This study examined the factor structures of “change triggered by the onset of illness” and the relationship between each factor and psychosocial aspects. The questionnaire items, which were based on semi-structured interviews, were sent to 654 “elderly with cerebrovascular disease” (CVD). We performed both factor and partial correlation analyses, and outcome indices were measured using the Sense of Coherence (SOC), Self-rated Health (SRH), and Physical Functioning scale (PF-10). As a result, 318 CVDs who answered all items were included. “Changes in self-concepts and activity indicator” was structured by 4 factors and 18 items, and the “perspective on family” was structured by 2 factors and 8 items. This resulted in a weak correlation between some factors and the psychosocial aspects SOC and SRH, suggesting that occupational therapists involved with CVD can promote positive changes of psychosocial aspects in order to develop coping abilities with “change triggered by the onset of illness.”
The purpose of this study is to create an original measurement item and examine the internal validity of professional identity scales among occupational therapists. Twenty-five scale items were created based on previous research in the subordinate concept of identity. Using the Delphi method, we performed an agreement degree investigation of the measurement item in OTR of 42 people. This resulted in the creation of 13 items in a description investigation, and 11 items were deleted in an agreement degree investigation. A measurement item internal validity of 27 was obtained. The results suggest that the professional identity of occupational therapists influences relationships with others. We were able to obtain 27 valid items with this study. It is necessary to examine the construct validity and reliability.
The aim of this study is to examine the rate of success in predicting successful collaborative goal setting. We conducted goal setting with 104 inpatients in an acute care hospital using ADOC. If the goal setting could not be completed, we asked the patients why and followed up in another session. The success rate with collaborative goal setting is as follows:first session 40%, until discharge 31%, and never 29%. The predictor of successful goal setting was >98 of FIM total scores, and unsuccessful was <13 of MMSE scores. The reason for the difficulty of goal setting was“lack of reasonable perception for their abilities” and “lack of prospects in future.”
The aim of this study is to clarify the meanings and experiences in building therapeutic relationships of occupational therapists (OTR) and clients (CL) in a convalescent rehabilitation ward. This qualitative research used an interpretive phenomenology, in which three pairs of CL and OTR were separately interviewed following observation of an occupational therapy session. The data regarding the relationship narratives were analyzed, and thematic analysis was performed from the viewpoint of interpretive phenomenology． The analysis revealed six themes of CL and five of OTR, suggesting that there is involvement between the OTR and the client in building the relationship, between the OTR and CL through sharing of experiences, and involvement between the two towards the end of the relationship. Regarding the therapeutic relationship, OTR revealed the meaning of <Attitude to try to understand feelings>, while CL revealed the meaning of <actual signs of improvement> and <OT let me discover my current self>.
In this study, we examined whether physical exercise was effective in improving the subjective sleep quality of subjects with chronic schizophrenia. The subjects were nine female patients with a mean age of 62.3 years. They performed exercises with an approximate intensity of 4.0 METs for 20 minutes in the evening. We observed improvement in the Japanese version of insomnia severity index (ISI-J) after 10 weeks, 6 times/week (63 times in total), and an average of 24 times per month. Furthermore, the ISI-J deteriorated one month after the discontinuation of physical exercise. Thus, the findings suggest that continuous physical exercise performed in the evenings is useful for the subjective sleep quality of elderly patients with schizophrenia who suffer from chronic insomnia.
The Behavioral and Psychological Symptoms of Dementia (BPSD) survey was administered to 183 patients with cerebrovascular diseases (CVA) and 82 patients with motor system disorders in sub-acute rehabilitation wards. The Neuropsychiatric Inventory-Nursing Home version (NPI-NH) was used for evaluation, and the total score and incidence rates and severity for each subscale were assessed at the time of hospital admission, one month after admission, and at the time of discharge to determine changes over time. At the time of hospital admission, BPSD was found in 44% of patients with CVA and 29% of patients with motor system disorders, and there were heightened incidence rates of agitation, irritability, and night-time behavior. Among CVA patients, both improvement and deterioration were seen in subscales heading towards hospital discharge. Overall incidence rates and severity improved significantly among CVA patients but did not change significantly in patients with motor system disorders. These findings indicate that there is a need to devise occupational therapy treatment plans for BPSD in sub-acute rehabilitation wards that account for differences in temporal changes in patients with these two types of disorders.
