Therapists to Therapy Assistants: Experiences of Internationally Educated Physiotherapists and Occupational Therapists.

Background: In Canada, internationally educated physiotherapists (IEPTs) and occupational therapists (IEOTs) may work as occupational/physical therapy assistants (OTAs/PTAs) while pursuing Canadian licensure. This experience presents personal and professional opportunities and challenges. Purpose: We explored a) the barriers and facilitators experienced by IEPTs and IEOTs working as OTAs/PTAs while pursuing licensure in Canada and b) how might their professional identity changes during this period. Methods: In this cross-sectional qualitative study, we sampled IEPTs and IEOTs working as assistants using online focus groups. Reflexive thematic analysis of data was used to generate themes. Findings: Fourteen IEPTs or IEOTs participated reporting barriers including financial impacts while working as an OTA/PTA, discrimination, and challenges completing licensing exams. Facilitators while working as OTA/PTAs included social support, acculturation with Canadian systems, and career opportunities. Changes to professional identity encompassed accepting a new identity, reclaiming their old identity, or having a strong sense of identity within a healthcare profession. Participants advocated for bridging programs and modifications for examination processes for IEPTs and IEOTs to improve their experiences while pursuing licensure in Canada. Conclusion: Increased advocacy is needed to address the current experiences of IEPTs and IEOTs working as OTA/PTAs after migration.

Brain fog in chronic pain: Protocol for a discourse analysis of social media postings.

Brain fog is a phenomenon that is frequently reported by persons with chronic pain. Difficulties with cognition including memory impairments, attentional issues, and cloudiness are commonly described. The current medical literature demonstrates a similar cloudiness: there is no clear taxonomy or nomenclature, no well-validated evaluations and a dearth of effective interventions. To focus our understanding of this complex phenomenon, we will perform a discourse analysis to explore how brain fog is described in public posts on social media. Discursive methodology will generate insights regarding the societal understanding and meanings attributed to brain fog, by sampling perspectives of persons with lived experience, currently underrepresented in the medical literature. It is anticipated that the results of the proposed study will 1) help healthcare professionals better understand the experience of chronic pain-related brain fog and 2) generate hypotheses for future research. To conclude, by incorporating innovative and contemporary methods, this proposed discourse analysis of social media sources will generate nuanced insights, bridging the gap between researchers, health care providers, and persons with lived experience.

Understanding the Experience and Impacts of Brain Fog in Chronic Pain: A Scoping Review.

Introduction: Approximately 15% to 40% of persons with chronic pain as a primary disorder experience brain fog. Prior research has investigated the etiology of "brain fog" in conditions in which pain presents as a key feature (e.g., fibromyalgia). However, it remains understudied in the context of chronic 10 musculoskeletal pain. Following current scoping review guidelines, we obtained stakeholder input from patient and health care professionals (HCPs) to define this phenomenon. Specific aims of this review were to (1) identify factors contributing to brain fog, (2) identify the functional correlates of brain fog and assessments used to measure them, and (3) establish a definition of brain fog that can be employed by researchers and HCPs to advance research and care. Methods: A scoping review was conducted using recommendations of the Joanna Briggs Institute methodology of scoping reviews and the Levac et al methodology. Embase, Cinahl, PsycINFO, and Medline was searched to identify relevant sources. Findings were verified with patient and healthcare professionals. Results: We identified four 15 key features of brain fog: perceived variability, subjective cognitive dysfunction, participation limitations, and changes in functional activities. We developed a model of brain fog illustrating the overlapping categories of contributors to brain fog in chronic musculoskeletal pain: (1) neuroanatomical and neurophysiological, (2) mental health/emotional, and (3) environmental/lifestyle. Conclusion: The results of this scoping review conclude that the inconsistency in research regarding brain fog in 20 chronic musculoskeletal pain is obstructing a clear understanding of the phenomenon and therefore may be impeding persons with chronic pain and brain fog from receiving optimal care.

Introduction: Environ 15 % à 40 % des personnes souffrant de douleur chronique en tant que trouble primaire ressentent un brouillard cérébral. Des recherches antérieures ont étudié l'étiologie du « brouillard cérébral ¼ dans des affections dans lesquelles la douleur se présente comme une caractéristique clé (par exemple, la fibromyalgie). Cependant, elle reste sous-étudiée dans le contexte de la douleur musculo-squelettiques chronique. Conformément aux lignes directrices actuelles en matière d'examen de la portée, nous avons obtenu les commentaires des parties prenantes provenant de patients et de professionnels de la santé (PS) pour définir ce phénomène. Les objectifs spécifiques de cet examen étaient de (1) déterminer les facteurs contribuant au brouillard cérébral, (2) déterminer les corrélats fonctionnels du brouillard cérébral et les évaluations utilisées pour les mesurer, et (3) établir une définition du brouillard cérébral qui peut être utilisée par les chercheurs et les professionnels de la santé pour faire progresser la recherche et les soins.Méthodes: Un examen de la portée a été mené en utilisant les recommandations de la méthodologie pour les examens de la portée de l'Institut Joanna Briggs et de la méthodologie de Levac et al. Des recherches ont été effectuées dans Embase, Cinahl, PsycINFO et Medline pour réertorier les sources pertinentes. Les résultats ont été vérifiés auprès des patients et des professionnels de la santé.Résultats: Nous avons recensé quatre caractéristiques clés du brouillard cérébral : la variabilité perçue, le dysfonctionnement cognitif subjectif, les limites à la participation et les changements dans les activités fonctionnelles. Nous avons élaboré un modèle de brouillard cérébral illustrant les catégories se de facteurs contributeurs au brouillard cérébral dans le système musculo-squelettique chronique Douleur qui se chevauchent : (1) neuroanatomique et neurophysiologique, (2) santé mentale/émotionnelle, et (3) environnement/mode de vie.Conclusion: Les résultats de cet examen de la portée concluent que l'incohérence de la recherche en ce qui concerne le brouillard cérébral dans la douleur musculo-squelettique chronique ne permet pas d'avoir une compréhension claire du phénomène et peut donc empêcher les personnes souffrant de douleur chronique et de brouillard cérébral de recevoir des soins optimaux.