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To summarise the range and nature of decision-making aids that guide upper limb (UL) neurorehabilitation. Our scoping review followed Arksey and O'Malley's 6-step framework. Electronic databases were systematically searched; grey literature was hand-searched. Included papers were: (1) published in English; (2) related to UL rehabilitation for people with upper motor neuron conditions; and (3) provided a description of, or research on, a decision-making aid that guides therapists when choosing between two or more intervention approaches, techniques, or applications of a technique. Levels of evidence were rated. An expert panel of occupational therapists working in UL neurorehabilitation was consulted. The 24 included articles described 15 decision-making aids with varying breadth and depth of the assessment process and suggested interventions. Six aids had published research, but lacked high quality evidence. The expert panel identified four key decision-making aids as being clinically useful. Preferred aids either included client-centred goal-setting within a holistic assessment or matched specific intervention options to distinct UL assessment results. Prompts to re-evaluate client performance are desirable. Few decision-making aids guide therapists to holistically assess and make specific intervention decisions across all domains of UL neurorehabilitation. Their usefulness depends on the purpose, setting, and therapist experience. Considering the complexity and heterogeneity of upper limb (UL) neurorehabilitation, a selection of evidence-based and purpose-designed decision-making aids may assist therapists across different experience levels and practice settings to choose individualised interventions. Decision-making aids for UL interventions in neurorehabilitation may be more clinically useful if they include a holistic and client-centred information gathering process that focuses on daily life goals. Decision-making aids should illustrate a clear clinical picture based on UL assessment results, with corresponding UL intervention recommendations provided. Inclusion of a cyclic process to re-evaluate client performance and function could also enhance the usefulness of a decision-making aid. [ABSTRACT FROM AUTHOR]

Introduction: Evidence‐based practice (EBP) is a critical framework for supporting clinical decision‐making that has been increasingly promoted in occupational therapy over the last 20 years. Discipline‐specific EBP frameworks and resources have emerged, primarily created by scholars from developed countries. However, EBP has received limited attention in literature published in developing and non‐English speaking countries. This study aimed to explore Chilean occupational therapists' perceptions of EBP, factors influencing the adoption of EBP and sources of information used to inform clinical decision‐making. Methods: A cross‐sectional online survey of Chilean occupational therapists included socio‐demographic information, closed questions using a fivepoint Likert scale and open‐ended questions. Numerical data were summarised using frequencies and percentages. Cross‐tabulations explored relationships between variables. Narrative data from openended responses were analysed deductively using content analysis. Results: Complete surveys were returned by 192 Chilean respondents. The majority of participants (68.3%) defined EBP as the use of research knowledge only and perceived EBP as useful and important. The most significant barriers to the application of research knowledge included: lack of time (68.2%), an emerging research culture (67.7%) and restricted access to scientific literature (56.8%). Additionally, Chilean occupational therapists did not feel confident finding, appraising and integrating research evidence. Of the four sources of knowledge used in EBP, participants predominantly relied on clinical observations of clients (99.5%), their clinical expertise (89.1%), and discussions with the multidisciplinary team (78.1%) and other occupational therapists (40.1%), to inform clinical decision‐making. Conclusion: Language barriers, lack of time, scarcity of locally produced research, and an emergent research culture within Chile impede occupational therapists' ability to implement EBP. The adoption of EBP can facilitate access to contemporary occupational therapy knowledge powerfully guide clinical reasoning, and build local research capacity. Building research partnerships and collaborations with the international scientific community are crucial to the global achievement of EBP. [ABSTRACT FROM AUTHOR]

Introduction: The Student Practice Evaluation Form—Revised Edition (SPEF‐R) is used by all Australian universities to assess the capability and performance of occupational therapy students on block practice placements. The occupational therapy landscape in Australia has evolved significantly since the SPEF‐R was developed. This study aimed to review the SPEF‐R and develop a revised edition, the SPEF‐R2. Methods: The first cycle of an action research process involved four phases: (a) mapping the SPEF‐R to the Australian Occupational Therapy Competency Standards 2018 (AOTCS); (b) development of the SPEF‐R2; (c) national consultation through an online survey with clinicians, university staff and students; and (d) reflection and further amendments. Results: In phase 1, good alignment was found between the AOTCS 2018 and the SPEF‐R. In phase 2, the SPEF‐R2 was developed to further enhance alignment, including expanded content related to culturally responsive practice, reflective practice and clinical/professional reasoning, resulting in two items being added to the tool. Further wording adjustments were made to improve clarity, reduce duplication and improve relevance to the contemporary occupational therapy landscape. In phase 3, survey results indicated that the SPEF‐R2 was well received overall, with most participants viewing it as an improvement on the SPEF‐R. Cultural content and reflective practice additions in particular received positive feedback. Concerns were raised by some participants, including perceived repetition, the length of the tool and time required for completion, and addressed by further amendments in phase 4. Three items were removed or consolidated elsewhere, and three items became core items. Conclusion: The Australian occupational therapy community considers the SPEF‐R2 to be a timely and much‐needed development. Piloting of the SPEF‐R2 and final revisions prior to release are planned for subsequent action cycles and amendments will be made to the online platform and associated training resources. [ABSTRACT FROM AUTHOR]

