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101 Relations found, displaying 1 to 50.
Occupational performance for occupational therapists in champion and coach roles
Day: Friday,  Time: 09:00-09:25, Session: F23

Introduction: Occupational Therapists (OTs) may assume leadership roles as clinical champions and coaches across several practice settings and populations. Research, client safety and clinical education programs may recruit OTs as the essential competencies of occupational therapy practice (ACOTRO, 2011) align with champion and coach roles and responsibilities (Soo, Berta & Baker, 2009). However, the reviewed literature has not examined the perspectives of OTs on occupational performance for champion and coach roles. Formal examination of these perspectives may enable occupational performance by identifying person, environment and occupation factors influencing role performance.

Objectives: Identify key roles and responsibilities for clinical champions and coaches. Establish relevance to the essential competencies of occupational therapy practice. Explore role performance factors for champions and coaches based on real – life experiences by OTs. Suggest directives for further qualitative research.

Approach: Literature review summarized research on conceptual frameworks for clinical champions and coaches. Narrative approach elicited the lived experiences of two (2) OTs with senior roles as a champion for a Cognitive Orientation to daily Occupational Performance Approach program and as a Falls Safety Coach in a rehabilitation hospital. The Theory of Environmental Press (Lawton, 1985) was referenced to illustrate how person, environment and interactional factors influenced role performance.

Results: Critical perspectives on person, environment and occupation factors influencing champion and coach roles performance were identified. Recommendations for enabling role performance were identified at several levels: champion; program manager; and executive sponsor.

Conclusions: Role performance factors are fundamental for enabling occupational performance for clinical champions and coaches.


Richard Kellowan & Meridith McClenaghan
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Development of a Mental Health Program for Immigrant Youth
Day: Friday,  Time: 08:30-08:55, Session: F13

Introduction: Children and youth in immigrant families face a unique intersection of challenges to their mental health: social alienation, discrimination, economic deprivation, and conflicting expectations from parents and peers – a so-called “perfect storm”. Add to this the fact that they are functioning in an environment that neither they nor their parents have the knowledge or skills to navigate, and the risk for mental illness increases many-fold. Our research group has developed a program called ‘Living Well’ to promote mental health among adult immigrants. We are aiming to revise the program for immigrant youth. Objectives: In this study, we will conduct 4 focus groups and 7 interviews to explore youth immigrants’ knowledge gaps and existing strategies that need to be considered in supporting the mental health literacy of immigrants. We will also explore aspects of the adult ‘Living Well’ program that are required to be adapted to the culture and age-specific needs of immigrant youth. The data will be collected from youth immigrants (13 to 18 years old), their parents, young immigrants (19 to 24 years old), and representatives from the local and provincial immigrant settlement organizations that regularly provide youth immigrant programs. Conclusion: During this ongoing funded project, we will build knowledge to improve the mental health of immigrant youth by including perspectives of different stakeholders.

Setareh Ghahari, Libby Alexander
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Bridging the gap in pediatric wheelchair skills testing and training
Day: Friday,  Time: 16:00-16:25, Session: F102

Introduction. The majority of young wheelchair users are dependant on a caregiver for everyday mobility, despite availability of the Wheelchair Skills Program (WSP), a ‘gold standard’ wheelchair skills testing and training program (www.wheelchairskillsprogram.ca). Given the suboptimal integration of the WSP into occupational therapy practice and the fact that wheelchair skills training is not systematically provided in pediatric rehabilitation, development of a context-specific knowledge translation (KT) intervention is warranted. Objective. To develop a WSP KT intervention adapted to the pediatric rehabilitation context. Methods. This in-progress mixed methods study, being conducted in a pediatric rehabilitation centre, is guided by phases 1-4 of the Knowledge-to-Action framework. Participants of relevant stakeholders’ groups (wheelchair users, occupational therapists, program managers and health insurance representatives) are completing questionnaires and participating in focus groups and qualitative interviews. These data will be analysed using the Consolidated Framework for Implementation Research. Results. Study findings will document the current pediatric wheelchair skills training practice, propose pediatric-sensitive considerations for the WSP, and present barriers and facilitators to WSP use in the pediatric context. The development of a pediatric-sensitive WSP KT intervention will be based upon these results and existing relevant literature. Conclusion. With the aim of integrating evidence into occupational therapy practice, development of the pediatric-sensitive WSP KT intervention will guide change in practice at the study site and may also inform other centers who wish to improve practice in this area or practice.

