Exploring Therapeutic Relationships in Pediatric Occupational Therapy: A Meta-Ethnography.

Background. Developing strong therapeutic relationships with families is a crucial aspect of pediatric occupational therapy. However, building such relationships is complex as they involve multiple directions of interaction. Purpose. To provide a thorough interpretation of children's, caregivers', and occupational therapists' experience of the therapeutic relationship. Method. A meta-ethnography was realized to synthesize qualitative studies. A systematic search was carried out using five databases from 2005 to 2022. The CAPS checklist was used to appraise included studies' quality. The analysis was completed using a constant comparison of findings. Findings. Three themes emerged from the 14 studies synthesized. The first theme illustrates that the therapeutic relationship can have different meanings depending on the perspective of children, caregivers, or occupational therapists. The second theme explores the components impacting the experience of the relationship. These include the power dynamics, the communication, and respect for diversity. Finally, the third theme illustrates how the relationship can empower positive change. Implications. Children, caregivers, and occupational therapists each have a perspective that ought to be heard. Occupational therapists should actively ask for children's and caregivers' perspectives to encourage power sharing and effective communication. By doing so, occupational therapists can strengthen the therapeutic relationship, which, in turn, promotes positive change.

Effectiveness of CO-OP group intervention for children with developmental coordination disorder: single-case experimental design study protocol.

INTRODUCTION: With the Cognitive Orientation to daily Occupational Performance (CO-OP) approach, children with developmental coordination disorder learn to use a problem-solving strategy to deal with their motor difficulties and perform daily activities of their choice. Therapists use guided discovery to enable children to find their own solutions. Although CO-OP is recommended in a group setting, studies are needed to support its effectiveness. METHODS AND ANALYSIS: A single-case study design with multiple baselines across participants and four systematic replications will be used. In each of the five groups, four children (aged 8-12 years) will be randomly included at the baseline. The baseline includes 5-8 measurements, and the CO-OP intervention stage is comprised of 10 sessions. The follow-up stage includes five measurements. Prior to baseline, each child in each of the five groups will choose five activities of which three will be carried out during the intervention sessions. Children's performance in each of these activities will be scored using the Performance Quality Rating Scale (PQRS) as the main measure. Three secondary measures will be collected: perceived activity performance using the Canadian Occupational Performance Measure, quality of life using the Kidscreen-27 and spontaneous motor rhythm using a computerised typing task. Graphed data will be analysed visually at the individual level with the Visual Aid Implying an Objective Rule (VAIOR) protocol which provides a colour code based on the level and trend of two consecutive phases, facilitating an objective visual analysis. Statistics will be performed for PQRS scores at the individual level and at the group level. ETHICS AND DISSEMINATION: The protocol has been approved by the Comité de protection des personnes Sud-Est I (CPP 2021070) and the Comité d'éthique de la recherche avec les êtres humains de l'Université du Québec à Trois-Rivières (CER-22-294-07.03). Results will be published in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: NCT05231486.

Effectiveness of CO-OP Approach for Children With Neurodevelopmental Disorders: A Systematic Review.

Objective: To examine the scientific evidence regarding the effectiveness of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach for children with neurodevelopmental disorders (NDDs). Data Sources: Selected articles published between January 2001 and September 2020 and listed in CINAHL, MEDLINE, and PsycINFO on the EBSCO platform, or found searching with Scopus, Google Scholar, OTseekern Central Register of Controlled Trials in the Cochrane Library, WHO International Clinical Trials Registry Platform, Turning Research into Practice, and ProQuest Dissertations and Theses. An update was performed in March 2022. Study Selection: Eligibility criteria included studies that assessed the effectiveness of the CO-OP approach on children (0-18 years) with NDDs. Unpublished results were excluded, as well as research published in a language other than English or French. Data Selection: The first 2 authors independently reviewed the titles, abstracts, and full texts. Discrepancies were discussed and resolved by consensus. Included studies were quality appraised using the PEDro-P scale or using the risk of bias scale in N-of-1 trials (RoBiNT) according to experimental design. Data Synthesis: Results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eighteen studies were initially included, with 2 additional studies added in the update. Three reached evidence level III (15%), 10 reached level IV (70%), and 5 reached level V (15%). All data collected on the activity-participation domain showed a significant improvement. Group therapy sessions show promising results for the improvement of activities or participation, as well as psychosocial dimensions such as self-esteem. Conclusions: The scientific evidence analyzed shows that the CO-OP approach has a positive effect on children with NDDs, particularly in regard to their activities and participation. Future experimental studies should be designed in ways that allow determining effect sizes. Group therapy sessions appear relevant but require further research.