Introduction: Newly graduated occupational therapists face well‐documented difficulties as they embark on professional practice. Occupational therapy departments need to ensure that new graduates conduct their roles appropriately while developing experience and building clinical and professional skills. This study aimed to explore the experiences of new graduates at a major Australian metropolitan hospital occupational therapy department, the support provided to them and their perceptions of this support. Methods: The research design was Interpretive Description. Semi‐structured interviews of approximately 60 min were undertaken with seven occupational therapists, their team leader and the Departmental Head. The two research questions were as follows: What were the graduates' experiences of their first year in practice? What support was provided to graduates and what were their perceptions of this? Results: New graduates perceived the transition to practice as overwhelming, particularly regarding their caseload responsibility. During the first few months, work tasks took them longer and they felt stressed and anxious. They received a range of support and education, both inter‐professional and discipline specific. Their occupational therapy team leader and clinical senior provided tailored support, guidance and reassurance. Guided questioning facilitated development of new graduates' clinical reasoning and professional skills. Reflection helped them to identify and address learning goals relating to occupational therapy professional competencies. New graduates valued having a consistent caseload and a supportive workplace was highly valued. Conclusion: New graduates initially feel overwhelmed by being responsible for their decisions. However, they can benefit from tailored supervision and guided questioning to help develop clinical reasoning and professional skills, formal and informal support from experienced occupational therapists and their inter‐professional teams and time to increase skill with their caseload. Engagement in a professional community of practice is important. [ABSTRACT FROM AUTHOR]

Occupational therapists implicitly rely on tacit knowledge to inform the strategies they use to engage children and parents in a therapy session. Objective: To identify strategies occupational therapists use in a therapy session to engage children and parents. Methods: A qualitative approach was employed using interpretive description methodology. This involved seven therapy session observations with six occupational therapists (involving child, parent and therapist) and a key informant interview with the therapist after each session. Thematic analysis was undertaken. Results: Two themes emerged. (a) 'Engaging the child' included 'building a connection', 'attending to feelings', 'thoughts and behaviours', 'structuring or designing the session', 'giving choice and respecting their choice', 'use of self', 'helping the child feel success' and 'helping the child understand and explore'. (b) 'Engaging the parent' included 'connecting', 'listening', 'explaining', 'demonstrating anddiscussing', 'including the parent and valuing their input' and 'collaborating'. Conclusions: The strategies therapists used to engage children and families can be mapped with autonomy, relatedness‐ and competence‐supportive strategies of Self‐Determination Theory. Therapist attunement and responsiveness to the child as well as collaboration with the parent were strategies that represented all aspects of SDT. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to understand parent engagement and disengagement in the delivery of occupational therapy to their children. Methods: This study used a qualitative interpretive description methodology. Focus groups and individual interviews were employed. Thirty-two occupational therapists participated in focusgroups or one-on-one interviews. Thematic analysis was used to analyse the data. Results: Thematic analysis of the data revealed two overarching themes which influenced parent engagement and disengagement in therapy: (1) Parent-therapist relationship and; (2) Therapist responsiveness. Within these two themes: parent feelings; time and timing of therapy; levels of engagement and factors influencing parent engagement were evident. Conclusions: Findings contribute to understanding parent engagement and disengagement in therapy. The findings extend current models of therapeutic engagement in occupational therapy informed by self-determination theory (SDT). Autonomy-, relatedness- and competence-supportive SDT strategies to enhance parent engagement in therapy are described. Occupational therapists reported that parents experience a range of feelings when engaged and disengaged in therapy. These feelings related to hopelessness, having confidence in the therapist and feeling supported, validated and empowered. Parent engagement and disengagement in therapy was described by occupational therapists as occurring at different levels: when it works well (engaged); engaged in the idea of therapy but not engaged in the doing of therapy (middle ground engagement); and when it doesn't work well (disengagement). Occupational therapists reported the importance of being aware of how the factor of time and family, service and therapist characteristics can variously impact parent engagement in therapy. Occupational therapists focus on the parent-therapist relationship and being responsive to parent needs and feelings when engaging parents in therapy. Occupational therapists can draw on principles from self-determination theory to guide them regarding the selection of strategies to engage parents in therapy. [ABSTRACT FROM AUTHOR]

Background.: Achieving optimal outcomes for children in occupational therapy settings is influenced, in part, by their engagement. The nature of child engagement from the occupational therapy perspective remains relatively unexplored. Method.: A qualitative research methodology was adopted, using an interpretive description approach. Thirty-two occupational therapists participated in five focus groups and six individual interviews that were thematically analyzed. Findings.: Four themes emerged from the data: (i) signs of child engagement and disengagement; (ii) it's about the child feeling safe; (iii) a sense of meaning and purpose; and (iv) service and therapist factors influencing child engagement. Implications.: Helping the child feel safe; providing meaningful experiences; and being flexible and responsive were key means of connecting with, and supporting, child engagement. Strategies occupational therapists reportedly used to engage the child aligned with the tenets of self-determination theory (autonomy, relatedness, and competence). [ABSTRACT FROM AUTHOR]

Introduction: The facilitation of meaningful leisure participation for children and young people requires an understanding of what leisure means to them. This study aimed to understand meaningful leisure from the perspective of children and young people with complex physical and communication disabilities. Method: A hermeneutic phenomenological research design was used. Data was gathered through multiple interviews with six young people supported by photo elicitation, Talking Mats and direct observation. Individual case studies were analysed, together with six autobiographies of people with similar disabilities. Data analysis was iterative and multi-directional, alternating between segments and the whole throughout interpretation. Results: Leisure experience meanings were uniquely constructed for each person, based on preferences, personality and circumstances. The tree of leisure emerged as a useful metaphor for three essential features (control, engrossing, enjoyment) and four key meanings (escape, exploration, exchange and expression) of leisure. Children and young people experienced five meaningful outcomes that lasted beyond the leisure activity (restoration, protection, construction, reflection and connection). Conclusion: For children and young people with disabilities, a balanced array of diverse leisure experiences provides a powerful and accessible route to wellbeing. Implications for practice include understanding the individual, focusing on the social environment, supporting self-advocacy and promoting opportunities for free movement. [ABSTRACT FROM AUTHOR]