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@#Introduction: Occupational therapists have been developing various handwriting intervention that has fundamental occupational goals with known validity to guide professional practice in the treatment of children with handwriting difficulties. This study aimed to explore the development and content validation of a developed handwriting intervention programme for children with handwriting difficulties. Methods: This study employed a combination of qualitative and quantitative methodology based on the sequential exploratory design in two main stages. The first stage is the focus group discussion and followed by a validation procedure using face and content validity scored by the expert reviewers. A total of thirteen experts participated in this study. Results: The findings were analyzed thematically according to physical appearance, language used, and content in the developed programme. The face and content validity report a convincing value, ranging from 0.99 to 1.00 of S-CVI values on four aspects, relevancy, clarity, simplicity, and ambiguity in the developed programme. Conclusion: This study provided preliminary approval for the development and validation of a handwriting intervention programme for children with handwriting difficulties to support the demand in the Malaysian school curriculum.
ABSTRACT
@#Handwriting difficulty is one of the main issues among school children, especially for those with motor coordination issues. The aim of this systematic review is to evaluate the effectiveness of occupational therapy interventions in handwriting components for children with motor coordination issues. Current research articles were systematically searched according to the PRISMA guidelines. Two hundred and sixty-eight (n=268) research articles were identified; however, only ten (n=10) were eligible to be evaluated for this study. Studies were appraised by using McMaster Critical Review Form-Quantitative Studies. Descriptive synthesis was executed due to the heterogeneity of included studies. The review found various types of intervention conducted by occupational therapists to have a positive effect on handwriting performance components among children with motor coordination issues. Types of intervention used were visual, motor, perceptual, sensory, activity of daily living skills, training device and assistive technology and specific handwriting programs. Most handwriting intervention showed effectiveness to improve handwriting performance in motor function, visual and perceptual components. Future research should focus on homogeneity of Occupational Therapy (OT) intervention to improve handwriting performance by using specific handwriting programmes and similar standardised evaluation instruments. Practitioners of OT intervention should consider collaboration with teachers, parents and other health professionals to expedite effectiveness of intervention in handwriting performance components.
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@#Self-care is defined as activities performed by individuals, families, and communities to enhance their health, prevent diseases, limit illnesses, and restore health. Previous research has mainly focused on self-care skills of older adults in either institution or residential homes separately but limited studies have compared between both these settings. This study aimed to compare the self-care skills between institutionalised and home dwelling older adults at selected area in Malaysia. A total of 43 participants aged 60 years old and above were recruited in our study; (23 participants were home-dwelled older adults and 19 participants were recruited from institutionalised older adults located in Kuala Lumpur). The Malay Version of Performance Assessment of Self-Care Skills (M-PASS-HOME) 4.0 was used focusing on four main subtests of self-skills; oral hygiene, trimming toenails, house mobility and shower mobility. The differences in self-care skills between institutionalised and home dwelling older adults are statistically significant (p<0.01) in the aspects of independency for all self-care activities. The results of this study revealed that home dwelling older adults group are more independent in self-care activities of oral hygiene, trimming toenails, house mobility and shower mobility compared to institutionalised group.
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@#The Performance Assessment of Self-care Skills (PASS-Home) is a client-centered, performance-based, criterionreference, observational form designed to capture client’s performance skills in completing daily task activities. The aim of the study was to describe the process of translating, adapting and validating the PASS-Home from English language version into a Malay language version. The development of the translated Malay version of the PASS-Home consisted of two stages. Stage one involved the exclusion of the items that were not culturally relevant to the Malaysian culture. Stage two involved the translation process. The five steps of the cross-cultural adaptation process were followed: (1) initial forward version; (2) a summary of recommendations by the expert panels; (3) the back-translation; (4) modifications of the translated Malay version of PASS and a summary of problems found during the pre-testing, and (5) the final version of the PASS Malay Version (M-PASS). A total of five items from the PASS-Home were omitted in the Malay version (M-PASS) and another five items that were considered as suitable in Malaysian context were added in the M-PASS. The Content Validation Index (CVI) showed perfect agreement with an average of I-CVI was reported at 0.99 and S-CVI/universal agreement (S-CVI/UA) was at 0.93. Test-retest reliabilty showed that the M-PASS were highly reliable reported of its three main constructs of Independence (ICC=0.706), Safety (ICC=0.906) and Adequacy (ICC=0.950). M-PASS showed strong evidence as a valid and reliable assessment in evaluating the functional level of older people who live independently in community.