Daoust G., Rushton PW., Demers L.
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Répertoire d'interventions efficaces auprès des personnes atteintes de démence
Day: Friday,  Time: 13:00-13:25, Session: F50

Introduction : Les démences affectent 7,1% des Canadiens (Agence de la santé publique du Canada, 2017) et sont accompagnées dans une proportion de 40 à 60% de symptômes comportementaux et psychologiques (SCPD) (MSSS, 2014). Ceux-ci, tels que l’errance, l’agressivité et l’agitation entraînent de nombreuses conséquences pour la personne, son entourage ainsi que pour le personnel soignant. Travers et coll. (2016), dans une revue systématique, font une synthèse de l’efficacité des interventions basées sur les occupations signifiantes aidant à diminuer les SCPD. Depuis, de nombreuses études viennent compléter le répertoire d’interventions efficaces. Objectifs : Exposer le répertoire des différentes interventions de l’ergothérapeute dans la gestion des SCPD en fonction de leur efficacité. Méthodologie : Une recension des écrits a été effectuée dans les bases de données suivantes : Cinahl, Medline, PsycInfo, Scopus, Cochrane Library et a conduit à l’appréciation critique de 37 articles scientifiques. Résultats : Les interventions telles que les activités structurées et adaptées, la modification de l’environnement, les interventions sensorielles, les activités physiques, les contacts sociaux et les interventions comportementales montrent de bons niveaux d’évidence pour confirmer l’efficacité à réduire la fréquence des problématiques de comportement. Conclusion : La connaissance des interventions efficaces pour gérer les symptômes est un incontournable afin que les ergothérapeutes adoptent de bonnes pratiques auprès des personnes âgées. Des pistes de recherche seront suggérées.

Julie Lahaie, Martine Brousseau
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Healthcare Students’ Knowledge, Attitudes, and Behavioural Responses Towards Mental Illnesses
Day: Friday,  Time: 14:30-14:55, Session: F85

Introduction: The knowledge, behaviours, and attitudes that many health professionals hold towards individuals with mental illnesses, shape the quality of care that they receive. Mental illness stigma can contribute to why people delay in help­-seeking, discontinue treatment, or have compromised therapeutic relationships with their healthcare providers. By understanding the views and conceptions of mental illnesses from future healthcare professionals, we can work to determine the necessary imminent steps to diminish potential mental illness stigma in the healthcare system. Objectives: The aim of this study is to improve the overall understanding of the knowledge, attitudes, and behavioural responses that healthcare students hold towards mental illnesses through an in­depth qualitative inquiry. Methods: Using purposeful sampling, eighteen students from nine healthcare programs at a Canadian University were recruited to participate in one­hour, individual, and semi­structured interviews. Participants were asked questions regarding their knowledge, attitudes, and behavioural responses towards individuals with mental illnesses. The thematic content analysis approach is used to guide the data analysis. Results: A variety of themes are expected to emerge from the data and will be reported on at the conference. Conclusions: This project uses qualitative interviews to understand the knowledge, attitudes, and behavioural responses of healthcare students towards individuals with mental illnesses. The study results can help to improve our understanding of the stigmatizing attitudes towards mental illnesses in the healthcare system and can contribute to shaping the mental health education that pre-­healthcare professionals receive.

Taylor Riffel, Shu-Ping Chen
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Multi Disciplinary Collaboration in Pediatric Fieldwork Placements
Day: Friday,  Time: 14:00-14:25, Session: F73

