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Objective: To investigate the relationship between on-road driving remediation and achieving fitness to drive following acquired brain injury. Design: Randomized controlled trial. Setting: Tertiary hospital outpatient driver assessment and rehabilitation service, Australia. Participants: Thirty-five participants (54.3% male), aged 18–65 years, 41 days-20 years post-acquired brain injury (including stroke, aneurysm, traumatic brain injury) recommended for on-road driving remediation following occupational therapy driver assessment were randomly assigned to intervention (n = 18) and waitlist control (n = 17) groups. Intervention: Intervention group received on-road driving remediation delivered by a qualified driving instructor in a dual-control vehicle. The waitlist control group completed a 6 week period of no driving-related remediation. Main measure: Fitness to drive rated following the conduct of an on-road occupational therapy driver assessment with a qualified driving instructor where outcome assessors were blinded to group allocation. Results: The intervention group were significantly more likely to achieve a fit to drive recommendation than no driving specific intervention (p = 0.003). Conclusion: Following comprehensive assessment, individualized on-road driving remediation programs devised by an occupational therapist with advanced training in driver assessment and rehabilitation and delivered by a qualified driving instructor are significantly associated with achieving fitness to drive after acquired brain injury. [ABSTRACT FROM AUTHOR]

Introduction: Occupation‐based interventions use engagement in a person's daily activities to achieve change. There is growing research into the use of occupation‐based group interventions in the inpatient rehabilitation setting. It remains unclear whether occupation‐based groups offer comparable outcomes to occupation‐based interventions delivered individually; this research will precede a clinical trial aimed at comparing these two approaches for improving occupational performance outcomes. This study details the process of co‐designing the intervention. Partnering with clinicians and patients in the design of healthcare interventions can promote patient‐centred care, enhance uptake, and improve applicability and sustainability of the intervention to that setting. Methods: A modified nominal group technique (NGT) design was applied to facilitate two meetings and an electronic survey with an expert panel of clinicians and patients. Twelve participants (n = 4 occupational therapists, n = 1 registered nurse, n = 1 physiotherapist, n = 1 occupational therapy assistant, n = 1 occupational therapy manager, and n = 4 patients) were purposively recruited. A modified approach to the technique's four stages was used: silent generation, round robin, clarification, and voting. Consensus was set at >50%. Qualitative data from group discussions were analysed thematically. Findings: All participants agreed the intervention should include patient‐centred, goal‐directed, practice of daily activities, including breakfast and lunch preparation, domestic tasks, and laundry. Other components that were agreed included where the groups could run, group size, eligibility criteria, and frequency. Key themes from clinicians included needing a goal‐directed intervention, focused on progressing towards hospital discharge; time and resource requirements were also discussed. Patients emphasised the importance of building social connections, opportunity to engage in meaningful activity, and the importance of linking participation to patient goals. Conclusion: Through collaboration with clinicians and patients, an occupation‐based group intervention considering the available evidence, alongside clinical, experiential, and contextual sources of knowledge was developed; this resulted in an evidence‐based, patient‐centred, and contextually relevant intervention. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aimed to explore topics on which the views of residents of Australian residential aged care facilities (RACFs) have been sought. Methods: Scoping review methodology as outlined by Arksey and O'Malley was used to identify, explore and report on the range of literature regarding views of RACF residents. Seven electronic databases were searched using broad search terms relevant to the RACF context. Descriptive numerical analysis was completed for publication year, journal name and target profession, research methods and participant types. Thematic analysis then focussed on the aims of the included studies. Results: Four thousand two hundred and ninety studies were screened, and 104 publications met the inclusion criteria. A broad range of topics were explored by researchers, with the largest number of papers focused on residents' views of systems within RACFs (n = 24) and new programs and interventions (n = 21). Smaller topic areas included health conditions and health‐care services (n = 13), socialisation (n = 13), physical activity (n = 3), self‐care (n = 4), leisure (n = 4), general everyday life (n = 20) and aspects of the residential aged care environment (n = 15). There was limited exploration of meaningful activity (n = 13). The inclusion of residents with cognitive impairment was inconsistent, and the voices of other stakeholders were often privileged. Conclusions: Voices of residents must be heard in order to prioritise the health and well‐being of this population. More research which focuses on what is important to residents is needed and must include residents with cognitive impairment more effectively. Identification of optimal research methods with this population would make an important contribution in this area. [ABSTRACT FROM AUTHOR]

