This study discusses the applied behavior analysis (ABA) as a more effective method of occupational therapy intervention for children with autism spectrum disorder. ABA has strong evidence, and occupational therapists have skills to adapt it. Therefore, based on this study, it is expected that Japanese occupational therapists should consider adapting ABA to improve the occupational therapy for children with autism spectrum disorder.
The purpose of this research is to create the construct of occupation of “nursing care” engaged by family caregivers. Unstructured interviews were conducted with 16 family caregivers who had provided at-home care for their family members for at least 1 year. Transcripts of the interviews were analyzed using the Steps for Coding and Theorization (SCAT) method. As a result, to form the constructs, 102 content codes were identified and categorized into the following 3 major categories:Feelings of family caregivers, caregiving life, and caregiving and environment. This study suggests that occupational therapists should consider these perspectives to more effectively support occupational adaptation of family caregivers.
There are few studies comparing the specificity of facial expression recognition in patients with cerebrovascular disease by brain damaged area. There is also no research comparing the top-down and the bottom-up information processing patterns in facial expression recognition of cerebrovascular disorder patients. This study classified the patients as follows:Frontal lobe Stroke (FS) group, Basal ganglia Stroke (BS) group, and Corona radiata Stroke (CS) group. Then, the Top-Down information processing Facial Expression Recognition Task (TDFERT) and the Bottom-Up information processing Facial Expression Recognition Task (BUFERT) were performed on the 3 groups, and the results of the facial expression recognition tasks were compared. Subsequently, the specificity of facial expression cognition in brain-damaged areas was investigated. As a result, the disgust and fear performance in the BUFERT was lower in the FS group and the BS group than in the CS group. The performance on the BUFERT was lower than the TDFERT in all three groups with disgust, indicating that the performance differs depending on the form of facial expression recognition task. On the other hand, happiness was high in both groups, implying that it is a more recognizable expression than other facial expressions.
This study aimed to clarify the significance of self-determination awareness for individual students of occupational therapy. First, the author asked 181 college students enrolled in occupational-therapy training courses to provide their levels of self-determination awareness. Then, of the 66 students who provided responses and completed the personal survey, 6 students-3 students each from the high- and low-level awareness groups-were selected, and an analysis of their personal attitude construct on self-determination awareness was conducted. The results demonstrate that students with high levels of self-determination awareness are the internal control type and have autonomous motivations, whereas students with low levels of self-determination awareness are the external control type and have external motivations, indicating that the psychological structures differ between the 2 types of students. These findings suggest that self-determination awareness is critical for the transition from external motivation to autonomous motivation.
In community rehabilitation, support is provided so that the elderly can play a role in society. However, few reports have described the effects of role promotion on health-related quality of life (HRQOL). This study aimed to examine the effects of role performance, environmental factors, and physical function on HRQOL using a provisional role checklist (Japanese version 3) for elderly people requiring long-term care. The analysis of our hypothetical model using a structural equation model approach revealed the direct effects of environmental factors and indirect effects of role performance on HRQOL. On the other hand, physical function had no effect on HRQOL. Our findings suggest that comprehensive environmental support and sufficient role promotion could improve the HRQOL of elderly people requiring long-term care.
The purpose of this study is to investigate the processes through which stroke survivors develop learned nonuse of their affected upper limbs. Design:A qualitative study design based on the Modified Grounded Theory Approach was used. Methods:Semi-structured interviews were carried out with stroke survivors who had strokes in middle age or late middle age and developed learned nonuse of their affected upper limbs. Results:8 stroke survivors were interviewed in this study, and analysis resulted in the emergence of 20 concepts, 4 subcategories, and 4 categories. Conclusion:The middle age and late middle age stroke survivors developed learned nonuse of their affected upper limbs under the influence of social interaction, and they repeatedly compared their current condition to before the onset, and they recovered through taking on the same roles as before the onset.
