[in Japanese]

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This study clarified the expected competencies of occupational therapists working in the community for elderly persons with chronic phase disease. In order to reveal the competencies, four rounds of the Delphi technique were carried out on expert panelists in Japan. In round 1, a list of 64 competencies were initially prepared and the competencies were subdivided into seven categories:“professional attitude and behavior”, “development of client/family-centered relationships”, “client-centered and evidence-based practice”, “risk management”, “management of daily work”, “community-based practice”, and “continuing professional development in the community”. After round 2, content validity was confirmed from the median and interquartile range. Finally, the 68 competencies were reached by consensus through the Delphi technique.

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Using qualitative methods, this study investigated the valued occupational characteristics of frail elderly males attending a daycare facility and the underlying situations that influenced them. Semi-structured interviews of approximately 60 minutes per person were conducted with 10 men attending numerous daycare facilities in Hokkaido, Japan. The resulting data were analyzed using the Strauss and Corbin grounded theory approach which identified the following characteristics of their valued occupations:(1) Occupations that realize visible achievements, (2) Occupations that confirm significance within society, (3) Self-resources that motivate choice of occupation, and (4) Understanding how current lifestyle influences the characteristics of valued occupations. The study concluded that understanding frail elderly males' thoughts on their valued occupations within the context of the implementation of such occupations can be effective for occupational therapists who support these individuals.

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We evaluated factors which predict independent manipulation of chopsticks in acute stroke patients with dominant hand paralysis in the upper extremities. Upper extremity function was measured within one week after the stroke (6.4 days). Grip strength, pinch strength, ten-second grip, and release were measured using Fugl-Meyer Assessment for Upper Extremity, Simple Test for Evaluating Hand Function (STEF), and Motor Activity Log. Independence in using chopsticks was also assessed before discharge (17.3 days). Results indicate that the STEF could significantly contribute to the use of chopsticks, and the STEF cut-off point was 50. These findings imply that the efficient ability to manipulate tools is needed to obtain independent chopsticks agility.

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This study compared the situation of and issues involved in a continuing education of occupational therapists (OTs). Males and females were compared by examining the working conditions and lifestyles of both childrearing and non-childrearing OTs. Members of Kochi Association of Occupational Therapists (KAOT) participated in a survey about private life and continuing education. The findings demonstrate that female OTs who work while raising children do not have adequate opportunities to take part in continuing education, and the degree of satisfaction with continuing education in childrearing OTs was significantly lower than with OTs who are not raising children, even though they have substantial interest in participating in continuing education. The study implies that there are two aspects to securing more opportunities for childrearing OTs who want to engage in continuing education. Firstly, childrearing female OTs should maintain their self-motivation for continuing education and get support from their families. Secondly, a working environment which offers childcare and other forms of support systems should be created for OTs.

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This study examined the structural relationship of occupational challenges, occupational participation, occupational dysfunction, depression, and health-related QOL for 164 elderly with physical disabilities living in the community. This study examined two hypothesis models in a cross-sectional study. Hypothesis model 1 assumed that occupational challenge promotes occupational participation, reduces occupational dysfunction, and alleviates depression. Hypothesis model 2 assumed that occupational challenge promotes occupational participation, reduces occupational dysfunction, and improves health related QOL. Each hypothesis model compared the case with and without covariates. As a result, all hypothesis models were adopted without covariates. We found that occupational challenge promotes occupational participation, reduces occupational dysfunction, alleviates depression, and improves health-related quality of life. Occupational therapists will contribute to the lifestyle redesign by intervening in an occupational challenge.

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Occupational participation is important for health and well-being, but epidemiological evidence for this theory has been inadequate. The present study aimed to clarify the influence occupational participation has on health-related QOL for one year. We conducted a one-year follow-up survey of 460 community-dwelling healthy middle-aged and elderly individuals in A Prefecture, Japan. Two groups were established:the maintenance and improvement group, and the deterioration group. Using the one-year survey on occupational participation, the differences between the two groups and the influence occupational participation had during one year on health-related QOL were examined and compared. Results have demonstrated that the maintenance and improvement group performed better on all scales of the SF-36v2 over one year (p<.05) compared to the other group. Moreover, results suggest that positive influences tend to develop early and are maintained thereafter, whereas negative influences tend to develop after 6 months. The results of this study can be used as epidemiological evidence for health promotion and preventive occupational therapy.