Introduction. At a tertiary pediatric hospital, early intervention rehabilitation services offer multi-disciplinary case management, assessment and intervention to provide holistic, family-centred care to patients and their families. However, occupational therapy and physical therapy student fieldwork placements operate in a single discipline model that is not reflective of multi-disciplinary rehabilitation programs and limits opportunities for students to develop competencies in multi-disciplinary collaboration. Objectives. Develop fieldwork placements to meet both the discipline specific fieldwork goals and provide opportunities to learn alongside their multidisciplinary student colleagues while providing early intervention rehabilitation services. Approach. Building on an established student led program, this poster details the process of program evaluation and stakeholder consultation where the site developed multidisciplinary, peer based, learning opportunities for occupational and physical therapy students. Practice Implications or Results. This fieldwork placement provided opportunities for students to refine their knowledge of their own discipline, learn more about the roles and scope of other disciplines and practice family-centred, team based care in a supportive learner environment. Occupational and physical therapy students were integrated into group programming that is typically single discipline (i.e) pool therapy, which challenged clinicians to think differently about incorporating multidisciplinary practice into group programming. Conclusions. Students and clinicians report benefits in learning about scope and roles of other disciplines and providing care in a multidisciplinary fieldwork practice setting. Additionally, this multidisciplinary fieldwork introduced occupational therapy services into new programs and groups, opening up possibilities for increased access to occupational therapy services within rehabilitation programming.

Valavaara, O'Krafka, Kingwell
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Supporting Clinical Expertise: The Experience of Joining a Well Established Community of Practice
Day: Friday,  Time: 13:30-13:55, Session: F64

Introduction
Occupational Therapists (OT) are versatile clinicians who work in a variety of clinical settings. However, OTs often have varying levels of expertise and limited opportunities to collaborate with colleagues in similar settings. The Canadian Stroke Best Practice Recommendations (CSBPR) are well established and should be implemented into Occupational Therapy practice for optimal patient outcomes, however there are limited discipline specific resources available to support this.

Objectives
Review the experience of joining an established OT community of practice focused on standardization of care and the implementation of stroke best practices for therapists who are new to the region.

Approach
An onboarding process is in place to support new OTs working in acute stroke care in Toronto. New members are provided with standardized orientation and practice resources. Face to face meetings occur on a bi-monthly basis, supplemented by online communication and practice support.

Practice Implications
Several benefits were experienced through membership in this committee. These benefits include (1) region-specific resources for processes in acute stroke care (2) a community of practice where collaboration and discussion are encouraged (3) standardized resources, grounded in best practice or clinician consensus, to be utilized in practice and (4) access to a virtual platform and CoP for further discussion to enhance professional development and support colleagues.

Conclusions
The Stroke OT Leadership Committee is an innovative method for regional support in enhancing clinical expertise and access to best practice resources

Ipshitha Anand, Michelle Mohan, Fatima Quraishi, Nicola Tahair, Elizabeth Linkewich
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Knowledge Translation: A Client-Centered Smoking Cessation Tool
Day: Friday,  Time: 09:00-09:25, Session: f21


Parisa Ghanouni, Samir Gupta, Stephanie Segovia, Laura Nimmon
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Horses in Occupational Therapy: Client and Therapist Perspectives
Day: Friday,  Time: 16:00-16:25, Session: F105

Rationale: Occupational therapists incorporate horses in rehabilitation with diverse populations across the lifespan. Strategies for utilizing horses in occupational therapy include supported riding, grooming, stable management, and animal companionship. Currently, a limited body of research indicates the physical, mental, and emotional benefits of using horses in occupational therapy. However, there is a necessity for qualitative research exploring the experiences of occupational therapists and their clients engaged in horse-related therapies. Objectives: To explore the experiences of occupational therapists and their clients involved in horse-related therapy. Methods: A phenomenological approach will be used to guide a minimum of six in-depth semi-structured interviews. Occupational therapists who use horses in practice will be interviewed, as well as clients and caregivers. Convenience sampling will inform selection of these participants within Canada. Participants will be asked to describe their experiences with horses in occupational therapy, including perceived advantages and shortcomings. Interview transcripts will be analyzed using a systematic process of coding and thematic analysis to develop overarching themes. Practice Implications: This research study provides an enriched understanding of the use of horses as a therapeutic medium in occupational therapy. Findings will enhance clinical knowledge regarding how horses can be used, and will provide insight regarding its suitability within different client populations. Conclusions: This study will advance existing knowledge by contributing client and therapist perspectives to current literature on the use of horses in occupational therapy. A holistic understanding can guide occupational therapists in considering horses as a therapeutic medium in their practice.

