Author: Patricia Semeniuk
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Languages : en
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Book Description
"Introduction: Occupational therapists evaluate occupational performance by older adults with cognitive impairments. Previous studies of the methods used by occupational therapists to evaluate this population suggest there is a lack of understanding of clinical practice in this domain, as well as a lack of tools. Given the importance of occupational therapy interventions in supporting the well-being of these individuals, we aim to understand the process that occupational therapists use to evaluate older adults with cognitive impairments, identify the knowledge and tools occupational therapists need to support them in their evaluations, and identify their preferred strategies to acquire new knowledge. Objectives: This study had three objectives : 1. To understand how occupational therapists evaluate cognitively impaired older adults and the reason behind their clinical choices ; 2. To understand the knowledge and tools needs of occupational therapists in this area of practice ; and 3. To take preliminary steps to identify knowledge transfer strategies that will increase uptake of research evidence into practice. Methods: A descriptive qualitative study with a deductive-inductive approach was used. Focus groups were conducted with occupational therapists who had at least one-year experience working with older adults with cognitive impairments. Recruitment of participants was discontinued when no new content emerged from the groups. Key interview questions were constructed to obtain information responding to the objectives of our study. Thematic content was analyzed using the Miles et al. (2014) approach for qualitative data analysis. A deductive approach was used for first cycle coding, allowing us to sort data into main content areas. An inductive approach was used to probe each content area, allowing us to further refine our analysis and create sub-themes. Sub-themes were then combined into overarching themes. The analysed data was presented in network and matrix displays to show how the themes responded to our research objectives. Results: Data saturation was reached upon interviewing sixteen occupational therapists (n = 4 focus groups). Each participated in two focus group meetings. Three themes emerged reponding to the first objective: 1) gather information from the individual and others involved to plan the evaluation ; 2) gather information from non-standardized observation and standardized testing to evaluate occupational performance and safety ; and 3) apply a clinical reasoning process to predict occupational capacity. Three themes responded to the second objective, describing the knowledge and tools needed to support participants in their evaluations. This included 1) knowledge related to cognition and occupational performance ; 2) knowledge related to legal capacity and protection regimes ; and 3) tools to evaluate the impact of cognitive function on occupational performance. Two themes emerged for the third objective, which described the preferred ways for participants to acquire new knowledge including: 1) formal interactions with experts ; and 2) informal interactions with students, peers and other professionals. Conclusion: Our findings indicate that there is a need for improvement within the evaluation process in order for occupational therapists to optimize their capacity to understand the impacts of cognitive impairments on occupational performance with more confidence and rigor. Clinicians have an important need for additional knowledge and tools to support them in their evaluations. The continued development of psychometric properties for existing tools is needed as well as collaboration between clinicians, management and research experts to move existing tools into practice. Future research should explore the needs of occupational therapists other than those related to knowledge and tools"--