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Research indicates that in Japan, 20 to 50 percent of long-term hospitalized patients with schizophrenia lack the will to be discharged. Thus, the Ministry of Health Labor and Welfare promote discharge by psychiatric hospitals. This study investigated individual factors that are related to the discharge intention of long-term hospitalized schizophrenic patients. The subjects were 50 schizophrenia patients who were hospitalized for more than 1 year. Outcome measures included the existence of discharge intention, Defeatist Beliefs and Negative Symptoms. Consequently, Defeatist Beliefs were significantly greater in patients with those who did not exhibit discharge intent (p=0.001), and a significant association was confirmed even when confounding factors were included (p=0.01). The results of this study suggest that psychological intervention is efficacious for promoting discharge among those patients with schizophrenia who do not have the will to leave the hospital.

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This study investigated the occupational therapists' roles at junior high school district care conferences. We conducted a survey in a municipality, and data from 123 descriptions were collected and analyzed. Text mining classified the data into 6 categories, and corresponding analyses revealed that “to give advice on daily life” was common at all conferences. However, the following different roles emerged at different conferences:“advice on physical functions and actions” at individual care conferences, “involvement in groups” at junior high school districts care conferences, and “think about initiatives of measures” at the community care promotion conferences. The results indicate that occupational therapists comprehend these roles and commitments in each community care conference.

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This study suggests an intervention method constructed through a reasoning process for clients with higher brain dysfunctions. The client had stroke-related variegated higher brain dysfunctions, which were manifested in his inability to get dressed, bathe, and do housework independently. Firstly, the client and his spouse were interviewed using narrative reasoning about their needs as indicated by Mattingly. Secondly, intervention methods were considered using scientific reasoning regarding getting dressed, bathing, and doing housework. Finally, the client became able to dress, bathe, and complete some parts of housework.

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Objectives:To examine the effects of limited frequency intervention using the Cognitive Orientation to daily Occupational Performance (CO-OP). Methods:Two cases experienced two interventions over two months, and the effects were compared before and after interventions. Results:Acquisition of both gross and fine motor tasks was possible through CO-OP. Furthermore, the findings suggest that even when used with minimal frequency, the intervention may lead to skill acquisition, skill generalization, and skill transfer. Conclusions:While some consideration is necessary when selecting children suitable for CO-OP, the method has been found to be effective for children capable of discovering and using new cognitive strategies.

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Clinical education using the MTDLP was provided to a student of occupational therapy who felt overwhelmed with creating case reports during their clinical training. A student who were not familiar with MTDLP were asked to extract issues, set goals, and make treatment plans using ICF that they learned at their schools. The instructor prepared MTDLP forms, compared what the student and instructor created, and then supplemented a student's missing knowledge and the thought process which resulted in reduced workloads for creating case reports and improved self-efficiency. Therefore, enhancing transparency of occupational therapy through the MTDLP enabled a student to understand the thought process of the occupational therapist, and consequently produced favorable results.

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Occupation-Based Practice 2.0 (OBP 2.0) is a methodology that assesses and intervenes in the classification of occupational dysfunction while overcoming belief conflict. This study examined the efficacy of OBP 2.0 in home visit occupational therapy targeting a post-stroke client living at home. The results indicate improvement of occupational dysfunction and living functions, and overcoming belief conflicts. OBP 2.0 shares goals in improvement of occupational dysfunction in home visit occupational therapy, and various methods can be used depending on the situation. In addition, it is also believed to promote home-visit occupational therapy in collaboration with the client and the surrounding community.

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The iPad application Aid for Decision-making in Occupation Choice (ADOC) was utilized to set goals when initiating outpatient rehabilitation. The subject was a woman in her 50s who suffered from hypertension-related heart failure. Outpatient rehabilitation included medication to prevent recurrence, and goal setting through interviews with ADOC. The target goals were “Preventing heart failure through continuation of diet and exercise therapies”, and “Socializing with friends at the dessert buffet”. After the goal setting, the patient participated in home-based outpatient rehabilitation, diet therapy, and exercise therapy. As a result, it became possible to socialize with friends, blood pressure and body weight were greatly improved at discharge, and one medication was discontinued.

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We investigated whether the use of frontal trunk supports could enable participants to achieve upright sitting posture with reduced trunk muscle activity. Twelve healthy men participated in this study which examined trunk supportability with participants seated with or without a trunk support using the Purdue Pegboard Test. We found that the participants' trunk tilt angles were significantly greater in seated positions with a trunk support than without. The engagement of the internal oblique and transversus abdominis muscles while using a trunk support in a seated posture was significantly lower than without the trunk support. Our results suggest that a trunk support is effective for decreasing trunk muscle activity, although it promotes leaning sitting postures.

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