Falls following a spinal cord injury (SCI) can have physical and psychological consequences, although some risk of falls may be acceptable to enable participation in meaningful activity. The study aimed to explore the patients' perspective of falls and fall prevention after discharge from a inpatient spinal injuries unit. An interpretive descriptive approach guided the study. Semi structured interviews were conducted in the 6–12 months post discharge period. Thematic analysis was used to analyze the data and identify themes. Fifteen individuals with SCI, with a mean age of 57 years and varied fall experiences were included. Three themes were identified including: 1. Expectation of falling; 2. Learning from my own experience and the experience of others' and 3. How to prevent falls. Learning from their own experience and the experience of others was highly valued by persons with SCI and influenced expectations of falls. A variety of strategies were used to prevent falls. Strategies that include learning from others, include activities that are individual and provide skills in self-reflection may aid to make fall prevention meaningful. Patients want to learn from practical experience and the experience of others with spinal cord injury (SCI). Clinicians need to consider patients' readiness to receive education and could benefit from the inclusion of peers in the delivery of information/education provided. A shift of focus for clinicians providing fall prevention education to skills in risk assessment, self-reflection and ability to formulate fall management plans may be beneficial to patients with SCI. Patients appreciate demonstration of skills. Clinicians are encouraged to learn wheelchair skills when performing functional tasks and demonstrate them to add credibility to their fall prevention education. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the process of implementing an evidence-based goal-setting package into five rehabilitation services across the continuum of rehabilitation. This study used a mixed methods approach guided by Medical Research Council (MRC) recommendations for conducting process evaluations, the RE-AIM framework, and the Theoretical Domains Framework (TDF). This study will evaluate the reach, adoption, implementation, and maintenance of the goal-setting package over six months. Environmental context and resources, the clinician's social and professional role and identity, social influences and clinician beliefs about goal-setting consequences and individuals' capabilities were all identified as barriers or enablers throughout the implementation process. Community rehabilitation services faced challenges implementing paper-based resources, whilst inpatient rehabilitation sites faced challenges engaging nursing staff in the interdisciplinary approach to goal-setting. Social influences were an enabler in two sites that used the case conference format to facilitate setting common goals. Clinicians in all sites continued to express difficulties implementing shared decision-making with people who had cognitive impairments or were no longer progressing in their rehabilitation. A team-based approach to implementing the goal-setting interventions centred around the case conference format appeared to be the most successful mode for implementing interdisciplinary person-centred goal-setting. The rehabilitation case conference forum can be used to facilitate teams to set interdisciplinary common goals. Rehabilitation teams should add further consideration to how they can involve clients as a member of the rehabilitation team throughout the rehabilitation process. Embedding changes into existing process and using structured templates and tools can enhance the process of goal-setting in rehabilitation. Strong leadership, dedicated facilitation, audit and feedback can enhance team's success in implementing elements of the goal-setting implementation package. [ABSTRACT FROM AUTHOR]

To critically review the evidence for occupation-based interventions in improving occupational performance and participation outcomes in the hospital setting. Five databases were searched from 2000–2022. Peer-reviewed studies of any design investigating the impact of occupation-based interventions in the hospital setting were included. Methodological quality was assessed using the appropriate tool for each study design. Following data extraction, a narrative synthesis was conducted. Thirty-three studies comprising of 26 experimental, five non-experimental, and two mixed methods studies were included (n = 1646 participants). Results indicate good evidence to support occupation-based interventions to improve occupational performance and participation outcomes in inpatient rehabilitation; it is unclear whether they are more effective than any control/alternative intervention. Research in the acute and mental health hospital settings were scarcer. Understanding the benefits of occupation-based interventions was enhanced through qualitative results including improving independence and confidence to discharge home, increasing motivation for therapy, connecting with others, and peer-based learning. Heterogeneity and methodological weaknesses across existing studies limits the conclusions that can be drawn on the impact of occupation-based interventions in the hospital setting. More rigorous research should be conducted with better reporting of intervention design and the use of robust measures of occupational performance. The use of occupation-based interventions should be considered to improve occupational performance and participation outcomes in the hospital setting. There is good evidence to support the impact of occupation-based interventions on improving occupational performance and participation outcomes in the inpatient rehabilitation setting; evidence in the acute and mental health settings is scarcer. Occupation-based interventions are valued by both patients and clinicians for their impact on patient outcomes and the patient experience. [ABSTRACT FROM AUTHOR]

