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Introduction: COVID-19-related restrictions resulted in changes to time use and occupational participation, impacting individual and collective well-being. This study addressed a knowledge gap concerning the adaptive process during periods of occupational disruption. We explored the experience of occupational disruption and how people managed disruption during the COVID-19 pandemic., Methods: We used a qualitative descriptive approach and interviewed 18 participants of a larger survey study of time use during the COVID-19 pandemic undertaken around a medium-sized city in Canada. Transcript analysis was conducted inductively using conventional content analysis., Findings: Two overarching themes were constructed during data analysis: The Disruption Experience and Adopting New Habits and Routines . In the face of disruption, participants described a sense of loss and disconnection, and challenges with time management. Establishing new habits and routines required new learning associated with increased time and flexibility, connecting with others and health and wellness., Conclusion: During changing pandemic restrictions, participants expressed a sense of loss, disconnection and time management challenges associated with occupational disruptions, but also described ways they adapted, improving their health and well-being. Strategies identified through this work may be used to enhance adaptation during disruptions. Future research should explore differences in adaptation, among more diverse populations., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background. The Canadian Occupational Performance Measure (COPM) assists occupational therapists to identify occupational performance problems using a client-centred approach. Since its first publication in 1991, there has been abundant evidence of the ability of the COPM to detect a statistically significant difference as an outcome measure. There has also been a tacit understanding that a difference of 2 points from pre-test to post-test on either Performance or Satisfaction COPM score represents a clinically significant difference. There is however, some confusion about the origins of this claim. Purpose. To ascertain empirical evidence for the claim that a clinically significant difference is a change score ≥2 points. Method. We conducted a scoping review of peer-reviewed literature (1991-2020) for intervention studies using the COPM as an outcome measure and examined intervention type and change scores. Findings. One hundred studies were identified. The COPM was used to assess effectiveness of eight types of occupational therapy interventions. The common belief, however, was not empirically supported that clinical significance can be asserted on the basis of a two-point change in COPM scores. Implications. Further research is needed to test alternative approaches to asserting clinical significance or a minimal clinically important difference.

Background: Wheelchairs, scooters, and related equipment are essential for the well-being of individuals with limited mobility and impact participation, health, and quality of life., Purpose: Our objective was to identify and evaluate policies governing equipment funding for Canadian adults. We reviewed funding legislation and program documentation for adult Canadians (≥18 years of age) covered by their provincial, territorial, or federal health care plan. Documents were obtained online or through administrative staff. Policy evaluation was guided by the Disability Policy Lens from the Canadian Disability Policy Alliance., Key Issues: Coverage ranges from full funding for all individuals within the jurisdiction to programs limited by strict eligibility criteria. Each jurisdiction defines "disability" or "basic/essential need" differently, contributing to further funding disparities., Implications: Funding policies differ substantially across Canada, resulting in unequal access to equipment dependent on province or territory. We identified eligibility, funding, definitions of mobility, repair and replacement, and prescriber requirement benchmarks that represent policy targets for improved access.

This study is a scoping review of 21 years of international occupational therapy literature. Its purpose is to identify and describe interventions used by occupational therapists to enable self-care, productivity, and leisure. The scoping review produced 59 articles published between 1990 and 2010. Nine articles evaluated the effectiveness of occupational therapy interventions focused on leisure outcomes, 21 on productivity outcomes, and 29 on self-care outcomes. The programs were classified according to eight types of interventions: training, education, skill development, task adaptation, occupational development, environmental modification, support provision, and support enhancement. Most studies produced at least one significant positive result (82%), indicating that occupational therapy programs were at least partially successful in improving self-care, productivity, or leisure. There is good evidence for task adaptation, training, and skill development interventions, and for the role of occupational therapy in multi-disciplinary teams., (Copyright 2013, SLACK Incorporated.)

Background: An underlying premise of occupational science and occupational therapy is that humans do better with a balanced lifestyle. What life balance means, how to design it, and to recognize when one has it have not been defined., Purpose: Our intention is to offer another perspective on life balance, one that we believe is at the root of what the term means., Key Issues: We suggest the notion underlying life balance is the extent to which a person designs and lives in integrity with his or her own personal values, strengths and what has meaning for them. The term we propose is occupational integrity and that it be regarded as an essential precondition to life balance., Implications: Occupational integrity expands the focus of therapy beyond "doing" to interventions at the level of the person and identity, helping clients to identify their strengths, values and purpose, what is meaningful and satisfying for them, and then designing and living their lives in congruence with that.