Daniela Kovacevic, Alanah Delaney, Sandra VanderKaay
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Predictive validity of the ScanCourse for on-road driving performance outcomes
Day: Friday,  Time: 13:30-13:55, Session: F61

Introduction: Being able to scan the environment when driving is critical for safety. The ScanCourse is a functional assessment that evaluates an individual’s ability to scan for visual information while in motion, which is similar to the task demands of driving. Some psychometric information on the ScanCourse has previously been reported (Lund, Moir, Kristalovich, & Mortenson, 2017); however, its predictive validity for driving is unknown. Assessing scanning abilities among those with neurological conditions who intend to return to driving can help identify safety risks and inform interventions. Objectives: To determine the predictive validity of the ScanCourse for on-road driving performance outcomes. Methods: Retrospective chart reviews (n=500) will be conducted at 5 Canadian driver rehabilitation programs. Demographic data, ScanCourse scores and on-road driving performance outcomes will be collected. A receiver operating characteristic (ROC) curve will be used to analyze the relationship between ScanCourse scores and on-road performance. Results: It is anticipated that the ScanCourse will have an area under the curve greater than 0.75, which indicates the ScanCourse would be an accurate predictor of on-road driving performance outcomes. ScanCourse cut-off scores determined from the ROC curve will help identify patients who may not be appropriate for an on-road assessment and may require additional assessments and interventions. Conclusions: This study will contribute to the limited body of evidence examining assessment tools for visual scanning. Establishing the predictive validity and cut-off scores of the ScanCourse will provide empirical support for its continued use in clinical practice as a diagnostic tool to assess fitness-to-drive.

Eric Chau, Adam Nishi, Lisa Kristalovich, W. Ben Mortenson
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Wearable robotic glove to optimize hand recovery following a stroke
Day: Friday,  Time: 11:00-11:25, Session: F41

Introduction: For individuals with hand hemiparesis following a stroke, engaging into intensive task-specific rehabilitation to regain optimal hand-related functional abilities and participate in every-day activities remains challenging. To overcome this problem, a new low-technology, low-cost wearable soft-robotic glove (WSRG) represents a promising solution. Objectives: 1) evaluate the design, usability, and acceptability of the prototype of the WSRG, and 2) co-create an exercise protocol to optimize neurorecovery of the hand in individuals with hand hemiparesis following a stroke. Methods: For objective 1, 15 rehabilitation professionals and 10 individuals with hand hemiparesis will participate to individual interviews during which the WSRG and its attributes will be presented. A standardized questionnaire including semi-structured questions, focusing on technology (i.e., perceived usefulness, ease of use) and its potential for implementation in clinical practice (i.e., needs, barriers, facilitators), will be completed. For objective 2, supported by the previous process, an intensive task-specific training protocol to optimize recovery of hand function during the early phase of intensive functional rehabilitation will be co-created. This protocol will be presented to and validated by 14 rehabilitation professionals and individuals with hand hemiparesis (n=7) during focus groups. Results: Results may enrich the WSRG design optimization process, confirm its usability and utility for hand rehabilitation, and lead to the creation of an exercise protocol meeting stakeholder needs. Conclusion: The WSRG may allow individuals with hand hemiparesis following a stroke to rapidly engage into intensive, task-specific hand exercise protocol. This study will inform the development of future feasibility, safety and preliminary effectiveness studies.

Proulx C, Higgins J, Klug F, Paradis P-O, Gagnon DH
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Preventive behaviours at work: an integrated theoretical model based on an occupational perspective
Day: Friday,  Time: 14:30-14:55, Session: F81

Introduction. Work is an occupation valued by billions of individuals across cultures and societies. As a determinant of health, work may have several positive effects on individuals’ well-being. However, it may also have negative effects as accidents, physical illnesses or transient mental disorders may occur. Workers’ preventive behaviours appear to be a lever of interest to foster health at work, but no clear definition does exist. The use of an occupational perspective (Njelesani, Tang, Jonsson, & Polatajko, 2014) seems a promising way to understand the characteristics of preventive behaviours at work. Objective. The aim of the study was to define those behaviours workers may adopt to foster prevention in order to understand their operational characteristics. Method. To achieve this aim, secondary qualitative analysis based on data collected during three prior studies were conducted. Results. Results allowed generating the Model of preventive behaviours at work. This model defines preventive behaviours at work as six different types of engagement toward prevention. Those engagements are realized into a context, which involves several factors related to the person, the occupation and the environment. Finally, the model proposes those engagements may lead to several positive outcomes on different health indicators. The model includes all five dimensions of the occupational perspective. Conclusion. This study demonstrated how occupational sciences may help understanding the engagement of individuals in their actions and how the doing may contribute to health, in an application related to the occupation of work.