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@#Older adults residing in community, as well as those who are residing in institutional or care home may experience various cognitive, health and physical impairments that may affect their independence. Continuous supports are needed to manage most of their personal care activities which are usually managed by their family members, often without proper training or guidance. To date, there is no personal care module that can be used as a guideline by family members and paid caretakers. Therefore, this study aims to develop and validate a personal care module as a guideline in assisting older adults with more significant disabilities. This study was a three-phase study, involving (1) development of the personal care module, (2) focus group discussion with healthcare experts and (3) face and content validity by the expert reviewers. A total of 10 older adults participated in semi structured interview in phase one and 13 occupational therapists were involved as experts in evaluating the module in phase two and three, having between 5 to 25 years of working experiences. The finding reported a high content validity in the developed module ranging from 0.88 to 1.00 on six domains of personal hygiene, bathing, dressing, feeding, bed mobility and stairs climbing. This study provides a preliminary support for the developed personal care module as a valid instrument to be used as a guideline in managing personal care activities of older adults with more significant disabilities.
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@#Inappropriate responses towards sensory input received from the environment, also known as sensory processing difficulties (SPD) may affect daily living activities of the children with Autism Spectrum Disorder (ASD). Sensory Processing Measure Home Form (SPM Home Form) as a parent report measure for SPD is available in English and other foreign languages. To enhance the applicability and meaningfulness of SPM Home Form for the Malay speaking population, a study that focuses on translating, adapting, and validating the SPM Home Form into the Malay language was conducted. The development of the Malay version of the SPM Home Form (SPM-MV Home Form) involved three steps: 1) Item evaluation, 2) Forward and backward translation, and 3) Expert review and content validity. The process of translation and adaptation of the form was performed according to standard guidelines. No item was excluded from the original SPM Home Form as all the items were considered by the expert panel as appropriate and relevance to evaluate the activity and social participation among children in Malaysia. Content validity as measured by 10 experts in occupational therapy is high. The mean of sub-scales I-CVI is between 0.96 and 1.00. The total S-CVI of the form is 0.95 with sub-scales S-CVI range between 0.82 and 1.00. Cronbach’s alpha for internal consistency was reported at 0.80 and ICC for test-retest reliability ranged from 0.80 to 0.97. The SPM-MV Home Form has high potential to be used for assessing SPD among children ages 5-12 years in Malaysia.
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Diabetes is often associated with dysfunction in activities of daily living (ADL), especially among older adults.Hospitalisation of older adults is often followed by decline in functional status affecting their quality of life and well-beingafter discharge. The objective of this study was to determine the functional independence in carrying out basic activitiesof daily living, its relationship with quality of life, and the factors influencing the quality of life in hospitalised olderadults with diabetes. This cross sectional study was carried out on 104 diabetic patients (mean age: 67.5 ± 9.2 years) whowere receiving in-patient treatment. Face-to-face interviews were carried out to determine functional independence usingModified Barthel Index (MBI) as well as quality of life using the World Health Organization’s Quality of Life instrument(WHOQOL-BREF). Results showed that only 37.5% (n = 39) respondents were catergorised as being fully-independent.Among the domains in MBI, using the stairs recorded the lowest score followed by mobility. The physical domain in qualityof life also recorded the lowest score compared to other domains of quality of life. There were significant (p < 0.05),positive correlations between the overall MBI scores and all domains of quality of life; physical (rs = 0.70), psychology(rs = 0.50), social (rs = 0.33) and environmental (rs = 0.25). Hierachical multiple regression analysis showed MBI scoreshad significant influence on all domains of quality of life, with the largest influence on the physical domain i.e. 36% [F(1,92) = 82.14, p < 0.01, R2 = .36]. As a conclusion, hospitalisation reduces the functional independence in carrying outbasic activities of daily living as well as the physical aspect of quality life in older adults with diabetes. Therefore, it isimportant to provide rehabilitation in activities of daily living while the elderly diabetics while undergoing in-patienttreatment in order to maintain quality of life after discharge.