Development of preventive behavior at work: Description of occupational therapists' practice.

BACKGROUND: Integrating more prevention interventions into different workplace settings as a component of the role of occupational therapists has a significant relevance recognized by the occupational therapy professional community. Even if some studies suggested that occupational therapists already provide prevention interventions, and that other studies showed the efficacy of such interventions, the literature does not offer a comprehensive understanding of the specific practice of occupational therapists engaging in prevention in workplace settings. OBJECTIVE: The aim of the study was to describe the practice of occupational therapists toward the development of preventive behaviour at work among their clients. METHOD: Semi-structured interviews were conducted with 13 occupational therapists. Phenomenological analysis was used to examine the content of the interviews. RESULTS: Results suggest that occupational therapists form representations of preventive behavior that are consistent with theory, but those are limited and do not take into account the complexity of the concept. Results of the interviews found eight different interventions provided by occupational therapists toward the development of their clients' preventive behavior at work. CONCLUSION: Occupational therapists recognize their role in supporting their clients' development of preventive behavior at work. However, they appear to lack a conceptual understanding and resources to help them in their practice toward prevention.

Preventive behaviour at work - A concept analysis.

BACKGROUND: Preventive behaviour is a significant intervention target in order to promote health at work, but has never been discussed in an occupational perspective. AIM: To clarify the concept of preventive behaviour at work. METHODS: The Walker and Avant (2011) method was used to conduct the study. RESULTS: The attributes of the concept are: (1) compliance with safety rules and procedures, (2) proactivity, participation, engagement and initiatives related to prevention, (3) maintenance of physical environment, (4) concern for social environment and (5) reflexivity and analytical skills of work situations. The analysis also identified the antecedents and the consequences of the concept that are all related to either the person, the environment or the occupation. CONCLUSION: Preventive behaviour occurs when a worker shows an active involvement to comply with safety rules and procedures of his trade, takes initiatives to improve prevention, preserves his physical environment, communicates with his peers and analyses work situations before committing to it. SIGNIFICANCE: Occupational therapists have a central role in primary prevention of work injuries and have the expertise to help develop each of the five attributes of the concept of preventive behaviour.

Accompanying citizen of persons with traumatic brain injury in a community integration project: An exploration of the role.

BACKGROUND: The APIC (Citizen Accompaniment Project for Community Integration) is an innovative program that seeks to increase the community integration of people with a traumatic brain injury (TBI) by offering the support of an accompanying citizen (AC) in the accomplishment of significant life activities. OBJECTIVE: This article aims to better define the AC's role in this process, by underlining the mental health risks they face, the strategies they use, and the impacts the role has on their own lives. METHODS: This qualitative study is based on the analysis of interviews conducted with the AC following the first year of implementation. The data is part of a larger project aimed at the implementation and evaluation of APIC program. The data were analysed according to the rules of thematic content analysis, which encourages grouping main ideas into categories. This is an iterative process allowing for the constant emergence of new categories during the analysis. RESULTS: Accompaniment is full of joys and positive moments for the AC and participants. However, some difficult situations are encountered and the AC are constantly faced with challenges and constraints. The emerging study themes are as follows: the environment, the characteristics of the person accompanied, the AC's personal limits, and the ambiguities in the accompanier-accompanied relationship. CONCLUSIONS: Five principles drawn from the results will help oversee this practice more efficiently and limit the mental health risks of accompaniers. These findings may permit further development of this type of program for people living with disabilities.

Personalized citizen assistance for social participation (APIC): A promising intervention for increasing mobility, accomplishment of social activities and frequency of leisure activities in older adults having disabilities.