AbstractAimsMethodsResultsConclusion1) Explore occupational challenges of individuals participating in pulmonary rehabilitation (PR), and 2) examine impacts of occupational therapy, embedded within PR, on performance of, satisfaction with, dyspnea in and experience of challenging occupations.A mixed methods cohort study recruited adults from a 8-week community-based PR program which incorporated targeted occupational therapy. Participant perspectives of the occupational therapy were explored using the Canadian Occupational Performance Measure (COPM) and Modified Borg Dyspnea Scale.Seventeen participants with either Chronic Obstructive Pulmonary Disease, Bronchiectasis, or Interstitial Lung Disease were recruited (age 71 ± 7(SD) identifying 269 problematic occupations. Nine participants completed the program obtaining clinically and statistically significant improvements in COPM performance, satisfaction scores and Modified Borg Dyspnea Scale, maintained at 12 wk, and validated through participants reporting they ‘now do things differently’.People with chronic respiratory conditions are occupational beings. Occupational therapy embedded within PR can influence participants’ engagement in challenging occupations. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo examine the lifespace of participants referred for occupational therapy driving assessment following acquired brain injury, to understand how, why, where and with whom access and participation in community-based occupations is occurring during the period of driving disruption.The mixed methods, convergent research design utilised a travel diary and Lifespace Mobility Assessment-Composite quantitative elements and semi-structured interviews analysed qualitatively with an interpretive description lens.Forty-eight participants (56.25% male) aged between 26 and 65 years, left home on average once/day, primarily to conduct instrumental activities of daily living, health management, and social participation community-based occupations. Most reported restricted lifespace (54.2%) requiring assistance to conduct community occupations (68.1%). Support was primarily provided by family members (80.3%). Analysis of semi-structured interviews (n = 15) created three themes that shaped participant occupational experience during driving disruption: (i) changes to occupational participation; (ii) reliance on others for community access and participation; and (iii) trying to move forward.The period of driving disruption following the onset of acquired brain injury is a time of occupational disruption which restricts lifespace, changing how, why, where and with whom participation in community-based occupations occurs. Rehabilitation facilitating occupational adaptation process to enhance community access capacity is indicated.The period of driving disruption following the onset of acquired brain injury is a time of occupational disruption which restricts lifespace and influences participation in community-based occupations.Occupational therapists should provide an individualised potential pathway to return to driving with frequent and varied means of reinforcing interim advice to abstain from driving.Implementing occupational adaptation can progress community participation goals by establishing community access skills, habits, routines and confidence to foster participation and satisfaction and rebuild occupational identity following acquired brain injury.The period of driving disruption following the onset of acquired brain injury is a time of occupational disruption which restricts lifespace and influences participation in community-based occupations.Occupational therapists should provide an individualised potential pathway to return to driving with frequent and varied means of reinforcing interim advice to abstain from driving.Implementing occupational adaptation can progress community participation goals by establishing community access skills, habits, routines and confidence to foster participation and satisfaction and rebuild occupational identity following acquired brain injury. [ABSTRACT FROM AUTHOR]

The article presents the discussion on research community increasingly partners with consumers and community in the design and conduct of research. Topics include Recent studies have explored the perceptions of Editor-in-Chiefs regarding the acceptability for consumer co-researchers to be authors on papers; and authorship were developed by the scientific community to ensure appropriate attribution for the work.