Alexandra Lecours
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What are everyday ethical issues for Canadian occupational therapists?
Day: Friday,  Time: 11:00-11:25, Session: F36

Rationale: Canadian occupational therapists (OTs) work in a variety of practice contexts where they commit to good clinical practice and adhere to the profession's values. However, ethical issues may challenge OTs’ abilities to promote good clinical practice. Identifying and understanding the types of ethical issues faced by practicing OTs is important to ensuring that OTs are adequately prepared to address these issues and to developing appropriate ethics education. If ethical issues are misunderstood or unaddressed, they can affect quality of client care and contribute to OT moral distress, burnout and attrition from the profession. Objectives: This research study aims to 1) describe the types and prevalence of ethical issues Canadian OTs encounter and 2) determine in what practice contexts they occur. Methods: An anonymous quantitative cross-sectional survey will be disseminated to Canadian OTs. Approximately 160 Canadian OTs are anticipated to respond to the survey’s questions on demographics, types and prevalence of ethical issues encountered, and in which practice contexts these issues occurred. Practice Implications: The results of this study may be used to improve ethics education to prepare OTs and student OTs for the ethical issues that arise within specific practice contexts and respond accordingly. Conclusions: Understanding the types of ethical issues experienced by Canadian OTs is important to ensuring that OTs are well-trained to address ethical issues and to developing appropriate ethics education. This study represents a first step in characterizing the ethical issues faced by OTs across Canada.

Natalie Zizzo, Elizabeth Cruchley, Kevin Reel
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Exploring elopement through story-telling: Personalizing “The Code Yellow Man.”
Day: Friday,  Time: 08:30-08:55, Session: F10

Introduction: Story – telling is a therapeutic activity that empowers clients to share their life histories, thus enabling occupational therapists to understand how client experience influence occupational performance (Frank, 1996). . Occupational Therapists (OTs) to examine the influence of list histories on occupational performance (Frank, 1996). Occupational Therapists may employ story – telling to identify the means, mechanisms and motivations for chronic elopement in clients with cognitive impairment. This may personalize Code Yellow responses to focus on least – restraint and occupation – based interventions.

Objectives: Poster examined story – telling approaches for elopement management from an Occupational Therapy (OT) perspective. Poster linked theoretical, ethical, and contemporary professional issues to guide clinical practice.

Approach: Literature review summarized life history assessment methods in OT. Case report identified outcomes of story – telling for chronic elopement management with a 61 year-old Indigenous man. Discussion linked outcomes with: professional standards for OT assessment, consent and documentation; the four pillars of medical ethics; and “calls to action” from the Truth and Reconciliation Commission (TRC, 2015). Narrative clinical reasoning elicited therapist reflections on three themes: care versus coercion; autonomy versus authority; and personalizing patients.

Results: Story – telling fostered active client participation in exploring elopement behaviours and facilitated a comprehensive behavioural management plan for clinical staff. Occurrence and duration of elopement incidents were reduced, and discharge barriers due to elopement behaviours were addressed. Implications for “personalizing” Code Yellow responses were identified on micro- and macro- institutional levels.

Conclusions: Story – telling is a client-centred OT approach for chronic elopement management that requires careful and conscious clinical reasoning by clinicians.