BACKGROUND: Social participation, a determinant of health in older adults, requires innovative interventions. The personalised citizen assistance for social participation (APIC) involves weekly three-hour personalised stimulation sessions targeting significant social and leisure activities difficult to accomplish. Recently adapted for older adults, the APIC's impact on this population is unknown. OBJECTIVE: This study explored the impact of APIC on older adults with disabilities. METHODS: A mixed-method design including a pre-experimental component was used with 16 participants (11 women) aged 66-91 (79.4±8.7) with disabilities, living at home. They completed functional autonomy, social participation, leisure and quality of life questionnaires, and semi-structured interviews. RESULTS: APIC increased older adults' functional autonomy (p=0.02), accomplishment (p<0.01) and satisfaction (p=0.02) with social participation, and frequency of leisure practice (p<0.01). Post-intervention, participants wished to modify the practice (p<0.01) and frequency (p<0.01) of leisure activities, and difficulties in their social environment diminished (p=0.03). Their attitude toward leisure (p=0.04) as well as their health (p<0.01) and psychological (p=0.03) quality of life improved. Older adults thought APIC helped them resume, maintain, explore and experiment with significant social activities. It also increased their psychological and physical well-being, feeling of control, connectedness, self-esteem and motivation to accomplish activities. Finally, APIC can compensate for an unavailable and crumbling social network. CONCLUSION: APIC is a promising intervention that leads to new opportunities for older adults to increase community integration and enhance the social component of their lives. It can also optimise how the needs of older adults are met, including utilisation of personal and environmental resources.

French transcultural validation of the Compliance with Safety Behavior Scale.

BACKGROUND: Preventive behavior of workers is a major determinant of occupational health and safety performance of an organization. The measure of this concept is a challenge with French-speaking workers as there is no existing French validated tool. OBJECTIVE: The main objective of this research was to realize a French transcultural validation of the Compliance with Safety Behavior Scale (CSBS). METHOD: Steps of parallel translations, reverse translation and pre-test were conducted before the administration of the CSBS to 195 participants. Exploratory and confirmatory factor analyses were conducted; Cronbach's Alpha coefficients were calculated for each subscale; and intra-class correlation coefficients were calculated for each item. RESULTS: Exploratory factor analyses support a three-factor structure explaining 53.44 % of the variance and confirmatory factor analyses validate that the measuring tool reflects three distinct factors, which are 1) compliance with safety rules and procedures, 2) participation and initiatives related to prevention, and 3) concern for social and physical environment. Results demonstrate that internal consistency is satisfying for two subscales (0.80 < α< 0.82) and that eight items are highly reliable (0.71 < r < 0.99, p < 0.01). CONCLUSION: The French version of the CSBS represents a valid and reliable tool allowing its use both for research and for clinical practice.

Identifying participation needs of people with acquired brain injury in the development of a collective community smart home.

PURPOSE: This study explored the personalized and collective participation needs of people with acquired brain injury (ABI) living in a future shared community smart home. METHODS: An action research study was conducted with 16 persons, seven with ABI, four caregivers and five rehabilitation or smart home healthcare providers. Twelve interviews and two focus groups were conducted, audiotaped, transcribed and analyzed for content. RESULTS: Seventy personalized and 18 collective participation needs were reported related to daily and social activities. Personalized needs concerned interpersonal relationships, general organization of activities, leisure, housing, fitness and nutrition. Collective needs related mainly to housing, general organization of activities and nutrition. CONCLUSIONS: Personalized and collective participation needs of people with ABI planning to live in a community smart home are diverse and concern daily as well as social activities. Implications for Rehabilitation To meet participation needs of people with ABI, the design of smart homes must consider all categories of daily and social activities. Considering personalized and collective needs allowed identifying exclusive examples of each. As some persons with ABI had difficulty identifying their needs as well as accepting their limitations and the assistance required, rehabilitation professionals must be involved in needs identification.

Implementation of interprofessional learning activities in a professional practicum: The emerging role of technology.