Background and Objectives Driving retirement can be a necessary but challenging and emotionally complex transition, especially for people living with dementia. This pilot study evaluated the utility of CarFreeMe™-Dementia (CFM™-D), a telehealth intervention providing tailored education and social support to those living with dementia and their care partners, as they prepare for or adjust to driving retirement. Delivered by empathetic health professionals, CFM™-D is a person-centric, flexible program tailored to address challenges specific to the participants' driving retirement stage and individualized contexts. Research Design and Methods A single-arm, mixed-methods design was used to follow participants over a 6-month period. Participants received CFM™-D, a 7–8-module semistructured intervention, including education and planning support for driving retirement (impact of dementia, transportation options) and emotional adjustment (grief and loss, stress management). Surveys evaluated the perceived utility of intervention components as well as changes in well-being and readiness for driving retirement over time. An open-ended survey item and semistructured interviews provided additional feedback and a contextual understanding of the empirical data. Results A total of 50 families enrolled (17 care partners, 16 retiring/retired drivers with memory loss, and 17 care partner-retiring/retired driver dyads). Nearly all participants would recommend the intervention. Care partners reported significantly reduced (p  < .05) isolation and relationship strain, and retiring drivers reported significant reductions in depressive symptoms. Driving retirement preparedness scores improved. Driving retirement phase, enrolling as a dyad, and retiring driver cognitive/functional impairment were associated with these outcomes. Participants also engaged in more driving retirement activities outside of the intervention (e.g. talking with health professionals). Discussion and Implications CFM™-D is a useful intervention for retiring drivers with dementia and their family members, with preliminary data suggesting it supports improved well-being and driving retirement preparedness. A randomized controlled trial is needed to determine the efficacy of the CFM™-D intervention and future translation needs. [ABSTRACT FROM AUTHOR]

Background: Fatigue following a traumatic brain injury (TBI) is a complex, chronic symptom, which can significantly impact quality of life. Investigation into the types of fatigue addressed by the multidisciplinary team and consequent outcomes may assist clinicians to target their care. The use of health frameworks to explore such phenomena may increase a teams' ability to incorporate multifaceted interventions. The objective of this paper is to profile and map the available evidence for fatigue management used for the TBI population onto the International Classification of Functioning, Disability, and Health framework. Methods: A scoping review was conducted and included papers that described an intervention focussing on post-TBI fatigue and used fatigue-specific outcome measures with an adult population. Studies were collated and summarised, and key findings are presented. Results: Forty-seven articles met the inclusion criteria. The results indicate that post-traumatic fatigue interventions in the literature are conducted by singular professions, that there is a strong focus on a body functions approach, and that there is a discrepancy between intervention intent and measurement. Conclusion: Although there is variety in multidisciplinary fatigue treatment, further opportunities to develop interventions that target other health and function components, including activities and participation, environment, and personal factors, may enable a greater impact of fatigue management approaches. Fatigue is one of the biggest problems for everyday life following a brain injury. There are some treatment approaches that have positive effects but these do not adopt the team approach that is promoted for brain injury rehabilitation. The findings highlight that further research is needed to develop, evaluate, and implement a team approach to fatigue that can reduce the impacts on everyday life. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive impairment is common post-stroke. There is a need to understand patterns of early cognitive recovery post-stroke to guide both clinical and research practice. The aim of the study was to map the trajectory of cognitive recovery during the first week to 90-days post-stroke using serial computerised assessment. Method: An observational cohort study recruited consecutive stroke patients admitted to a stroke unit within 48 hours of onset. Cognitive function was assessed using the computerised Cambridge Neuropsychological Test Automated Battery (CANTAB) daily for seven days, then 14, 30 and 90 days post-stroke. The CANTAB measured visual episodic memory and learning, information processing speed, visuo-spatial working memory, complex sustained attention and mental flexibility. Repeated measures MANOVA/ANOVA with Least Squares Difference post-hoc analyses were performed to ascertain significant change over time. Result: Forty-eight participants, mean age 73, primarily mild, ischaemic stroke, completed all assessment timepoints. There was a trajectory of early, global cognitive improvement, indicative of a post-stroke delirium, that largely stabilised between 6 and 14-days post-stroke. Change over time was examined within each cognitive test, with one measure stabilising by day 6 (Reaction Time) and others detecting improving performances up to 14 days post-stroke. Conclusions: Serial, computerised cognitive assessment can effectively map post-stroke cognitive recovery and revealed an early phase of global improvement over 14 days that is evidence for an acute post-stroke delirium. Resolution of post-stroke delirium in the second week following mild stroke indicates more extensive neuropsychological testing may be undertaken earlier than previously thought. [ABSTRACT FROM AUTHOR]