Background: What does it mean to focus on the spiritual in occupational therapy? What interventions would qualify as spiritual modalities? This paper attempts to define the boundaries of what may be considered legitimate uses of spirituality in occupational therapy by using the example of prayer., Purpose: The purpose of this paper was to provide an in-depth analysis of the use of prayer in practice., Method: Medical and allied health journals were searched using the terms spirituality, spirit, religion, and prayer. Identified articles were synthesized to identify potential advantages and disadvantages of using prayer in therapy., Findings: Prayer can be considered an appropriate occupational therapy intervention so long as four questions can be answered positively., Implications: To answer these questions, guidelines are provided that will lead the therapist through a decision making process to determine the appropriateness of incorporating prayer into any clinical situation.

Background: The Canadian Occupational Performance Measure (COPM) is an outcome measure designed to assess performance and satisfaction with occupation. It was developed to coincide with the occupation-focused, client-centred Canadian Model of Occupational Performance., Purpose: The COPM has been a feature of the occupational therapy landscape for approximately 15 years and has pervaded the consciousness of occupational therapists around the world. In this paper, we examine issues associated with application of the COPM in targeted clinical and non-clinical situations., Results: The paper suggests considerations required to ensure that the highest quality of information is derived from the COPM in all situations., Practice Implications: Although the paper emphasizes the centrality of the client-centred approach, it also demonstrates the flexibility and adaptability of the COPM to different situations, clients, settings and purposes.

Background: There has been an increased focus on home care service provision in recent years, yet there are few data available about the provision of home and community occupational therapy for children and youth., Purpose: To evaluate key elements of a service provision model for home care occupational therapy in terms of occupational performance outcomes, perception of care and cost., Methods: Eleven centres in Ontario and Quebec recruited 167 children and youth up to 18 years of age to a before and after study of occupational therapy services in the home and community. Occupational performance, quality of life and costs were measured at baseline and study end. Perception of care was measured at study completion., Results: A statistically and clinically significant improvement in occupational performance was demonstrated (p < 0.001). The clients' families gave high ratings to the process of care provided by the occupational therapists. These data did not demonstrate a clear relationship between amount of service, cost and occupational performance outcome., Practice Implications: Children receiving home and community occupational therapy services change in their occupational performance abilities. These changes are not directly related to the amount or focus of the occupational therapy services.

Background: It has been 13 years since the Canadian Occupational Performance Measure (COPM) was published. In that time there has been a remarkable growth in its acceptance as an outcome measure within the occupational therapy practice and research., Purpose: The purpose of this paper is to review the emerging research and clinical literature related to the COPM since 1994 and to document its impact upon occupational therapy practice and research throughout the world., Method: A systematic search was conducted to the professional and research literature in English publications (primarily occupational therapy). Eighty-eight papers that met the inclusion criteria were reviewed, 86% of which examined the COPM in relation to its psychometric properties (19 papers), research outcomes (33 papers) or practice (33 papers)., Results: Overall, although there are a few limitations discussed in the review, the conclusion is that the COPM is a valid, reliable, clinically useful and responsive outcome measure acceptable for occupational therapist practitioners and researchers., Practice Implications: The COPM is used with a wide variety of clients, enables client-centred practice, facilitates evidence-based practice and supports outcomes research.

Background: This study explored the perceptions and experiences of teenagers with physical disabilities attending regular secondary schools. In particular, the study focused on social integration and the factors that influenced it. Social integration was defined as a sense of belonging in the school community., Methods: A phenomenological approach was used to explore the viewpoint of physically disabled young people themselves. Seven secondary school students with ambulation disabilities were interviewed using a semi-structured interview guide., Results: The findings identified both factors that facilitated and those that limited integration. Extrinsic factors included peer and staff support, negative reactions and inaccessible activities. Intrinsic factors included the disability itself, as well as strategies of self-exclusion, masking the disability, finding a niche, making fun of the disability, and educating peers. Interpretation of the findings suggested that the participants occupied a secondary place in their schools, as opposed to being fully integrated., Practice Implications: Occupational therapists have the opportunity, expertise and responsibility to be instrumental in the process of ensuring that schools are inclusive and that their young clients are capable of participating fully.