The purpose of this study was to investigate the domestic research trends and clarify future issues in children with learning disabilities who have difficulty acquiring kanji characters. Although there is robust research on visual and auditory information processing as factors that impede kanji writing, there are also reports in which recognizing style and accuracy of stroke order contributed to writing performance. In addition, the intervention study highlighted few studies using single case experimental designs. Future research should include single case experimental designs, focusing not only on cognitive styles, but also on writing movements and kinesthetic images. Furthermore, a flow chart of an intervention method adapted to the characteristics of each child, as well as a tool that facilitates self-directed learning should be created. At the same time, it is also important to disseminate support using ICT.
Prejudice towards people with mental disabilities is a known obstacle for individuals with mental disabilities living in the larger society. This study reviewed these prejudices towards people with mental disabilities. It aimed to obtain reliable knowledge to develop effective interventions and understand the characteristics of a person with fewer prejudices. Additionally, this review analyzed the kind of interventions that can reduce prejudice. We used iCHUSHi, Citation Information by National institute of informatics and J-Dream Ⅲ (Japanese databases) to gather data between 1st January 2002 and 13th October 2017. The literature review during this period identified 13 original articles as subjects for analysis out of 1,906 related articles. The findings of the analysis suggested that the factors influencing a person to be less prejudiced are experience of interacting with persons with disabilities and knowledge about mental disabilities. Doing things with people with mental disabilities and increasing awareness about mental disabilities through educational activities can reduce prejudice towards them.
In this study, we examined how to effectively prevent falls by self-monitoring. Three months of intervention were conducted for the frail elderly over 65 years old living in the area. For the intervention group, we created an activity schedule table and fall prevention gymnastics. The control group included fall prevention gymnastics only. The intervention group was divided into five groups:(1) improvement of muscular strength of lower limbs, improvement of dynamic balance ability, and improvement of walking ability;(2) improvement of cognitive function;(3) feeling of falls, and fear of falling;and (4) improvement of physical QOL, (5) Improvement of physical activity and social participation activities was recognized. In addition to physical exercises for fall prevention, teaching self-monitoring for fall prevention instruction for the frail elderly was effective.
This study investigated whether or not the effects of long-term hospitalization among patients with schizophrenia on their social functioning such as daily life activities, interpersonal relationships, employment, and so on would create negative symptoms such as anhedonia, asociality, avolition, blunted affect, and alogia. The sample was comprised of 51 participants. The dependent variable was one item in the Life Assessment Scale for the Mentally Ill, and the independent variables were subdomains of the Brief Negative Symptom Scale. The items were analyzed with Spearman's rank correlation coefficient and subsequently entered in a multiple regression analysis. Results showed that daily life activities and work contribution significantly predicted avolition. Furthermore, interpersonal relationships significantly predicted asociality and blunted affect. Self-recognition was not associated with any factor. For managing the negative symptoms of schizophrenia, relief efforts must focus on discharge support, avolition, asociality, and blunted affect.
The occupation-focused group programs for health and well-being promotion of community-dwelling elderly in occupational therapy have been developing. This study aimed to verify the effects of a group program using the Activity Diary for satisfaction with occupation, the feeling of Ikigai, and life satisfaction among community-dwelling elderly. The participants of the program were 125 community-dwelling elderly over 65 years old. Sixty-two participants who were allocated to the intervention group attended four sessions of 120 minutes weekly and wrote in the Activity Diary daily during the program period. Sixty-three participants were allocated to a non-intervention control group. The primary outcome was the Activity and Daily Life Satisfaction Scale (ADLSS) to measure satisfaction with occupations. The secondary outcomes were K-I Scale for the Feeling that Life is Worth Living among the Aged (K-I Scale) to measure the feeling of Ikigai, and Life Satisfaction Index-Z (LSI-Z) to measure life satisfaction. There was a follow-up period of one and a half months. The percentage of participation was 99.2%. The scores of the intervention group improved significantly more than the control group for the ADLSS, K-I scale and LSI-Z (p<.001). The effect sizes r for each outcome were medium (r=0.33-0.38). The program can contribute to enhanced satisfaction with occupation, the feeling of Ikigai, and life satisfaction for community-dwelling elderly.
This study investigates the effect of workplace stress, positivity of workplace culture, and sense of coherence (SOC) on psychological health. Mail surveys were conducted among occupational therapists in Gifu prefecture (72.4% response rate of valid surveys). Using a hierarchical multiple regression analysis, the twelve-item General Health Questionnaire (GHQ12) was used as a dependent variable, and workplace stress, positivity of workplace culture, and SOC were performed as independent variables. Our results suggest that workplace stress is negatively associated, and SOC is highly positively associated with psychological health. In addition, the results show that positivity of workplace culture reduces the effect of workplace stress through SOC. Because SOC is shaped through a positive workplace culture, efforts to improve both workplace environment and SOC among occupational therapists may be important.
The case experienced total knee arthroplasty (TKA) which resulted in anxiety, depression and decreased self-efficacy. The Canadian Occupational Performance Measure (COPM) indicated difficulty moving up and down stairs, resulting in cognitive behavioral therapy to alleviate the anxiety caused by the preoperative fall experience. As a result, the case became experienced cognitive distortion, and began to carry out climbing in stages, leading to a sense of accomplishment, and improved self-efficacy and stair climbing. Furthermore, COPM indices improved from 1 to 6 in both the categories of performance and satisfaction. This indicates that cognitive behavioral therapy in cases where occupational therapy is difficult due to anxiety and distortion can promote goal achievement.
