Objective: To clarify the process of occupation choice and continuation of ME/CFS persons through a qualitative study. Subject: Ms. A, a female in her forties, suffered from ME/CFS-like symptoms when she was a university student. After 10 years, she was diagnosed with ME/CFS. Method: A TEM diagram was created based on the results of an interview with Ms. A, and the diagram was analyzed by matching the concept of TEM with Ms. A's experience. Results: Ms. A's subjective and social circumstances revealed the circumstances and factors of her work choice and continuation. Discussion: The absence of coordination between physical condition and work content risks disruption of work continuity and worsening of symptoms. An environment that affirms the existence of disability and illness, and can vector toward social transformation centered on them, may promote both choice and continuation of interesting occupations.

The aim of this follow-up study is to clarify the changes in the quality of occupational performance from 3 weeks to 1 year after stroke onset. The quality of occupational performance showed statistically significant improvement from 3 weeks to 1 year after stroke onset, but unlike the general functional recovery curve, it rose and fell repeatedly. Although there was no statistically significant change between 6 months and 1 year, 6 of the 16 patients showed clinically significant improvement in quality of occupational performance, including 3 patients who showed a decline in physical function. The results suggest that the quality of occupational performance may improve even six months after stroke onset. By focusing on the quality of occupational performance, we may be able to detect changes in clients that have not been observed in the past.

[Objective] To investigate and summarize the minimum clinically important difference (MCID) in the assessment of upper limb function after stroke. [Methods] Studies that calculated the MCID using the Fugl-Meyer Assessment (FMA), the Action Research Arm Test (ARAT), and the Motor Activity Log (MAL) were extracted from multiple search databases. [Results] Four FMA (4.0-12.4 points), one ARAT (12-17 points), and one MAL (1.0-1.1 points) studies were included, all of which differed in terms of time since stroke onset and intervention details. [Conclusion] It is necessary to consider the subjects and intervention conditions of each study when referring to MCID values for the assessment of upper limb function after stroke.

Objectives: This scoping review aims to identify research gaps in goal-setting processes during rehabilitation programs for people with orthopedic disorders. Study design: This scoping review followed Arksey and O'Malley's framework. Data sources: Electronic searches of PubMed, Web of Science, Scopus, ProQuest, and CINAHL were conducted using predetermined search strategies. Eligibility criteria: We included studies involving goal-setting processes in rehabilitation for patients with orthopedic disorders without limiting the region/country or target disease. Data extraction and synthesis: Two reviewers independently screened the abstracts and full texts and extracted the data based on the eligibility criteria. A third reviewer adjudicated any disagreement and collated the extracted data. Results: Results of the database searches yielded 968 studies, 17 of which were deemed eligible to include in this review. Most studies enrolled patients with spinal cord injuries (n=10, 58.8%), while the number of other diseases was 2 or less. There were only a few studies using decision aids to identify occupational problems. Conclusion: Our review indicates that there is a scarcity of evidence of goal setting in orthopedic rehabilitation. Furthermore, establishing clinical practice is required, while focusing on goal-setting processes.

The purpose of this study is to clarify the relationship between the depression of the care recipient and the care burden of the caregiver for home-visit rehabilitation users. We investigated the basic information of the care recipient, the degree of depression, cognitive function, the degree of ADL independence, the expansion of the living space, and the basic information of the caregiver, and examined the relationship with the care-giving burden. Through multiple regression analysis, the high degree of depression of the long-term care recipient and the low degree of independence of defecation management were extracted as important factors for the care-giving burden, and interventions for reducing the care-giving burden were performed by the long-term care recipient. The results indicate that it is important to consider the depression of the care recipient.

To clarify major factors that influence professional identity of occupational therapists, we adopted a hypothetical model for quantitative analysis. Participants were 207 Registered Occupational Therapists who worked for the elderly and people with physical disabilities. This model rebuilt the effects of education and practice on the theory and methods used in occupational therapy on professional identity, using structural equation modeling to estimate this hypothetical model. Professional identity was affected by post-graduate education on occupational therapy's own theory and practice method, as well as on the perception of the current ideal occupational therapists and gender. These results, taken together, suggest that this model will guide educational methods for enhancing professional identity of occupational therapists.

We investigated the influence of interpersonal conflict management strategies on attitudes toward Interprofessional Working among a total of 94 nursing and rehabilitation professionals in acute and convalescent wards. The modified Attitudes toward Health Care Teams Scale was used to assess the attitudes toward Interprofessional Working, and interpersonal conflict management strategies were assessed by the Rahim Organizational Conflict Inventory-Ⅱ. The results indicate that the interpersonal conflict management strategies of Integrating and Compromising were positive factors for attitudes toward Interprofessional Working. These findings imply that the perspective of integrating to find a mutually acceptable solution and the perspective of compromising to provide a midpoint to break a deadlock have a positive influence on the attitudes toward Interprofessional Working.

A case of higher brain dysfunction including apraxia and motor paralysis caused by cerebral infarction complained of fatigue while manipulating chopsticks during mealtime. OT evaluation and movement characteristics indicated that due to the pathological condition, the patient was unable to grasp the chopsticks appropriately, leading to strenuous chopstick manipulation, an inability to recognize and correct errors in movement, and increased fatigue. OT intervention included helping the patient establish an optimal chopstick grasping form through replacing the somatosensory information with the patient's own movement and constructing the grasping form by looking at the object. As a result, the grasping form of the chopsticks imagined by the patient was established, and the fatigue of chopstick manipulation during mealtime was reduced.