Purpose: To examine associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, and personality variables. Methods: An exploratory cross-sectional study with purpose-designed survey was completed online or via mail. The survey was comprised of demographic and health-related questions and multiple questionnaires, including the Stroke Impact Scale Version 3.0 (SISv3) (participation/perceived recovery), Community Integration Questionnaire (CIQ) (participation), Head Injury Semantic Differential III (pre- vs post-stroke self-concept/self-discrepancy), Appraisal of Threat and Avoidance Questionnaire (threat appraisal), Life Orientation Test – Revised (optimism) and Relationships Questionnaire (adult attachment style) that measured variables of interest. Sixty-two participants, aged 24–96 years who had experienced a stroke (one or multiple events) and had returned to community living, completed the survey. Associations were examined using correlations, and univariate and multiple linear regression analyses. Results: Regression analysis showed that greater participation, measured using the CIQ, was associated with younger age, female gender, lower self-discrepancy and higher perceived recovery, explaining 69% of the variability in CIQ participation. Further, greater participation on the SISv3 was associated with lower self-discrepancy and higher perceived recovery, explaining 64% of the variability in SISv3 participation. Conclusions: Results indicate that personal factors, particularly self-appraisals like self-concept/self-discrepancy, in combination with perceived recovery may be important in explaining a large portion of variance in post-stroke participation. Specifically, findings highlight the interrelatedness of self-concept change, perceived recovery and post-stroke participation. Further longitudinal research is needed to clarify the directionality of these associations throughout the hospital-to-home transition. [ABSTRACT FROM AUTHOR]

Objective: Driving cessation is a major life transition; lack of support in this process may lead to deleterious outcomes in terms of physical, mental and social well‐being. Despite approaches to driving cessation being developed, their integration into ongoing geriatric clinical practice has been slow. Methods: Health‐care providers were surveyed about their impressions of the barriers and facilitators to implementing a driving cessation intervention as part of regular clinical services. Methods of funding the intervention were queried. Surveys were sent via professional listserves and a snowballing strategy employed. Twenty‐nine completed surveys were analysed by content analysis. Results: Participants identified that an understanding of driving cessation and optimal driving cessation supports was required. They identified four key approaches to support the implementation of driving cessation support: the need to consider complexity and emotional support needs in clinical contexts; knowing and showing the outcomes by clearly communicating the benefits and values to different stakeholders; managing systemic barriers included workforce issues, funding models and efforts required for initiating and sustaining an intervention; and not doing it alone, but instead developing processes supports to collaboratively provide access to programs. Conclusions: The current study reveals a recognition of unmet needs of older persons and families regarding driving cessation as well as signalling service delivery, costing and workforce needs which act as barriers. [ABSTRACT FROM AUTHOR]

The present study aimed to quantify the perceived needs and adequacy of realised access to post-acute services in a sample of people with acquired brain injury in the first 6-months after discharge from inpatient rehabilitation. A secondary focus was the influence of access to funding and specialist transitional rehabilitation on unmet needs. Participants were 51 adults with a median age of 50 (IQR 35–57) recruited from an inpatient rehabilitation unit in an Australian tertiary hospital. The sample was those who had an acquired brain injury, including 23 who sustained a traumatic injury and 28 who sustained a non-traumatic injury. Measures were collected via telephone at 3- and 6-months, in a prospective observational cohort design using the Needs and Provisions Complexity Scale. A series of logistic regression models were used to determine the effects of participation in a transitional rehabilitation program and funding pathway on adequacy and unmet needs. Unmet needs for rehabilitation were most commonly reported (60%), followed by unmet needs in relation to health care (40%), social care (35%), personal care (32%) and environment-related (14%). Participants who attended transitional rehabilitation were more likely to indicate unmet health care needs (OR = 6.40, 95% CI = 1.40–29.24, p = 0.02). The study highlights the need to look beyond functional impairment when conceptualising appropriate access. Additionally, the present research highlighted the need for greater work into an expectation of services. The majority of people with an acquired brain injury report unmet needs at 6 months post discharge. Present findings support the utility of patient reported measures when considering treatment evaluation with people with ABI, where assessing the personal appraisal of individuals needs may prove to be a key indicator to facilitate optimal service access. There are specific services that needed and not provided including psychological, speech pathology, family carer needs and vocational rehabilitation, and therefore are a key target for ensuring appropriate support is provided. [ABSTRACT FROM AUTHOR]

