebecca 
Published: January 2023

Abstract
The chapter “Energy Conservation Interventions for Multiple Sclerosis” provides a detailed review of a randomized controlled trial studying the impact of an occupational therapy delivered 6-week energy conservation course on fatigue, self-efficacy, and quality of life for individuals with multiple sclerosis. Additionally, this chapter reviews related relevant literature, including 1-year follow-up data, energy conservation group delivery for individuals with progressive multiple sclerosis, teleconference delivery of the energy conservation protocol, and one-to-one implementation of the energy conservation protocol. The chapter concludes with clinical implications and a case study to demonstrate clinical decision-making recommendations for energy conservation programming in the multiple sclerosis population.
Development of a Client-Centered Occupational Performance Measure
Authors: Roberts Pamela 
Published: January 2023

Abstract
The Canadian Occupational Performance Measure is a standardized outcome measure that assists in structuring and focusing the occupational therapy assessment, reassessment, and intervention process. Using a semi-structured interview with patients who have a wide range of diagnoses in various practice settings, the information gathered by the Canadian Occupational Performance Measure reflects the importance of the skill or activity to the client in the areas of self-care, productivity, and leisure. The Canadian Occupational Performance Measure is designed to assist the occupational therapist in establishing occupational performance goals based on client perceptions of need and measures the change in defined problem areas.
A Practical Guide to Clinical Supervision in Genetic Counseling
Authors: Veach Patricia McCarthy 
Published: January 2023

AbstractThis book provides a comprehensive overview of supervision, with an emphasis on supervision of genetic counseling students. It draws from theory and research in genetic counseling, psychology, and counselor education and from supervision practice. It describes the infrastructure required for effective supervision; relationship dynamics inherent in supervision; and critical supervision processes, including goal setting, feedback, evaluation, culturally responsive supervision, and common clinical supervision challenges. It also reviews models of supervisor and supervisee development, strategies to promote student wellness, recognizing and addressing problematic performance, and models of supervision delivery. The content emphasizes student supervision, but basic concepts and skills presented are relevant for individuals engaged in supervision of all types of individuals. Each chapter begins with chapter objectives, provides illustrations of major topics with supervision vignettes and examples, and offers specific strategies for promoting self-reflective supervision practice. This title includes instructional tips for designing and conducting supervision training opportunities; and every chapter contains experiential activities to facilitate the professional development of current and future genetic counselor supervisors at all levels of experience.