[in Japanese]

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[in Japanese]

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[in Japanese]

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Occupational therapy endeavors to support positive psychological states such as satisfaction and enjoyment, and “flow theory” is a concept that does so. We reviewed the current literature on the practical application of flow theory in occupational therapy. Six papers were extracted, and all showed improvement of cognitive function, higher brain function for interventions, flow experience, subjective QOL, and health-related QOL. Further occupational practice and research was pointed out as an effective approach in occupational therapy and rehabilitation.

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This study utilized the Modified Grounded Theory Approach (M-GTA) to clarify the process of forming the professional identity of occupational therapists working in a forensic psychiatric ward in Japan. The results indicate that the subjects with vaguely formed OT identities experienced an identity crisis in multidisciplinary collaboration settings in the medical observation method ward. However, subsequent efforts to reestablish one’s personality as an occupational therapist made it possible to form relationships peculiar to occupational therapists, leading to increasing self-efficacy as an occupational therapist. In the future, it will be important to tackle strategies which advance the formation of professional identity.

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This study examined how social factors affect participation in community-based activities (local event groups, neighborhood associations, senior citizen clubs, hobby groups, intergenerational groups, and volunteer groups) among community-dwelling older adults by gender. The participants were 3,058 older adults who lived in Ayase City, Kanagawa Prefecture. The results from 1,266 older adults, excluding those showing long-term care certification, indicated that females participated more in community-based activities than males. Logistic regression analysis revealed that the relationship between community-based activities and social factors such as community attachment, bonding and bridging social capital, trust in neighbors, norms of reciprocity, and ongoing contact with neighbors vary according to gender. To promote participation of community-based activities in older adults, it is important for occupational therapists to focus on the characteristics of social factors among older adults in the target community.

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The aim of this study was to clarify the commonality and diversity of school adaptation processes in children with acquired brain injury. The experiences of five parents were analyzed using a qualitative research method:the Trajectory Equifinality Approach. As a result, a new concept of “conflict over adjustment” and three Bifurcation Points in the process of returning to school for children with acquired brain injury were generated. The adaptation to school is a transitional point goal, and the concept of adaptation is a fluctuating state that included parents’ conflicts. The role of the occupational therapist is to provide long-term support for problem-solving in the participation of the child and parents in community life, while considering future life stage changes.

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The purpose of this study was to clarify the evaluation items for the development of occupational therapy evaluation in community life support for schizophrenic patients. In Study I, eight items were generated as assessments from information gathered from data analysis of semi-structured interviews with 10 OTRs with extensive experience in community life support, and 62 items were extracted from a questionnaire based on the ICF Core Sets. In Study II, a Delphi questionnaire was administered to 82 OTRs to check the content validity of the items by median, interquartile range, and agreement rate. Finally, a total of 70 items were identified as occupational therapy assessment items in community life support for patients with schizophrenia.

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The purpose of this study was to develop the Self-Rating scale of Occupational Therapists for Terminal Cancer (SROT-TC), and to examine its reliability and validity. We analyzed 246 occupational therapists at the admission fee notification facilities in palliative care wards. As a result, five factor structures consisting of 20 items were estimated based on categorical exploratory factor analysis. The goodness-of-fit index shown by categorical confirmatory factor analysis revealed a root mean square error of approximately 0.067, a comparative fit index of 0.958, and a Tucker-Lewis index of 0.951, indicating good structural validity. Internal consistency reliability was also ensured with ω of 0.8-0.92. The criteria-related validity showed weak correlation. Future studies need to examine the relationship between the SROT-TC and occupational participation status among occupational therapists.

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This case study describes a patient who requires long-term care due to spinal cord injury. The patient’s desire to go out was limited due to his reliance on assistance in both endotracheal suction and moving. In addition, he believed that he could not participate in neither daily living activities nor hobbies unless his disability was cured, so he depended on the caregiver for motions that could be performed by himself. We did going-out support for persons with severe disabilities using Management Tool for Daily Life Performance. As a result, he became able to go out regularly by public transportation. Furthermore, both his self-efficacy and independence increased.

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In this study, we provided evidence-based practice for two cases with upper limb paralysis after cerebral hemorrhage. The intervention was tailored to the condition of the affected arm. We also investigated the relationship between improved upper limb function, behavior of using the affected arm, and changes in white matter Fractional Anisotropy (FA). As a result, the intervention improved both upper limb function and affected arm behavior in both cases. However, only FA in the uncinate fasciculus was improved. Therefore, it is unlikely that plastic changes in the corticospinal tract related to motor function will occur along with improvement of the upper limb function and behavior of using the affected arm. On the other hand, it was shown that the plastic change of the uncinate fasciculus related to the reward system may occur.