To prepare future healthcare professionals to collaborate effectively, many universities have developed interprofessional education programs (IPE). Till date, these programs have been mostly courses or clinical simulation experiences. Few attempts have been made to pursue IPE in healthcare clinical settings. This article presents the results of a pilot project in which interprofessional learning activities (ILAs) were implemented during students' professional practicum and discusses the actual and potential use of informatics in the ILA implementation. We conducted a pilot study in four healthcare settings. Our analysis is based on focus group interviews with trainees, clinical supervisors, ILA coordinators, and education managers. Overall, ILAs led to better clarification of roles and understanding of each professional's specific expertise. Informatics was helpful for developing a common language about IPE between trainees and healthcare professionals; opportunities for future application of informatics were noted. Our results support the relevance of ILAs and the value of promoting professional exchanges between students of different professions, both in academia and in the clinical setting. Informatics appears to offer opportunities for networking among students from different professions and for team members' professional development. The use of technology facilitated communication among the participants.

[Citizen accompaniment for community integration : a challenge for mental health ?]. / Accompagnement citoyen personnalisé en intégration communautaire : un défi pour la santé mentale ?

APIC (Citizen Accompaniment Project for Community Integration) offers support for the social integration of people living with traumatic brain injury. The accompanying citizen meets the person three hours a week for a period of a year in order to offer assistance in the accomplishment of his/her projects and activities. This role confronts the accompanying citizen with many challenges that may put their mental health at risk. This article offers a reflection on this practice from the accompanying citizen's perspective. Five principles that can help better delimit and define citizen accompaniment are drawn from the results: 1) finding a "good distance" in the relationship to the accompanied person, 2) considering all of the actors in the process, 3) putting the accompanied person and their desires at the heart of the practice, 4) accepting not knowing everything, 5) being committed to the project and accepting it may transform you.

Innovating in teaching collaborative practice with a large student cohort at Université de Montréal.

Université de Montréal implemented an interprofessional education (IPE) curriculum on collaborative practice in a large cohort of students (>1,100) from 10 health sciences and psychosocial sciences training programs. It is made up of three one-credit undergraduate courses (CSS1900, CSS2900, CSS3900) spanning the first 3 years of training. The course content and activities aim for development of the six competency domains identified by the Canadian Interprofessional Health Collaborative. This paper describes the IPE curriculum and highlights the features contributing to its success and originality. Among main success key factors were: administrative cooperation among participating faculties, educators eager to develop innovative approaches, extensive use of clinical situations conducive to knowledge and skill application, strong logistic support, close cooperation with health care delivery organizations, and partnership between clinicians and patients. A distinguishing feature of this IPE curriculum is the concept of partnership in care between the patient and caregivers. Patients' representatives were involved in course planning, and patients were trained to become patients-as-trainers and cofacilitate interprofessional discussion workshops. They give feedback to students regarding integration and application of the patient partnership concept from a patient's point of view.

[Nursing in prison: inmates as patients]. / La pratique infirmière en milieu carcéral: des détenus pour patients.

There are very few studies investigating the work nurses do in prisons. Based on data stemming from a research in Psychodynamics of Work and a literature review, this paper describes nursing practices in a Canadian penitentiary institution. Three male nurses and two female nurses participated in three two-hour long focus group sessions. Central sources of pleasure that emerged from the focus groups were the scope of nursing care practice ; the autonomy and collaboration with physicians; nursing care practices devoid of moral value judgments, the humanitarian approach, caring and the wish to make a difference in the lives of the inmates ; the pride connected to this unusual professional context, and the recognition by peers and inmates. The main sources of suffering on the other hand were the feeling that rehabilitation was more an ideal than reality ; the paradox of providing both care and safety ; the scary characteristics of working alone ; the fear of lawsuits, and the feeling of being observed continuously. The resulting data we discuss show the issues of a certain dissociation that exists between the patient and the inmate, the fear of contamination of a healthcare nursing identity by the place of practice, but also the feeling of plenitude and sublimation. The conclusion stresses the tension that exists between security and caring, distance and proximity.