We examined the external validation of the Prediction for Resuming Domestic Chores After Stroke (PRDCAS) models in forty-six stroke patients admitted to a recovery rehabilitation ward. First, we used the PRDCAS models to predict whether each stroke patient resumed the six items of domestic chores (preparing meals, washing dishes, washing clothes, light housework, heavy housework, and local shopping) after discharge. Next, we investigated resumption status of domestic chores three months after discharge. After that, the prediction accuracy of each model was calculated, and the discrimination was assessed using the Area Under the Curve of Receiver Operator Characteristic curve. As a result, the prediction accuracy for each item ranged from 75.0 to 82.2%, and the AUC ranged from 0.71 to 0.86. The results of this study indicate moderate accuracy of the PRDCAS models.
The purpose of this study was to calculate the cut-off point of the visual field with inhibitory tasks (VFIT) test, which is based on pass/fail judgment of car driving evaluations among brain injury survivors. The subjects were 104 brain injury patients under 65 who underwent driving evaluations. Using medical records, the test and pass/fail results were extracted retrospectively. For each VFIT test item, the receiver-operating characteristic curve and area under the curve were obtained. As a result, the cut-off point of the go/no-go task was 98% with a sensitivity of 68.7% and a specificity of 85.7%. The cut-off point of dual-task Stage I was 60.5% with a sensitivity of 92.8% and a specificity of 47.6%. The cut-off point of Stage II was 66.5% with a sensitivity of 78.3% and a specificity of 66.7%. The cut-off point of Stage III was 64.5% with a sensitivity of 80.7% and a specificity of 61.9%. The cut-off point of Stage IV was 54.5% with a sensitivity of 90.4% and a specificity of 47.6%. These results indicate that the cut-off point of the VFIT test may be helpful in future driving occupational therapy.
This research utilized the Elderly version of Leisure Activity Enjoyment Scale (LAES) to improve depressive state and living satisfaction for a man who developed subarachnoid hemorrhage and unilateral spatial neglect (USN). We practiced leisure activities considering the enjoyment of thinking and the enjoyment of interacting with others by LAES. As a result, depressive state, living satisfaction, and Behavioral Inattention Test all improved. Therefore, providing leisure activities that take into account the results of LAES might contribute to the improving depressive state, living satisfaction, and USN.
We describe occupational therapy for a case with metastatic tumor who underwent minimally invasive spine stabilization. Initially, in addition to back pain and neurological symptoms, she suffered from social and psychological pain due to difficulty performing housework and parenting. We assessed occupational performance and movement before surgery, and upon discharge she returned to her daily roles eight days after surgery. One year has passed since the operation, and she has continued her ADL without changing her role. Breast cancer patients treated with a combination of radiation and chemotherapy often have a long-term prognosis even with bone metastases. The results of this case study suggest that evaluation of pre/post-operative symptoms and occupational performance and support for how to move, environmental adjustment, and proposal of social resources with other professionals are effective.
This study aimed to describe home occupational therapy in which meaningful occupational relationships can be achieved by creating and utilizing tools for mothers and children. The patient was an infant with trisomy 18 syndrome. Physical examination confirmed indentations between the fingers due to hypertonia of the digits. In addition, sweating of the left buttock was confirmed without decompression due to difficulty in turning over. The general condition was easy to improve, although the mother was worried about the development of her relationship with the child. Therefore, tools were created with the mother such as hand cushions and mats, which could be used for hugging and manual therapy to promote the mother-child relationship. As a result, there was no further evidence of indentation or sweating of the child, and the mother was able to comfort her child, which improved her mental state. The attachment of mother and child was promoted by realizing meaningful occupational relationships through creating and utilizing home occupational therapy tools.
