This paper presents an historical analysis of occupational therapy's role in hospice care with relation to past and current hospice practices, as well as cultural forces that impact that role. Since the beginning of the movement, hospice has developed into a strong component of end-of-life care, and occupational therapy practice models and interventions are unique in addressing the occupational needs of clients during this stage of life. Despite compelling evidence of the positive impact of employing occupational therapists, there continue to be significant barriers to implementation of services. The author proposes that the concept of occupation, as experienced at the end-of-life stage, needs to be more clearly defined and occupational therapy's role broadened in order to strengthen the profession's presence in the hospice setting.
While patient-reported outcomes measures (PROMs) are used in many practice settings as a standardized system of outcome measures, various factors may impact the meaningful use of PROMs by clinicians operating in various settings. Very limited research exists that focused on examining the use of FOTO® in outpatient rehabilitation settings. This study aimed to explore the barriers and facilitators in achieving FOTO® treatment completion rates and patient functional outcomes among physical therapists. Additionally, the study aimed to explore the internal acceptance of FOTO as a useful tool in rehabilitation from the perspectives of physical therapists. Qualitative data were collected through four focus group interviews with physical therapists at outpatient rehabilitation clinics. The interviews were audio-recorded and transcribed, and transcribed, and qualitative content analysis was applied for data analysis. Four major themes emerged from qualitative data analyses including (a) use of FOTO® in clinical practice, (b) reasons why the FOTO® process may not be followed, (c), therapists’ perceptions of FOTO®, and (d) perceived barriers and enablers related to FOTO®. The study concluded that multi-level determinants impact the successful use of FOTO® by therapists in outpatient rehabilitation settings. The findings have important implications for clinical practice, organizational leaders, and PROM developers.
The relevance and popularity of online occupational therapy education have been increasingly recognized. This paper describes the historical development of online occupational therapy education. Findings revealed three shifts in occupational therapy education, namely shifts in perception, in mode of instruction, and in the roles of teachers and students. The inception of online education in occupational therapy was a product of technological advancement and the demand for improved access to occupational therapy online education. The early phase of occupational therapy online education was confronted with challenges related to hesitance in the development and implementation of online programs and to negative perceptions about online education. The development and implementation of online occupational therapy programs were greatly shaped by factors such as technological tools, methods of teaching delivery, and the dynamics of teaching and learning processes. The potential of online occupational therapy education remains vast, but experts caution that quality should not be compromised. Comments The authors report that they have no conflicts of interest to disclose.
Importance: Interventions that promote function, medication reconciliation, and skin integrity assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing health care costs. Objective: In this systematic review, we focus on three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: functional status, medication reconciliation, and skin integrity. Data Sources: We conducted a search of the literature published between 2009 and 2019 in CINAHL, Cochrane, MEDLINE, PsycINFO, OTseeker, and Scopus. We also hand searched the systematic reviews and meta-analyses in our search results for articles that met our inclusion criteria. Study Selection and Data Collection: This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings: We found 47 articles that address the three outcome areas. Regarding functional status, low strength of evidence is available for cognition and functional mobility interventions to support functional performance, moderate strength of evidence supports interventions for vision, and moderate evidence supports task-oriented and individualized interventions to promote activities of daily living (ADL) outcomes among people with neurological conditions. Strong strength of evidence supports individualized occupational therapy interventions focusing on medication adherence. Low strength of evidence was found for occupational therapy interventions to reduce pressure ulcers and promote skin integrity. Conclusion and Relevance: The evidence supports occupational therapy interventions to improve functional status in ADLs and medication management. Additional research is needed that examines the outcomes of occupational therapy interventions for other areas of function and skin integrity. What This Article Adds: We found evidence to support occupational therapy interventions that align with value-based measures in the three outcome areas of interest. The effectiveness of these interventions highlights the viability of occupational therapy as an essential profession and the worth of occupational therapy to the public, potential clients, and payers.
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