[The Citizen Accompaniment Project for Community Integration for people with traumatic brain injury: a step towards resilience?]. / Un accompagnement citoyen personnalisé en soutien à l'intégration communautaire des personnes ayant subi un traumatisme craniocérébral :vers la résilience?

INTRODUCTION: most people with a traumatic brain injury (TBI) live with physical, sensory, or psychological sequelae that affect their day-to-day functioning and prevent them from performing their regular activities. CONTEXT: a Citizen Accompaniment for Community Integration project (APIC) was implemented for people with TBI to fulfill the lack of access to resources and gives them support to redefine their life projects. OBJECTIVES: this study's aim is to evaluate the APIC's impacts on the participants' wellbeing and their ability to participate in recreational and day-to-day living activities. METHODS: it uses a mixed research design of multiple case studies supported by a participative and collaborative research approach. Qualitative and quantitative datas were collected from 9 participants with TBI in 2 stages, at the beginning of the APIC after 6 months and at the end, after 12 months, using semi-structured interviews. RESULTS: this study shows the APIC's positive impacts in the development of the participant's autonomy and satisfaction with their social participation. DISCUSSION AND CONCLUSION: it tends to reveal that the APIC is a safe space for experimentation, founded on a reciprocal relationship between accompanied and accompanier, and promoting the commitment to the resilience process.

[Retrospective study of a method of automobile driving evaluation in adult mental health]. / Etude rétrospective d'une pratique d'évaluation de la conduite automobile en santé mentale adulte.

BACKGROUND: In adult mental health, there are few practice guidelines for occupational therapists with regards to the assessment of driving capacities. PURPOSE: This article describes a clinical approach, with regards to driving assessments, in adult mental health. METHOD: A retrospective study was completed from a chart review of clients seen in occupational therapy, between 1999 and 2004, in the psychiatric out-patient clinic of a university-affiliated hospital. FINDINGS: The occupational therapists are not offering road tests but results on the following tests discriminate those individuals considered safe or unsafe drivers: "Trail A" (p=0,0004), "Trail B" (p=0,0005), "Cognitive Behavioural Driver's Inventory" (p=0.006), "Continuous Performance Test" (p=0,001). IMPLICATIONS: Results on some psychometric measures have an impact on recommendations made by occupational therapists assessing driving capacities. Future studies should include road test performance of clients in adult mental health.

Trabalho, estudo e produtividade: da confusão à definição / Work, study and producivity: from confusion to definition

Na última década, os conceitos de trabalho, estudo e produtividade têm sido fortemente associados às pesquisas clínica e teórica em Terapia Ocupacional. Na verdade, esses conceitos são muito diferentes entre si e são erroneamente associados à desempenho ocupacional. Essa associação provoca confusão e efeitos negativos tanto para os clientes quanto para o desenvolvimento...

In the last decade, the concepts of work, study and Producdivity have been closely associated in clinical and theoretical research in 'Occupational Therapy'. In fact, these concepts are very different from one another and are wrongly associated to Occupational performance...

[Paradoxical situation in the organization of work: a threat for workers' mental health]. / Situation paradoxale dans l'organisation du travail: une menace pour la santé mentale des travailleurs.

For the past decades, in a world of high competition, firms struggle to regain an advantage over foreign competition. Thus, new management trends, usually based on price reduction, high quality products and speed production are now part of strategic reorganization plans of high impact on work organization particularly in terms of large demands put on workers, and take a heavy toll on workers. Thus the incidence of mental health problems in the work place has risen sharply in recent years and currently counts as one of the leading causes of work absenteeism. A study based on the psychodynamic of work was conducted among machine operators working in a high-technology company in the aviation sector. Important management and technological transformations were recently introduced in the factory. The content analysis of the study shows that the work organization places the operator in a double bind situation. They are caught between an injunction where the capacity of making a high quality product is directly opposed to that demanding speed production. Moreover, severe and arbitrary sanctions are applied when the operators do not comply with either injunction. The operators are put in a deadlock situation that creates fear and anxiety. They are obliged to turn to defensive psychological strategies such as individualism and cheating. Those defensive strategies have negative impacts on social relationships.