Measuring Caregiver Outcomes in Pediatric Rehabilitation Telehealth Services: A Scoping Review.

Pediatric occupational therapy practitioners use telehealth to facilitate performance and participation in natural contexts. Optimal therapy outcomes occur when caregivers are integrated into telehealth sessions. This scoping review describes how caregiver outcomes are measured in the pediatric rehabilitation telehealth literature. We searched SCOPUS, MEDLINE, CINAHL, PsycINFO, and ERIC for articles on pediatric telehealth interventions published from January 2005 to June 2022. We excluded non-empirical articles and articles that measured children's underlying deficits only. Thirty-one articles met inclusion criteria. Studies measured caregiver outcomes with study-specific questionnaires, standardized measures, electronic tracking, and interviews. Caregiver outcomes improved after treatment, and caregivers reported high acceptability and satisfaction with telehealth. Ample evidence supports measurement of caregiver outcomes in pediatric rehabilitation telehealth services (PRTS). Future PRTS work should incorporate existing sound measures that comprehensively evaluate caregiver outcomes, including caregiver engagement and its components, to demonstrate the effect of occupational therapy telehealth services.

Occupational therapy, cancer, and occupation-centred practice: impact of training in the model of human occupation.

INTRODUCTION: This study examined the influence of training in an occupation-centred model on the practice of occupational therapists working in a cancer hospital. There is an increased need for occupation-based rehabilitation services for individuals with and surviving cancer. Incorporating an occupation-centred model into practice has unique challenges for occupational therapists working in oncology settings. Utilizing an occupation-centred model of practice may influence the therapeutic reasoning of occupational therapists. METHODS: A generic qualitative inquiry (Patton, 2015) was used to examine therapeutic reasoning as related to post-professional training in a specific occupation-centred model, the Model of Human Occupation (MOHO). Initially, ten occupational therapists with various levels of experience, working across populations in a large cancer centre completed a training session about the MOHO. This was followed by participation in monthly focus groups with an emphasis on the use of MOHO in daily practice (Taylor, 2017). Focus group sessions were video recorded and transcribed. The transcripts were then analysed using open coding and theme generation (Patton, 2015). RESULTS: Three major themes were extracted from the data during the thematic analysis: understanding and using MOHO language; challenges in incorporating a conceptual model of occupation-centred practice in an oncology setting; and therapeutic reasoning implications. Patterns in the themes indicated a progression from learning the model, to applying the model, to reflection on practice. CONCLUSION: Post-professional training in an occupation-based model influenced the therapeutic reasoning and practice of occupational therapists in an oncology setting.

Long-Term Impact of Model of Human Occupation Training on Therapeutic Reasoning.

This general qualitative study explores occupational therapists' perspectives related to the long-term impact of Model of Human Occupation (MOHO) training on therapeutic reasoning in practice. MOHO is a widely used, occupation-focused theory that promotes participation and engagement in meaningful activities for occupational adaptation. One-on-one, semi-structured interviews were conducted with six occupational therapists at a cancer rehabilitation center who previously underwent systematic MOHO training. Therapists acquired or expanded MOHO knowledge as a result of training and retained that knowledge 9 months later. They also implemented training-related practice changes including the provision of more holistic, client-centered occupational therapy services and systematic use of the MOHO to reason in practice 9 months later. Specific results varied based on experience with the MOHO prior to study-related training. MOHO training promotes knowledge acquisition and positive practice changes long-term for occupational therapists in cancer rehabilitation. Similar trainings would meet therapists' desire to learn more about theory-driven practice and improve their clinical reasoning skills. Future research should explore how results transfer to other facilities and how therapeutic reasoning with the MOHO impacts quality of care.