The objectives of this research were to compare time use for occupation: self care, work and leisure, from the perspective of people with schizophrenia and their relatives, and investigate the expectations of people with schizophrenia and of their relatives towards their time use, and the congruence of these. The time use checklists were used to interview seven people with schizophrenia and their relatives. The results demonstrated that there were significant differences among the time use of three types of occupation from both perspectives (p < 0.05). The most expectation of the participants was being able to earn a living.
Objective: Despite the considerable importance of maintaining support for instrumental activities of daily living (IADLs) for patients with dementia living at home, there have been no formal investigations of what factors influence IADLs.
Method: We administered various neuropsychological tests, the Timed Up and Go [TUG] test, and the Geriatric Depression Screening Scale-15 to 54 individuals in Japan who had visited a day care center or a preventative care class and who had either 23 mild Alzheimer's disease (mild AD) or 31 no dementia. IADLs were measured using the Self-Report Frenchay Activities Index.
Results: The factors related to the domestic chores subscale of the Frenchay Activities Index were gender, backward digit recall performance (Wechsler Memory Scale-Revised [WMS-R]), and TUG test performance (R2 = 0.53). Factors related to the leisure/work subscale were backward digit recall and logical memory II performance on the WMS-R, scores on the Behavioral Assessment of the Dysexecutive Syndrome, and TUG test performance (R2 = 0.66). Finally, factors related to the outdoor subscale were backward digit recall, logical memory II, and the TUG test performance (R2 = 0.62).
Conclusions: The factors affecting IADLs among elderly individuals with mild AD or no dementia vary depending on the type of IADL. Notably, TUG test performance has a direct influence on all IADL types, and might relate to cognitive function. When providing preventative care or IADL support, it may be beneficial to evaluate and intervene with a focus on the cognitive and physical functions highlighted in this study.
Purpose: Toileting independence is important for patients to maintain self-esteem and to return home. Unaffected grip strength and trunk functions have been noted in earlier studies to be associated with toileting independence in stroke patients. The objective of this study was to explore appropriate indices and calculate cut-off values with regard to unaffected grip strength and trunk functions that could be completed in a short time for estimating toileting independence in stroke patients.
Methods: The subjects were 37 stroke patients, each of whom scored at least 21 points in the Revised Hasegawa's Dementia Scale. The patients were divided into independent and non-independent toileting groups by FIM® scores related to toiling items (“Toileting” and “Toilet transfer”). Logistic regression and receiver operating characteristic curve were used to elucidate items that showed an association with the presence or absence of toileting independence, and to calculate cut-off values of grip strength and trunk function from the Stroke Impairment Assessment Set as variables.
Results: Grip strength was significantly associated with toileting independence. The cut-off value was 3 points (sensitivity, 74%; specificity, 71%; receiver operating characteristic area under the curve, 0.730).
Discussion: Because grip strength can be quickly measured, calculated grip strength cut-off values can estimate a patient's ability for toileting independence. However, the cut-off value shown in the present study may be applicable to only patients with good trunk function.
This paper articulates for the first time an Asian-Western fusion model of therapeutic use of self for occupational therapy practice. The Sky Mirror Model synthesizes concepts, metaphors, and praxes from Asian and Western cultures. Metaphors of sky and mirror form the epistemic receptacle for a set of twelve therapeutic factors. A case study illustrates the interplay of key factors as the therapist embodies and enacts the ‘sky mirror’ in the fluid dance of a therapeutic relationship with the client. Sky Mirror Model's paradigm of unconditioned being and therapeutic presence is counter-hegemonic, radically different, and intimately linked to the psychospiritual integration frame of reference.
Introduction. Many researchers have indicated a need for interventions to improve self-awareness in people with acquired brain injury, but the intervention methods are still in its developmental stage. The purpose of this study was to investigate the effectiveness of an original awareness intervention using a single-case experimental design with each subject's individual occupation. Methods. We used the ‘alternating treatments design’, two types of interventions (ordinary occupational intervention and awareness intervention) were administered 10 times each (a total of 20 interventions) to four subjects. In the original awareness intervention, the subject participated in activities with self-prediction and self-evaluation before and after participating in activities and a therapist assists them to reinforce appropriate strategies. The Japanese version of the Self-Regulation Skills Interview (SRSI) was administered after each occupation experience, scores and responses for each of the ten interventions were compared between two interventions. Results. Three of the four subjects showed significantly lower SRSI scores in the awareness intervention that indicated their awareness were higher than the ordinary intervention and the details of their responses also indicated higher awareness during the awareness intervention. One subject who showed the lowest score of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) in the subjects didn't show any major change. Conclusion. The results would suggest the effective of the awareness intervention. Future studies require a larger number of subjects, and investigation of the necessary level of subject's cognitive functions.
NEURO-15 is a 15-day program that combines low-frequency repetitive transcranial magnetic stimulation (rTMS) and intensive occupational therapy for patients with chronic hemiparesis following stroke. Though the evaluation of upper-limb function has been used in the past to verify the effects of NEURO-15, the reacquisition of performance skills required for daily living has not been sufficiently evaluated.
Therefore, we conducted this study with an objective of clarifying the effectiveness of NEURO-15 from the viewpoint of regaining performance skills in daily living. We conducted the Assessment of Motor and Process Skills (AMPS) and evaluated upper-limb function before and after NEURO-15 to evaluate performance skills in activities of daily living (ADL) in 20 patients with chronic hemiparesis after stroke.
Our results found that not only upper-limb function performance, but also ADL performance skills changed significantly. Significant difference was found in the Wolf Motor Function Test (WMFT) log performance time, the Simple Test for Evaluating Hand Function (STEF), and paralysis of the dominant hand between those who improved and not improved on the AMPS. In particular, the results of this study on dominant hands would be a key findings for applying NEURO-15.
This study showed the effectiveness of NEURO-15 in patients with chronic hemiparesis after stroke from the viewpoint of regaining performance skills.
Attentional functions are essential to safely and smoothly perform activities of daily living. A range of different symptoms is observed in patients with impairments of attentional functions. Thus, the same patient may show differences in symptoms depending on the environment in which he or she is situated. In this study, we sought a means to characterize attention deficit with higher sensitivity than conventional neuropsychological tests, such as the Trail Making Test (TMT) and the Clinical Assessment for Attention (CAT), do. We developed two reaction time (RT) tasks: a simple task and a speed change task. We then enrolled 10 right-handed healthy older adults with no history of brain injury and 10 right-handed patients with stroke to perform the RT tasks. In addition, the stroke group underwent the TMT, the CAT and behavioral observation by an occupational therapist to identify symptoms characteristic of attention deficits. Results for findings of attention deficits on standard neuropsychological tests had a sensitivity of 25% in static situations (e.g., desk activities) and 33% in dynamic situations (e.g., walking or moving). In contrast, when applied to static situations, the simple and speed change RT tasks achieved a sensitivity of 75% and 100%, respectively. The sensitivity in dynamic situations was 33% to 44% for the simple task and 100% for the speed change task. These results suggest that the RT tasks developed in this study are capable of identifying attentional deficits in patients with stroke, and may be more sensitive than neuropsychological testing combined with behavioral observations.