Support needs of rehabilitation professionals in the disability service field are increasing in terms of establishing community-based integrated care systems. A survey was conducted to clarify the needs for employing rehabilitation professionals in the disability service field as perceived by the facility managers. Survey results indicated that “necessary” accounted for 54.6% of respondents and “occupational therapist” accounted for the largest proportion, at 78.9%, in the required job category. Based on support needs, the needs pertaining to daily life care and training for daily living were significantly higher than those for employment services. Reasons for “do not feel the need to employ rehabilitation professionals” included “human resource allocation” and “compensation issues”. In order to solve these problems, it is urgent to transmit the specialties and uniqueness of rehabilitation professionals in the disability service field to other professions, and to verify the effects.
This study aims to pilot a group program for community-dwelling middle-aged and elderly people using the Activity Diary to examine the effectiveness of the program and to receive program evaluations from participants. The participants of the program were community-dwelling people ranging from 60 to 75 years old. The participants attended weekly 90-minute sessions and completed the Activity Diary daily during the 4-week program. Satisfaction with their occupations, feeling of Ikigai, and life satisfaction were measured at the start and end of the program. 29 participants attended the program, and participation rate was 99.1%. All participants expressed satisfaction with the program at the last session. There were statistically significant improvements of the score of satisfaction with occupations (the Activity and Daily Life Satisfaction Scale:ADLSS), feeling of Ikigai (the K-I Scale for the Feeling that Life is Worth Living among the Aged:K-I Scale), and life satisfaction (the Life Satisfaction Index-Z:LSIZ). Effect sizes (r) were for the ADLSS 0.50, for the K-I 0.41, and for the LSI-Z 0.50. These results indicate the program meets the needs of community-dwelling middle-aged and elderly, and that the program can enhance satisfaction of occupation, Ikigai, and life for community-dwelling middle-aged and elderly.
In our hospital, protocols differ between the Task-oriented approach (TOA) and Transfer package (TP), and the Impairment-oriented approach(IOA) and TP for paralyzed hands after stroke. 13 subjects participated in the study:7 in the TOA/TP group and 6 in the IOA/TP group. The upper extremity function (FMA) and the usage behavior of the paralyzed hand (MAL/AOU, QOM) were compared, and results indicated no significant change in FMA (p=0.18), but MAL changed significantly in the TOA group compared to the IOA group (MAL AOU:p = 0.04, MAL QOM:p ＜0.01). These results suggest that TOA could transfer the functions acquired in practice to life more efficiently even if the same TP is performed.
This study aimed to enhance regional collaboration through identifying how occupational therapists are recognized by Community General Support Center staff in Hyogo prefecture. A questionnaire and free descriptions were used and the results were analyzed by KH Coder. The center staff recognized OTs in three ways:“person”, “occupation”, and “life”. Moreover, the results showed that OTs are professionals who support dementia patients and the life patients wish, which is different from both other rehabilitation professionals and the standardized OT definition. This study reconfirmed that OTs are viewed as supporting not only activities of daily living, but also general lifestyle.
This study examined the changes in subjective experiences of rehabilitation specialists who experienced belief conflict and how mindfulness training affects rehabilitation specialist belief conflict. The subjects practiced mindfulness training for 8 weeks. We examined the change in subjective experience of subjects using qualitative methods and the effect of mindfulness training using quantitative methods. As a result, the psychological aspect of the subjects' belief conflict improved, but the belief conflict itself did not improve. These results indicate the necessity to use mindfulness training in combination with a dissolution approach for belief conflict in order to correspond to belief conflict.
We previously prepared the “Self-assessment scale of the competencies of occupational therapists (OTs) engaged with community-dwelling elderly adults with disabilities” consisting of 68 items, using the Delphi technique. The purpose of this study was to investigate the reliability and validity of this scale. Questionnaires were sent to randomly chosen OTs engaged with community-based rehabilitation (CBR) of elderly adults who belong to Japan OT association. We performed exploratory factor analysis (EFA) and covariance structure analysis (CSA) after evaluating sample characteristics. Internal consistency reliability (ICR) was evaluated using Cronbach's α coefficient. As a result, 363 OTs who answered all items were included. This scale was structured by 5 factors and 30 items. CSA was performed based on this prediction, and revealed CFI=.921 and RMSEA=.055, respectively, in which sufficient applicability of the constructive concept was confirmed. ICR was calculated as Cronbach's α =.79〜.95. Our developed scale was reliable and valid.