We performed task-specific training in proximal parts and task-oriented training in distal parts for a stroke patient with severe paralysis in proximal parts of the upper extremity. Comparing this intervention with the usual occupational therapy resulted in changing the scores of both the Fugl-Meyer Assessment and the Action Research Arm Test. In addition, the improvement of the Fugl-Meyer Assessment exceeded minimal clinically important differences. This case study suggests that depending on the stage of recovery of each part of the upper extremity, upper extremity paralysis training in stroke patients is important in choosing appropriate treatments.
Mirror therapy (MT) is an evidence-based treatment method for upper-extremity dysfunction after stroke. We conducted multiple treatments with evidence-based treatment methods including Constraint-induced movement therapy and robot therapy for a stroke patient with severe upper extremity dysfunction;however, we could not improve finger extension. We implemented MT in the late subacute period, resulting in improved extension function of the index finger. Furthermore, the patient could undergo task-oriented training with the paralyzed hand, resulting in partial use of the paralyzed hand in activities daily of living. Although the mechanism of recovery of MT is still unknown, combined therapy using MT for severe upper limb dysfunction may improve upper limb function.
We performed an assessment and administered interventions using horticultural activities which focused on the classification of occupational dysfunction in a client who exhibited general reluctance in a special elderly nursing home. Observation-based evaluation enabled us to clarify the necessary interventions for the four types of occupational dysfunctions:occupational imbalance, occupational deprivation, occupational alienation, and occupational marginalization. The client started to enjoy horticultural activities, talked with a smile, had more opportunities to go out, and got enough sleep at night. Her occupational dysfunction improved, and she was able to spend a healthy life in the facility. Therefore, the assessment and interventions which focused on the classification of occupational dysfunctions were effective in a client who could not identify a meaningful occupation.
The patient with ataxia of the upper right limb caused by cerebellar hemorrhage was provided occupational therapy to attain independent chopstick-use. The patient initially grasped the chopsticks using excessive force with the paralyzed right hand. Moreover, to stop the right hand from shaking, the patient strengthened its grip on the chopsticks and had difficulty perceiving the sensory information from the operation target. To promote purposeful finger action, the patient was instructed to perform continuous flexions and extensions of the fingers while objects were grasped and handled with the entire hand. Thereafter, the patient manipulated the chopstick in three ways:cutting, mixing, and picking up material. That was subsequently instructed to perform movements to straighten the tips of the chopsticks, resulting in the improvement of chopstick-use.
The purpose of this study is to investigate how occupational therapists (OTs) in Ota-city, Tokyo support employment, and to clarify the issues concerning future efforts. From the analysis of 105 OTs who were working in Ota-city during 2016, 47.6% of them carried out several employment support initiatives for meaningful employment of their clients. The employment support programs were mainly focused on training for physical function and PC operation, and there were programs based on daily living skills, such as promoting well-health and IADL skills. It is important for the OTs to continue to acquire methods and skills of employment support, and it is necessary to construct a system to guarantee it as a policy at the local level. At the same time, OTs have to examine potential needs of their clients such as rework initiatives.
This case study reports the effect of Cognitive Remediation Therapy (CRT) on cognitive functional disorder resulting from schizophrenia. Furthermore, the influence of divergent thinking on the generalization of the effects of interventions on daily life activities has been noted. As a result of conducting VCAT-J of CRT in this study, improvement of neurocognitive function, and divergent thought increased;furthermore, daily live experiences changed. Although the results were displayed only when the patient engaged with the game task during the early intervention stage, the patient eventually started to become aware of his own weak points and took necessary measures to improve from the middle stage onward. Furthermore, it was observed that the patient exchanged opinions more frequently during the bridging group work activity. After the intervention, working memory remarkably improved and fixations present prior to intervention decreased. These results suggest CRT may contribute to generalization of cognitive function and divergent thinking in daily life activities.
This study investigates the effects of outreach service by an occupational therapist on a patient's social functioning and quality of life. The subject of this study is a patient who suffers from severe schizophrenia and has been withdrawn from society for four years. The outreach service was conducted for four months using the Management Tool for Daily Life Performance (MTDLP). The MTDLP, developed by The Japanese Association of Occupational Therapists, is an intervention tool used in occupational therapy and is a support method that focuses on finding meaningful daily activities for the patient. The MTDLP consists of a series of processes that include acquiring information about the patient's meaningful daily activities, assessment, planning, and intervention. In this study, using the MTDLP, the OT asked the patient about her desired daily life performance, which revealed that the patient would have liked to work. The OT devised a multidisciplinary plan using the MTDLP, which evaluated and intervened at the patient's workplace. As a result, the patient was able to work at the Supported Employment Workshop. Furthermore, the patient's scores on the Global Assessment of Functioning, the Social Functioning Scale, and the World Health Organization Quality of Life 26 improved significantly after the intervention. These results suggest that performing the meaningful daily activities can subsequently improve the social functioning and quality of life. In addition, cooperation between medical and welfare workers in job support for patients with schizophrenia is important.
Interventions were performed during hospitalization for a patient with vascular-type Ehlers-Danlos Syndrome, taking into consideration psychological aspects and the risks due to joint symptoms and vascular fragility. The patient was highly adverse to pain and blood vessel rupture and continued his own procedures and methods to maintain ADL. Therefore, considering the risk of vascular fragility, we instructed the patient in various methods of transfer and introduced a self-help device so that transfer operations could be performed safely according to the situation to prevent the patient's feet from being hit during transfer. In addition, to reduce the patient's fear of pain and blood vessel rupture, we used repeated movement exercises and safety equipment after discharge from the rehabilitation program and the hospital ward. It is important to consider psychological aspects during ADL training so that not only physical symptoms, but also anxiety and fear can be eliminated.