The purpose of study was to examine changes in an occupational therapy intervention program. The program was based on cognitive behavioral therapy intervention that graded exposure in vivo with 8 participants suffering from complex regional pain syndrome due to upper extremity dysfunction. We compared the following assessments through intervention:Complex Regional Pain Syndrome (CRPS), Cognitive function for Pain Catastrophizing Scale (PCS), psychological status for Hospital Anxiety Depression Scale (HADS), Activity of daily living for Pain Disability Assessment Scale (PDAS), disability due to upper extremity dysfunction (HAND 20), body function related to upper extremity function by Simple Test for Evaluating hand Function (STEF), lateral pinch power, and grip strength examination. There was improvement in CRPS, PDAS, and HAND. However, there was no significant change for cognitive function nor psychological status. Cognitive behavioral therapy based on graded exposure in vivo improves upper limb dysfunction of CRPS type. However, it is necessary to replicate the assessments specific to CRPS and OT programs in the future.
An occupational therapist intervened for three months in an elderly woman with post-lingual deafness who was in the hospital for humeral neck fracture and heart failure primarily to improve her dysfunctions. She remained unconfident in spite of improved ADL. Therefore, based on the Model of Human Occupation, the occupational therapist aimed to resume the woman’s contact with her friends by e-mail and provided her with gradual supports to be able to send and check e-mail using a mobile phone. As a result, she could send and check e-mail herself and resume contact with her friends. She also developed a stronger sense of self-efficacy and was able to maintain relationships more widely during hospitalization than before. Therefore, this case suggests the importance of contact with friends, as well as the significance of e-mail as an instrument of communication.
We present a case which favors returning to work despite higher brain dysfunctions such as attention disorders, memory disorders, and nerve fatigue. We believe that occupational therapy interventions which incorporate seamless cooperation from medical institutions and job assistance agencies will be beneficial to such patients. We examined the effect of workplace support using a sheet for job assistance. To do this, we analyzed the periods of both absence and income security and collaborated with job assistance institutions while simultaneously improving vocational readiness. In addition, training was provided before returning to work, and duties were redesigned based on the job assistance sheet. The patient returned to work with a change in his job tasks. Occupational therapy intervention was necessary to formulate a reinstated plan from a comprehensive perspective regarding information on returning to work, vocational readiness, job assistance, and the functions of job assistance agencies. We also found that redesigning duties using the job assistance sheet would help support the workplace.
The purpose of this study is to examine the factors affecting grief emotion and motivation for exercise by implementing the elderly version of Leisure Activity Enjoyment Scale (LAES), and to make clinical suggestions for occupational therapy for heart failure patients. Changes in grief emotion resulted from LAES activating only positive memories of her husband. Increased motivation to exercise stemmed from enjoyment of flower bed management, which lead her to move her body naturally and to recognize the importance of walking. Therefore, occupational therapy for heart failure may increase intrinsic motivation for leisure activities by implementing LAES for heart failure subjects with psychological problems, and improve motivation for exercise by leisure activities utilizing the enjoyment feature of LAES.
It has been reported that pusher syndrome was eliminated in almost 80% of affected patients within three months after stroke. However, prolongation of pusher syndrome results in reduced ADL performance and extended hospitalization. As Subjective Postural Vertical (SPV) is a mechanism of pusher syndrome, we intervened with long-term occupational therapy which was graded for the components of the SPV. As a result, pusher syndrome was reduced, and ADL performance was improved, indicating that long-term graded occupational therapy increases the understanding the pathogenesis of pusher syndrome.
Occupation-Based Practice 2.0 (OPB 2.0) is a theoretical approach for occupational dysfunction and clarification of belief conflict. This study aims to consider the efficacy of OBP 2.0 among patients in a convalescent rehabilitation ward experiencing cerebrovascular disease. As a result, we were able to reduce both belief conflicts and occupational dysfunction, thus achieving a common goal with the client. OBP 2.0 may be useful in convalescent rehabilitation wards where multidisciplinary collaboration is a core concept.
In this study, we compared the effects of repetitive writing of kanji and kanji practice after sensory integration therapy (SIT) for children with difficulty writing kanji. We practiced kanji writing using the ABAB method based on the single case experiment method. We practiced repeated kanji in the A term, and kanji practice after the SIT intervention in the B term. We used the correct answer rate and the morphological similarity of the kanji test as indicators of effect judgment. There was no difference in the correct answer rate in both A and B terms in the kanji test. Morphological similarity was improved in the B term compared with the average in the A term. The practice of kanji after SIT was found to improve the morphology of kanji. In the future, we would like to generalize the results by increasing the number of cases and the number of training sessions.