Previous studies indicate the existence of several barriers that prevent initiating school-based occupational therapy (SBOT). This study aimed to clarify how occupational therapists overcome these barriers using the Trajectory Equifinality Model (TEM). We identified six Bifurcation points (BFPs) which are the critical in extensively providing SBOT, and five beliefs that determine the direction when occupational therapists face the BFPs. The common concept among the five beliefs was that occupational therapists strive to understand others and have an attitude to help others to show their strength. Our results suggest that these beliefs are the basis for overcoming several barriers before providing extensive SBOT.

Among the subjects of the Medical Treatment and Supervision Act Law (MTSA), there are cases in which intellectual disability and cognitive dysfunction coexist with mental illness. Furthermore, poor basic skills in housework and cooking lead to unstable living and worsening of the patients' condition. The present case had both intellectual disability and cognitive dysfunction, and was indifferent to health and life, which contributed to an unhealthy lifestyle. Through occupational therapy and overnight training, the authors used positive feedback on what the patient was able to accomplish and provided effective examples and advice to help the acquisition of skills in health care, housework, and cooking. As a result, improvement in health management and daily living skills was achieved. The health management and life skills intervention for this case under the MTSA resulted in an increase in the value of social life. This intervention prevented the recurrence of harmful behavior and influenced the future reintegration into society.

The rate of return to work in patients with higher brain dysfunction after stroke is low, and improvement in support for return to work is needed. We intervened with simulated job training and gradual support in continuous employment at a rehabilitation hospital which resulted in the patient with higher brain dysfunction after stroke successfully returning and continuing to work. This study aims to demonstrate how to use the simulated job training and gradual support in continuous employment, as well as clarifies the effectiveness of the simulated job training and gradual support in continuous employment. As a result, this case successfully returned to work as a part-time worker and full-time worker 11 and 12 months respectively after the stroke onset. These findings suggest the effectiveness of interventions with simulated job training and gradual support in continuous employment as support for returning to work at a rehabilitation hospital.

The purpose of this study was to comprehensively evaluate driving behavior using an event data recorder and to support the resumption of driving. An on-road driving assessment was conducted on a person with brain injury. The occupational therapist mailed the results of the evaluation in writing and asked for his feedback. In the questionnaire after the on-road driving assessment, positive impressions about the opportunity to objectively recognize his own driving behavior were recorded. We performed an on-road driving assessment using an event data recorder and presented the results in writing. This may have provided an opportunity for him to reflect on his own driving behavior and provide useful information for his family to help them understand his driving ability.

This study examined the effect of upper-body dressing training based on the time-delay and visual prompt fading methods using applied behavior analysis on a stroke inpatient with severe hemiplegia and visual-spatial deficit (left-homonymous hemianopsia and ocular motility disorder). In this single-case experimental study, to assess the effect of the intervention, the performance times of upper-body dressing and amounts of dressing scores in the baseline and intervention phases were measured and compared. Statical analysis was performed by the split-middle line method and a binomial test. As a result, performance times of upper-body dressing were shortened and amounts of the dressing score increased significantly in the intervention phase compared to the baseline. Moreover, these outcomes were also consistent during the follow-up. These results suggest that upper-body dressing training based on the time-delay and visual prompt fading methods are effective in improving upper-dressing ability in a stroke patient with impaired visuospatial ability.

In this study, we conducted occupation-based practice to improve occupational dysfunction using CAOD in two oldest-old patients in a convalescent rehabilitation ward. The two cases have orthopedic disease and require assistance with ADL. Mr. A, who had good cognitive function, was able to share his goals easily. On the other hand, Mr B, whose cognitive function had declined, had difficulty sharing his occupation goals as easily as Mr. A, and took time to improve his occupational dysfunction. Mr. B showed improvement in his occupational dysfunction after re-recognition occupational therapy using visual information. Interventions aimed at improving occupational dysfunction using CAOD can help us to understand the subject's occupational problems, and may be a useful perspective in developing occupational therapy for oldest-old patients.

This study aimed to test the usefulness of Positive Occupation-Based Practice (POBP) by applying the Engagement Estimation System (EES), which can assess participation in occupations that promote well-being on a five-level rank point scale. The method was implemented through POBP, with EES applied to two individuals with mental illness for 3 months. The intervention content supported both the learning of positive occupations appropriate to the client's condition from the results of the EES and making them a habit in their daily life. The results showed therapeutic effects on the two clients in terms of positive emotions and mental stability. This suggests that this practice has the potential to apply EES to POBP based on its positive impact on clients.

A case of Whiplash associated disorders after an accident was treated with a graded occupational therapy program using the Aid for Decision-making in Occupation Choice to set goals and the Goal Attainment Scaling. The case had difficulty in daily living, and suffered from chronic pain, severe central sensitization syndrome, and psychological trauma. Although the treatment resulted in no improvement in VAS, PCS, or PSEQ, the achievement of GAS improved, and improvement was observed in "activities using the lower back" of PDAS, which was related to the goal, and lead to behavioral change. This case study suggests that goal-based occupational therapy for patients with chronic pain due to Whiplash associated disorders may promote behavioral change.