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This study utilized the combined approach which included the transfer package by the ward staff, task-oriented training, and electrical stimulation/vibration of the affected arm for sub-acute stroke patients with left hemiplegia and general cognitive disorder leading to left unilateral spatial neglect. Consequently, there was improvement in affected upper extremity function beyond the minimal clinically important difference and achievement of meaningful occupation in patients with poor prognosis. In addition, unilateral spatial neglect improved from severe to mild impairment after the intervention. Although the improvements indicate spontaneous recovery, this intervention might be useful for devising solutions to the arm functional approaches for sub-acute stroke patients with cognitive disorders.

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The purpose of this study was to facilitate screening of attentional functions and to simplify clinical reasoning including prognostic predictions of daily activity. We created and conducted stepwise tasks to observe the improvement process of the attention deficit for every achieved level. Subjects were 14 patients (6 males and 8 females, mean age:74.9 (8.7) (SD)) with cerebrovascular diseases, admitted within 2 months of onset. Using the change of the achievement level of this task, we analyzed the improvement process of the attention function and the relationship between outcomes of the task and existing assessments and daily activity. As a result, the achievement level of the task and existing assessments scores of the subjects were significantly improved. In addition, achievement of the tasks in the initial and final stages significantly correlated with the initial and last scores of existing assessments and daily activity. The achievement level in this task suggested that we could infer an achievement level of daily activity in patients with attention deficits. The present study suggests that a program and scene setting on matching the level of individual attention deficits were possible.

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There are very few reports of shared decision making (SDM) on goal setting and interventions in occupational therapy for the acute phase of stroke in Japan. In this study, we conducted a guideline-based SDM on interventions for a case in which the paralyzed hand was used infrequently, and the patient was reluctant to set goals or make decisions about interventions. As a result, the case was encouraged to actively participate in occupational therapy, and the frequency of use of the paralyzed hand increased beyond the minimal clinically important difference. The results of the case study suggest that SDM on goal setting and guideline-based interventions may be useful in occupational therapy during the acute phase of stroke.

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Repetitive facilitative exercise (RFE) is a form of physiotherapy that has been shown to improve hemiplegic upper limb function, the ability to manipulate objects, and the patient’s quality of life after stroke;however, the use of the hemiplegic hand in daily life and the effect on targeted movements after intervention have not yet been reported. We evaluated the effects of “Task-oriented RFE,” which combines RFE under continuous neuromuscular electrical stimulation and task-oriented training for the treatment of a hemiplegic upper limb in a subacute stroke patient. The subject did not report any adverse effects during RFE sessions. Upper-extremity function, use of the paralyzed hand in daily life, and the quality of movement improved after 6 weeks of intervention. In addition, satisfaction with performance of the targeted movements also improved. The function of the upper extremity improved 1 month after discharge. The results suggest that Task-oriented RFE may be effective in improving function and the use of a paralyzed upper extremity in subacute stroke patients.

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The Management Tool for Daily Life Performance (MTDLP) was used in the forensic psychiatric ward in Japan during intervention of a schizophrenic client who had attempted murder. Through “the Report of Daily Life Performance,” client information was shared with the occupational therapist at the designated outpatient medical institution, and we worked collaboratively to support the patient to find gainful employment. As a result, the client was able to find a worthwhile job at a facility of continuous employment support. This intervention suggests that MTDLP motivates the client to participate in his treatment actively and promotes cooperation between the client and his parents, the professional multidisciplinary team, and the staff of the designated outpatient medical institution to achieve the consensus goals. In addition, MTDLP was thought to strengthen the collaboration between designated inpatient and outpatient medical institutions and to enable seamless support for a client.

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Systematic lupus erythematosus is an autoimmune disease that causes systemic multi-organ malfunction. The purpose of this study was to demonstrate that splinting and education of joint protection are effective in changing hand behavior after a case of non-induced extensor tendon rupture of the left middle finger accompanied by Jaccoud arthritis. The case involved a seventy-year-old woman who has been affected since she was thirty years old. Jaccoud arthropathy caused middle and extensor tendon dislocation and a ruptured synovial tendon sheath. After tendon reconstruction, we intervened with rest and dynamic splinting for three weeks, which resulted in preventing ulnar deviation. After six weeks, we educated the patient in joint protection during cooking and washing, which resulted in improving ulnar deviation and increasing the automatic extensor angle in the middle finger. In addition, behavioral change toward the hand was promoted, and safe use of the hand in daily life was acquired. Jaccoud arthroplasty may cause rupture of the synovial tendon sheath, affecting the extensor digits. It is important to change behavior toward the hand as soon as possible to protect the joint.

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