Background and Aims: Assistive technology services and devices support the participation and inclusion of people living with disability. In Australia, the regulatory bodies, agencies and schemes that manage assistive technology provision are governed by national and / or state-based Acts and Legislation. This study examined the assistive technology sector from the perspective of the regulatory bodies, agencies and schemes. Design and Methods: Regulatory bodies, agencies and schemes that manage funding for assistive technology in Australia were identified by the research team. A website audit reviewed publicly available documents and information. Semi-structured interviews with representatives from the agencies and schemes were audio-recorded and transcribed verbatim. Findings: The audit (n =17) found that the range and level of information publicly available was variable. The availability of assistive technology for driving and transport, design and building for access and safety, and mobility was most often promoted. The qualitative findings (n = 11) indicated variability and challenges within four themes: operationalising the legislation ; internal assistive technology processes; reasonable and necessary; and risks in the assistive technology pathway. Conclusions: Regulatory bodies, agencies and schemes are critical to the effectiveness of the sector. The findings identified opportunities for the organisations to review how internal processes are communicated publicly, and for the sector to address the perceived risks related to health professional availability, knowledge and skills, and limited accessibility to trial assistive technology. Subsequent studies explored the perspectives of the assistive technology advisors and suppliers and the recipients of assistive technology services and devices. [ABSTRACT FROM AUTHOR]

There is minimal understanding of how people with mild stroke experience health services. With recent acknowledgement of the difficulties this population faces, it is imperative that their views are sought on services required to meet their needs. This study aimed to answer the question: 'How do people with mild stroke perceive their experience of stroke-related healthcare services?'. Qualitative investigation using an interpretative phenomenological analysis. Five participants were interviewed at 1-, 3-, and 6- months post discharge. Three themes were identified that reflected the 'essence' of healthcare service experiences: 1) The difficult diagnosis, 2) Standard care: good but not good enough, and 3) A journey better not done alone. It was clear that people with mild stroke and health professionals experienced difficulty linking symptoms to stroke. Following hospital discharge, issues relating to service coordination, information provision, and secondary prevention were identified. A formal support person appeared to increase participants' feelings of support. [ABSTRACT FROM AUTHOR]

Background driving disruptions have significant impact on individuals living with dementia, their care partners and family members. Previous studies show that for older people with dementia, stopping driving is one of the hardest things that they cope with. To date, no studies exist that address the expressed needs and experiences of people living with young onset dementia (YOD) who are adjusting to life without driving, whose needs are not well understood and whose needs might be expected to differ from those of older people with dementia. Methods a multi-perspective, qualitative descriptive phenomenological approach was undertaken. A topic guide was developed in consultation with lived experience experts. In-depth interviews (n  = 18) with 10 people with YOD and eight family caregivers were conducted, to elicit lived experiences in relation to changing and cessation of driving. Interviews were recorded and transcribed verbatim. Data were analysed using a hybrid approach, employing deductive and inductive coding. Results core findings reflected the impact and coping strategies employed by people with YOD and their care partners across four themes: (i) losses and burdens, (ii) the unique challenges of YOD, (iii) coping and adjustment and (iv) how to meet needs. Conclusions driving disruptions often come at a time when people living with YOD are likely to have significant financial and family commitments, or they/their partners may be employed or raising a family, negatively impacting individual's roles and self-identities. Intervention to support emotional and practical adjustment and reduce social isolation is essential for coping. [ABSTRACT FROM AUTHOR]