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Enhancement of physical function had been shown in older adults who actively participate in physical activities,particularly in the form of aerobic training with addition of progressive resistance training (PRT). However, it is quitechallenging and risky for most older adults to exercise in standing position without any support. Chair Based Exercise(CBE) is an alternative mode of exercise for older adult to facilitate exercise participation and increase safety. Its effectwhen combined with resistance training is unknown to date. Therefore, the aim of this study was to evaluate the outcomeof CBE with PRT on physical performances among older adults. A total of 18 older adults (13 females (72%)) and 5 males(28%)), aged 60 to 83 years with mean age (SD) 72.67 (6.17) years completed the study. All subjects performed CBE withPRT intervention twice weekly for 8 weeks, with individually-tailored exercise progressions. Pre and post measurementsof physical performance were performed using Six MinutesWalk Test (6MWT), Five Times Sit to Stand (FTSTS) and HandGrip Strength (HGS) test. Significant improvement in 6MWT (p < .001), HGS Right hand (p = .043), HGS Left hand (p <.001), FTSTS (p < .001) was shown after the eight-week intervention. Adding PRT into seated exercises results in furtherimprovement in physical performance of older adults. CBE-PRT may be recommended as an exercise routine for olderadults living in the community.
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Autism spectrum disorder is a developmental disability that has gained increasing attention in Malaysia. Much effort is now being taken to include children with autism spectrum disorder in the school system, either in inclusive settings or in special educational settings. However, this endeavor raises many challenges for the children with autism spectrum disorder, their families and for service providers. The current study uses a qualitative approach to investigate parents’ perceptions of problems faced by their children with autism spectrum disorder in issues related to academic skills. A face-to-face interview was performed with parents of children with autism spectrum disorders who were receiving occupational therapy services for their difficulties in academic related skills. Findings indicate that most of the difficulties faced by these children are related to skills needed to be accepted at school, such as ability to communicate and socialize and this often limit their performance at school. These findings not only raise and discuss important implications for service providers such as teachers, health care professionals and policy makers, but also lead to suggestions for future research.
Subject(s)
Autism Spectrum DisorderABSTRACT
Functional mobility among the older population is an important element for a meaningful quality of life. The implementation of functional mobility assessments among the older people is vital to ensure appropriate steps can be taken in order to detect changes in functional mobility. There are varieties of functional mobility assessments available however most of the reliability test are based on Western countries. Therefore this study was to determine the reliability of three types of functional mobility status assessment of physical activity, especially among the older person. Sixty older respondents with the average age of 76.32 years and standard deviation of 8.66 participated in this study performed three types of functional assessments; Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Sit-to-Stand Test (STS). Two measurements were carried out with a week gap from the first measurement. Intraclass Correlation (ICC), Limits of Agreement (LOA) and Standard Error of Measurement (SEM) statistical tests followed by the combination of the three statistical analysis measurements were used for data analysis. The results showed all functional measurement tools using ICC, LOA, SEM and combination of three types analysis were highy reliable. The ICC value was exceeded 0.90 (ICC=0.94-0.99). The LOA graph for all activity measurement tools showed some degree of reliability while the SEM percentage recorded a value of less than 10% (SEM%=0.95%-9.95%). In conclusion, all three functional measurement tools are highly reliable and can be used as one of the functional test among the older people in Malaysia.