Richard Kellowan & Meridith McClenaghan
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'Ms-Understandings'? : Troubling Stereotypical Assumptions of Older Single Women
Day: Friday,  Time: 11:00-11:25, Session: F40

‘Ms-Understandings’? : Troubling Stereotypical Assumptions of Older Single Women
Rationale
More Canadians are living ‘single’ than ever before, but singleness for women remains a stigmatized and marginalized position. In occupational therapy, single women stereotypes (e.g., lonely, sad, and vulnerable) have not been problematized as a gendered phenomenon with concomitant political and ideological dimensions that play out at interactional and systems levels. Drawing on findings from completed doctoral research that explored the identity negotiation strategies of older single women, previously unexplored aspects of the social dynamics around singleness for women are outlined.
Objectives
To examine the talk of older life-long single women for the range of interpretive resources drawn upon and how those resources were employed in singleness identity negotiation.
Approach
Using discourse analysis, talk data from repeat interviews with four women was examined for patterns in the resources drawn upon and how those resources were employed.
Results: Singleness talk was strongly polarized into two repertoires: the ‘deficit’ (failure, loneliness) repertoire that undermined the relatively weak ‘singleness-as-freedom’ (to do and be) repertoire. Deficit discourses were strongly refuted, but positive claims about singlehood were weakly upheld. Identity negotiation strategies included distancing from the category ‘single’, and using rhetorical maneuvers to close down conversations, rendering singleness an invisible identity.
Conclusions:
The study demonstrates that singleness for older women is an identity of difference and a ‘troubled’ identity (i.e. difficult to be aligned with), thus exposing a previously unidentified equity and social justice ‘blind-spot’ within OT.
Abstract Summary (50 words)
An unprecedented numbers of Canadians today are ‘single’, yet in occupational therapy, older single women stereotypes (e.g., lonely, sad, and vulnerable) are commonly assumed and not questioned. Drawing on findings from doctoral research that explored the identity negotiation strategies of older single women, OT’s are invited to re-evaluate existing ‘Ms-Understandings’.

Rona M Macdonald & Pia Kontos
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Flow in older adults: Observation as an alternative to self-report
Day: Friday,  Time: 11:00-11:25, Session: F38

Introduction: Engagement in activities is important across one’s lifespan and positively impacts perceived quality of life. With age-related decline in cognitive and physical abilities, older adults can find themselves unable to participate in previously valued activities. Flow theory, conceptualized by Mihaly Csikszentmihalyi, can be used to identify and develop engaging activities, such as computer games, for older adults. Historically, flow has been explored primarily through self-report measures. Memory, comprehension, age, and response biases may impact the validity of self-report data in older adults. Observable indicators of flow may enhance researchers’ and therapists’ ability to understand older adults’ level of engagement during activity participation. Objectives: The purpose of this paper was to explore flow theory as it relates to computer games and identify observable indicators associated with flow states in older adults during gameplay. Approach: A literature review was conducted examining flow theory and flow in electronic gameplay. Minimal research has focused on indicators of flow states based on observation, therefore, literature related to elements of flow, such as focused attention, enjoyment and challenge was also reviewed. Connections between observable behaviours and flow during electronic gameplay are proposed. Practice Implications: Occupational therapists may be able to identify elements of flow through observational methods, allowing them to better understand engagement in populations with whom self-report data may not be sufficient, such as in older adults with dementia. Conclusion: Three categories of potential observable indicators are proposed: gaze/eye movements, facial expressions and body positioning.

Alexandria Wickins, Christine Daum, Adriana Rios Rincon, Antonio Miguel-Cruz, Lili Liu
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Function as defined by young adults with mental health disorders: A qualitative study
Day: Friday,  Time: 14:30-14:55, Session: F86

Background
One in four Canadian young adults, 25 and under, experience a mental health disorder each year. Improved “function” is a common outcome targeted by mental health practitioners. However, no known studies exist that define or measure function from the perspective of young adults with mental health disorders.

Methods
We recruited young adults with mental health disorders, aged 19-25, from an integrated youth health centre to participate in 90-minute focus groups. Two focus groups were conducted using a semi-structured script, audio recorded and transcribed. Transcripts were analyzed using an inductive thematic analysis with NVIVO 11.