The elderly in low-cost nursing homes who did not participate in activities other than FIM correction independence, rehabilitation, and meals were enrolled in a study and divided into 2 groups (fall and non-fall groups), and the details of falls and fall factors were investigated. In addition, considering the roles of OTs from the results, we evaluated the relationship between seven items, including physical function, the amount of assistance for daily living (FIM), and the fall risk index (FRI-5). As a result, significant differences were found between sleep duration and FIM between the two groups, and FRI-5 was negatively correlated with sleep duration and FIM. Therefore, we concluded that shorter sleep duration and having a large amount of assistance for ADL were patterns that were easy to turnover. In addition to environmental adjustments, the design of occupational therapy programs that improves spontaneity and activity levels to meet individual needs is warranted.
Occupational therapy based on Assessment of Motor and Process Skills (AMPS) and Assessment of Compared Qualities-Occupational Performance (ACQ-OP) was provided to a stroke patient who was able to acquire the skills to cook, which was the client's demand. We set up the menu and goals with the client for each cooking exercise and practiced once a week. The ADL motor ability measure increased by 0.7 logits, and the ADL process ability measure increased by 0.2 logits. The ACQ-OP discrepancy measure increased by 0.6 logits. These evaluations facilitated the sharing of the occupational performance with the client and helped to develop a continuous occupational therapy intervention. Additional case studies are desired to examine the effects of AMPS and ACQ-OP in the occupational therapy process.
The purpose of this report is to consider the effectiveness of the Intentional Relationship Model and Model of Human Occupation on an elderly client with dementia. In the beginning of occupational therapy, the client showed clear indications cognitive decline and behavioral and psychological symptoms of dementia. The occupational therapist established an effective relationship through the Intentional Relationship Model and assisted the client engage in occupation through the Model of Human Occupation. As a result, these models made good therapist-client rapport, reduced the client's disorganized behavior, and improved her routine, suggesting that the Intentional Relationship Model and the Model of Human Occupation are effective for an elderly client with dementia.
The purpose of this report was to present the change in psychosocial behavior of a person with severe dementia through utilizing the Model of Human Occupation (MOHO)-based intervention over a period of four months in convalescent rehabilitation wards. The Mini-Mental State Examination (MMSE), Short version of the Dementia Behavior Disturbance Scale (DBD13), Functional Independence Measure (FIM), and Model of Human Occupation Screening Tool (MOHOST) assessments were completed one week after the client moved from the general wards to the convalescent rehabilitation wards. The occupational therapist provided him with MOHO-based intervention involving torn-paper pictures, shaving himself, playing catch, and practicing activities of daily living for four months. The MMSE, DBD13, FIM, and MOHOST data were then collected, and the results showed that the MMSE, FIM, and MOHOST scores increased, and the DBD13 score decreased 4 months after the MOHO-based intervention compared to the initial assessments. Therefore, MOHO-based intervention effected a positive change in behavioral and psychological symptoms of dementia, activities of daily living, and occupational participation for a person with severe dementia.
A case is presented according to the Person-Environment-Occupation (PEO) Model. The occupational history of a client with Lewy body dementia was elicited and the occupational needs of the client were identified. The occupational form, meaning, and function that the client wanted to engage in were subsequently investigated. Furthermore, client interactions in terms of person, environment, and occupation were analyzed. When actual occupational performance was observed, satisfactory occupational implication was subjectively confirmed from the client's perspective. With the client as the subject, an occupation-based practice was implemented. As a result, in a diary entry recorded after training, the client mentioned that “it felt as if the self was born”. Firm engagement between the client and the form, meaning, and function of the occupation led to a moment in which a sense of occupational being was regained. The occupational therapy had an effect on the client's daily life by contributing to decreasing the frequency of somnolence.
We describe a case of right hand impaired dexterity and an inability to grasp tools with both hands with precise ability to move her hand and fingers individually. Magnetic resonance brain imaging demonstrated acute left frontal and temporoparietal ischemic infarctions. Once she grasped a tool correctly, she could use it. In addition, the inability to grasp tools was mitigated upon being handed a tool or shifting the tool from one hand to the other. Right hand training with tools consisted of utilizing these compensatory strategies over a 14-day period, resulting in resumption of her being able to use tools with her right hand in daily life.