The purpose of this research is to investigate the relevance of the driving resumability judgment and the results of the driving simulator (DS) and to clarify to what degree the DS evaluation results are used. The subjects were 50 responders who requested to resume driving after brain injuries (27 resumed driving groups, 23 non-resuming groups). Statistical analysis was performed by comparing the sub-items of the DS with each other between the groups, examining the performance and cutoff values. The cut-off values were calculated as the total number of false reactions, total stop-start, overall total, and total judgment scores. In the cases where the cutoff values were 3 or more, the accuracy of judgement of non-resuming subjects was 78%;it became clear that there was a high probability that subjects would be judged as non-resuming.
It is important to support family caregivers of individuals with dementia to maintain an appropriate home life. We implemented a co-occupation support program using the Measure of Supporting Co-occupation with two elderly individuals with dementia and their family caregivers during home-visiting occupational therapy. During the occupational therapy intervention for co-occupation, the Measure of Supporting Co-occupation revealed co-occupations that the participants intended to improve. Additionally, the severity of behavioral and psychological symptoms of dementia of the elderly individuals decreased. Among family caregivers, the care burden decreased, and the intention to continue co-occupation increased. These results suggest that the intervention for co-occupation among elderly individuals with dementia and their family caregivers improved their occupational performance, which could lead to a more satisfying home life.
We used the N-back task to treat a hemodialysis patient with mild cognitive impairment. It was possible to carry out the task for 3 months without dropping out. The results show an improvement in memory and attention. Additionally, throughout activities of daily living, the patient managed to do the shopping without using notes, and felt positive changes, such as the feeling that the brain was reactivated. In this case study, we observed no significant changes in biochemical values that may affect cognitive function before and after the intervention. In conclusion, this case study demonstrates that the N-back task might be useful for dialysis patients with mild cognitive impairment.
A CI therapy cooperation table attached to the stroke regional alliance path was created and initiated. We report on the stroke case of a 70s woman suffering from a hemorrhage of the left putamen that utilized CI therapy from the acute phase to the recovery phase. 21 days a day after the stroke, CI therapy began, and FMA and FIM (exercise/cognition) values were 4 and 13/16, respectively. Then, the hospital was changed as part of the cooperation path. In the recovery phase, CI therapy was introduced 71 days after the stroke, resulting in further improvement in FMA 62, MAL (AOU/QOM) 4.7/4.7, and FIM (exercise/cognition) 83/35. Continuing with the CI therapy cooperation path has a potential for functional recovery and resumption of activities of daily living.
This case study investigates the treatment options, including gaining stress-coping skills through occupational therapy, for a patient with depression and repeating, deliberate self-harm. The patient used deliberate self-harm as a stress-coping skill, and the goal was to “decreasing deliberate self-harm”. Occupational intervention aimed to discover new coping skills and ways to lessen stressors. As a result, the number of wrist cutting instances decreased, and the patient has been able to apply new coping skills. A multidisciplinary approach to occupational therapy may lead to a generalized reduction in stressors resulting in an overall decrease in self-harm, a formation of new stress-coping skills, and acquisition of cognitive flexibility in everyday life.
In this study, we analyzed the 25 occupational therapy case reports of the elderly with dysphagy and discussed improving occupational therapy in this field. An abstract table was constructed and the contents of interventions were shown in order of appearance frequency and classified by ICF. As a result, 17 types of mind and body functions and structures, 8 types of activities and participation, and 5 types of environmental factors were classified into intervention contents. However, there was no clear OT practice for personal factors. These results suggest that the future occupational therapy should not overly focus on body function and structure, but should emphasize practices which consider personal factors.
“SST in which anyone can participate” was conducted in a regional city. During the program, some problems associated with feelings of insecurity regarding the location where anyone could participate regardless of medical care and welfare were observed. On the other hand, many participants who took part continuously were able to make new friends. The results indicate that this trial was valuable for both the promotion of health and the formation of connections among inhabitants. On the other hand, in practical terms, it was thought that the program needed collaboration among staff, local support personnel, and people with mental disabilities.