Results
Nineteen youth participated with a median age of 24 years (range 19-25 years). Seven (37%) identified as female, twelve (63%) as male, and one (5%) as genderqueer. Twelve (63%) of participants were unemployed and not in school. Participants’ self-reported mental health diagnoses included mood disorders (79%), anxiety disorders (74%), post-traumatic stress disorder (PTSD) (32%), other disorders (32%) and psychotic disorders (16%).
69% of participants reported using alcohol, 53% reported using cannabis and 31% reported using substances. Major themes around defining and conceptualizing function emerged, including intrinsic and extrinsic factors. Major themes within intrinsic factors included holistic health and self-awareness. Major themes within extrinsic factors included personal resources and professional supports.

Conclusions
Our results provide a novel conceptualization of function as described by young adults with mental health and substance use diagnoses. This definition aligns with the World Health Organization’s definition of function, as per the International Classification of Functioning (ICF), with critical emphasis on activity and participation as core needs to function. We also identified motivation, self-awareness and structure as key components of function, which supplements the ICF.

Rozmin Irani, Arianna Coles, Rebecca Zivanovic, Adelena Leon, Skye Barbic
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Readability of Occupational Therapy Research Articles
Day: Friday,  Time: 13:00-13:25, Session: F54

Peer-reviewed articles in occupational therapy are a primary source of information for clinicians and researchers. To maintain the standard of practice, clinicians and researchers need to make sense of emerging evidence. To achieve the timely implementation of new information, papers need to be clear and highly readable. Clear communication is especially important in occupational therapy, which brings together different research approaches. The readability assessment of occupational therapy articles has not been performed. Objectives: To assess and compare the readability of articles in four prominent occupational therapy journals. Methods: We tested the readability over time of articles from the four most cited occupational therapy journals (AJOT, BJOT, CJOT, and AOTJ). We randomly sampled 400 articles from different years and issues of publication (2008-2018) and collected information about the type of characteristics. We analyzed the Abstract, Introduction, and Discussion sections of each paper using ten validated readability metrics [1]. We will complete a linear regression analysis to understand the impact of study characteristics on readability. Results: Our analysis is nearing completion. Based on preliminary findings, we expect that the readability level of occupational therapy journals will be good and higher than articles published in general medicine journals. We also hypothesize that readability will be predicted by journal impact factor and article type. Conclusions: A study of this nature has not been previously conducted in occupational therapy. To improve practice and ensure efficient exchange of information, it is imperative that we optimize the readability of articles in occupational therapy journals.

Heather Robertson, MOT student, Rachelle Abotswat, MOT student, Suzanne Huot, PhD, Skye Barbic, PhD, OT
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The Occupational Therapy Role in Combating Human Trafficking
Day: Friday,  Time: 13:30-13:55, Session: F62

Introduction: In 2016, approximately 17,000 people in Canada were affected by human trafficking (Dovydaitis, 2010; Global Slavery Index, 2016). This population often goes unnoticed by the health care systems, despite occupational therapists (OTs) having the underlying skills to not only identify victims of human trafficking, but to assist with the restoration of meaningful occupations. Objective: To determine the role of OTs in the care of victims and survivors of human trafficking by using the occupational justice (OJ) framework and trauma-informed care model (TIC) to guide practice. Approach: An extensive literature search was conducted on the occupational justice framework, trauma-informed care, and the role of OT in combating human trafficking. Practice implications: OTs can use the OJ framework and TIC model to inform their practice with this population in a variety of settings such as: individual counselling, group settings, providing occupation-based training, and preventative education. These strategies should also be incorporated into the MOT programs across Canada to increase awareness and competence when working with victims of human trafficking. Conclusions: It is evident that gaps in the literature exist regarding protocols for how OTs can provide care to victims of human trafficking. This may be due to issues related to self-disclosure, and the minimal education provided to OTs about the prevalence and signs of human trafficking in Canada. Despite the emerging role for OTs in assessing and treating this population, future research is needed to explicitly state the role of occupational therapy in combating human trafficking.

