Working With Lesbian, Gay, Bisexual, and Transgender Clients: Occupational Therapy Practitioners' Knowledge, Skills, and Attitudes.

IMPORTANCE: A lack of health care provider knowledge and training has been identified as one factor that contributes to health disparities for sexual and gender minority (SGM) populations. OBJECTIVE: To explore occupational therapy practitioners' self-reported knowledge about, clinical preparedness for, and attitudes toward working with lesbian, gay, bisexual, and transgender (LGBT) clients. DESIGN: Online survey of occupational therapy practitioners. PARTICIPANTS AND SETTING: Respondents were recruited by means of snowball sampling through social media groups, state occupational therapy association websites, and emails. Surveys were posted to electronic occupational therapy social media sites. MEASURES: Knowledge, clinical preparedness, and attitudes were measured using the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS). Information about demographic characteristics, education, and workplace was also collected. RESULTS: Five hundred eighty-nine occupational therapy practitioners responded to the survey. Degree level (master's vs. bachelor's or less), continuing education (minimum 1-2 hr of LGBT-specific training), practice setting (mental health), minority sexual orientation, and having a close friend or family member who identifies as SGM were associated with higher mean scores on the LGBT-DOCSS. Higher religiosity and frequency of religious practice were associated with lower scores on knowledge and attitudinal awareness. CONCLUSIONS AND RELEVANCE: Occupational therapy practitioners often care for clients from backgrounds and cultures that differ from their own. Identifying gaps in education and opportunities for fostering LGBT-positive attitudes can facilitate the development of programs to improve practice with LGBT clients and help measure the effectiveness of such programs. What This Article Adds: This study provides evidence that a basic level of continuing education can improve occupational therapy practitioners' knowledge of and skills for working with LGBT populations and highlights the need to examine and change structural biases.

Incivility in the Occupational Therapy Workplace: A Survey of Practitioners.

IMPORTANCE: Incivility in health care settings has detrimental effects on practitioners' well-being, patient outcomes, and health care costs. OBJECTIVE: To explore the prevalence and types of perceived incivility experienced by occupational therapy practitioners in their workplaces and the relationships between perceived incivility and practitioner demographics. DESIGN: Cross-sectional, online survey. SETTING: Surveys were posted to occupational therapy social media sites. PARTICIPANTS: Occupational therapy practitioners throughout the United States. Outcomes and Measures: The Negative Acts Questionnaire-Revised (NAQ-R) was used to measure incivility and bullying. Participants answered demographic questions, and one-way analyses of variance and t tests were used to examine differences between demographic characteristics and mean scores on the NAQ-R. RESULTS: A total of 1,320 practitioners completed the survey. Although the incidence of incivility was low compared with prior research in other health professions, 11% of respondents reported being victims of bullying in the workplace. Practitioners with less experience and who worked in long-term care and skilled nursing settings were more likely to experience incivility, and occupational therapy practitioners experienced significantly less incivility than occupational therapy assistants. CONCLUSIONS AND RELEVANCE: Practitioners, colleagues, managers, and organizations must collaborate to foster an environment of civility and respect to mitigate the effects of incivility on patient outcomes, practitioners' well-being, and health care costs. What This Article Adds: This survey provides baseline information regarding incivility experienced by occupational therapy practitioners, an important first step in developing evidence-based interventions to promote safe and healthy workplaces.

Falls in the Geriatric Patient.

Falls in older adults are multifaceted, and are caused by biologic, behavioral, environmental, and socioeconomic risk factors. An estimated 25% of older adults fall each year. With 10,000 people turning 65 each day, it is essential that those at highest risk receive intervention to decrease the risk and rate of falls. In addition, those older adults at lower risk still need to understand the risk of falls and be educated about maintaining healthy lifestyles. Fall risk assessment and referral to individualized or group-based programming can reduce fall risks and falls.