Introduction: Chronic respiratory diseases have a clear impact on occupational performance and engagement. Although occupational therapists have long provided services to this population, evidence regarding the unique role and true impact of occupational therapy is emerging. Aims/objectives: The purpose of this scoping review was to explore the range, context, and outcomes of occupational therapy services for adults with chronic respiratory conditions. Methods: A scoping review guided by the methodological framework of Arksey and O'Malley was completed. To be included articles needed to be peer reviewed primary studies published in English between 2000 and September 2022 describing occupational therapy service delivery for people with chronic respiratory conditions. Results: Twenty‐six articles met inclusion criteria including 12 cohort studies, seven randomised control trials, four qualitative, two case reports, and one service evaluation. Interventions were targeted at body functions and structures (n = 18), activities and participation (n = 17), and environmental factors (n = 14). Ten studies reported impacts of occupational therapy ranging from physiological responses through to quality of life. Conclusion: Occupational therapy service delivery is common for this population, often occurring as part of multidisciplinary programs, and is inclusive of a range of assessments and interventions. Further details in future primary research are needed to describe the mode and unique occupational nature of service delivery. [ABSTRACT FROM AUTHOR]

Decreased participation and life satisfaction are common post-stroke. Exploratory studies have indicated associations between these outcomes and personal factors. Information remains limited and experiences of people with stroke are not well-represented or understood. The aim of this study was to explore how personal factors influence experiences of participation and life satisfaction for people with stroke living in the community. Qualitative in-depth semi-structured interviews were conducted with eight participants living in the community post-stroke, chosen purposively based on participation and life satisfaction levels. Data were interrogated using interpretative phenomenological analysis. Three themes were identified: (1) What does participation mean to me? (2) Looking forward or looking back, and (3) Appraisals, avoidance, and "getting on with it". The first acknowledged the multifaceted nature of participation, although it was typically viewed as incorporating active involvement and social interaction. The additional two themes explored impacts of pre/post-stroke self-discrepancies and threat appraisals on participation and life satisfaction outcomes. Relationships between participation and personal factors seem to be bidirectional. Life satisfaction appeared to be influenced by rumination on negative self-discrepancies based on difference in pre/post-stroke participation. Findings suggest there may be value in examining the influence of personal factor-related interventions on post-stroke outcomes. [ABSTRACT FROM AUTHOR]

The quality of the academic workforce is influenced by multi-level interactionist factors yet there is limited research into these influencing factors. To investigate relationships between individual characteristics of Australian occupational therapy academics and work-related variables. An exploratory cross-sectional online survey collected demographic data and used standardized scales including the Turnover Intention Scale, 9-item Utrecht Work Engagement Scale, Work-Life Balance Scale, Role Overload Scale and Self-Defined Burnout Scale. Data were analysed using descriptive and inferential statistics. Academics who were more than five years in their current academic level were: significantly more likely to consider leaving their job; more often frustrated when not given opportunity to achieve their work-related goals; and less engaged. Those who had worked in higher education for longer than ten years were more likely to report role overload while participants working in higher education for less than five years were less likely to report burnout. To meet current and future demand for Australian occupational therapists, an engaged and supported academic workforce is needed. These findings suggest the need for attention to mentoring and career development particularly for those in academic levels longer than five years to increase work engagement and retention. [ABSTRACT FROM AUTHOR]

The article explores the evolution and challenges of co-design, emphasizing that current practices often deviate from its original principles of participatory, user-centered design. Topics discussed include the historical roots of co-design, the dilution of its principles in practice, and the need for genuine collaboration to enhance outcomes in disability and healthcare settings.

Internationally recognized best practice care in the early management and rehabilitation of individuals following stroke includes multidisciplinary assessment and treatment by a coordinated team of health care professionals that includes occupational therapists. Occupational therapists assess the impact of changes in motor function, sensation, coordination, visual perception, and cognition on a person′s capacity to manage daily life tasks. Intervention improves participation in meaningful roles, tasks, and activities; remediates deficits; minimizes secondary complications; and provides education and support to the patient and caregivers. Occupational therapists′ focus on independence and function, individual goal-setting, and their specialist skills in task adaptation and environmental modification underpin the profession′s contribution to the multidisciplinary stroke rehabilitation team. The aim of this paper is to provide an overview of occupational therapy practice in stroke patients.