Carrie Mandryk, Meagan Korell, Truc Le, Reg Urbanowski
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Sexuality after a stroke: Bringing up the topic for patients
Day: Friday,  Time: 13:00-13:25, Session: F53

Introduction: A stroke can interfere with a person’s sex life and intimacy. However, sexuality issues are poorly addressed by occupational therapists and other health professionals during stroke rehabilitation. Innovative strategies are thus required to promote the integration of sexuality in stroke rehabilitation. Objective: This study aimed to assess the feasibility and acceptability of implementing a screening test of sexual dysfunction (STSD) in a stroke rehabilitation setting. Methods: This prospective qualitative study involved the implementation of the STSD from March to September 2018. Clinicians (n = 18) were trained on how to implement the STSD. After the implementation phase, individual interviews were conducted among a sample of screened stroke patients (n=5) and the neurology program coordinator. Fifteen of the trained clinicians participated to a focus group. Results: All participants considered the STSD relevant for stroke rehabilitation. Among the total amount of STSD conducted (n=27), 13 were positive, indicating an expressed need of patients to address sexuality during their rehabilitation. Therapeutic relationship, privacy and timing were identified by patients and clinicians as key factors for a successful implementation of the STSD. However, the lack of clinical resources regarding sexuality was among the most important barriers to the implementation of the STSD, according to clinicians and the coordinator. Conclusion: Even though it was well accepted by participants, some barriers influenced the implementation of the STSD. Future studies addressing the integration of sexuality in stroke rehabilitation should consider these barriers in order to optimize the results and improve the quality of rehabilitation for patients. Experience level: Intermediate

Auger, Louis-Pierre; Pituch, Evelina; Filiatrault, Johanne; Courtois, Frédérique; Rochette, Annie
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Discharge planning for criminalized persons with traumatic brain injury
Day: Friday,  Time: 09:00-09:25, Session: F18

Introduction: Traumatic brain injury (TBI) is becoming recognized as a leading cause of death and disability. The prevalence of individuals with TBIs are particularly high within the criminal justice involvement. Providing appropriate resources prior to being discharged from prison can facilitate successful reintegration into the community, and reduce the risk of homelessness, addictions, recidivism, and re-incarceration. This population would benefit from a comprehensive resource booklet to address their basic needs once released from prison. Objective: The objective of this project is to explore the methods of developing a resource booklet for front-line staff to assist persons with lived experience using an occupational therapy framework. Methods: An environmental scan was conducted utilizing three approaches: (1) academic and grey literature, (2) content specific websites, and (3) consultations with experts. We developed a data extraction tool to screen websites. Practice Implications: The material developed from this research may assist in facilitating successful community reintegration. Conclusions: This research identified the resources currently available in Toronto to assist this population with community reintegration. An OT framework was used to develop a comprehensive resource booklet, which may inform future community reintegration planning for this population.

Sonia John, Alexandra Saffran, Flora Matheson, Catherine Wiseman-Hakes, Hyun (Jeff) Ryu, Angela Colantonio
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Cerebellar Differences with Rehabilitation in Children with Developmental Coordination Disorder
Day: Friday,  Time: 09:00-09:25, Session: F20

Introduction: Cognitive Orientation to Occupational Performance (CO-OP) is effective in helping children with Developmental Coordination Disorder (DCD) to achieve functional motor goals, but the neural mechanism underlying this intervention is unknown. Objective: Given the hypothesized role of the cerebellum in DCD, we sought to determine if CO-OP was associated with changes in cerebellar structure and if these changes were associated with improved motor outcomes. Methods: Sixty children with DCD (8-12 years) were randomized into the treatment or waitlist group. Each child participated in weekly, 1-hour CO-OP sessions for 10 weeks. Magnetic Resonance Imaging (MRI) was performed pre- and post-intervention and Voxel Based Morphometry (VBM) was used to explore differences in cerebellar grey matter volume between the treatment and waitlist groups. Linear correlation will be used to explore the relationship between grey matter volume and clinical measures of motor skills. Results: Using quality scans suitable for VBM [n=18; treatment (8); waitlist (10)], preliminary findings indicate that following CO-OP, children in the treatment group had increased grey matter volume in motor regions of the cerebellum (Lobule IX & Lobule VI, both p<0.001) compared to the waitlist group. Children in the treatment group also had increased grey matter volume in regions associated with cognitive skills (Crus I & Crus II, both p<0.001). Data collection and analysis are ongoing. Conclusion: Children with DCD show increased grey matter volume in sensorimotor and cognitive regions, indicating that CO-OP intervention is associated with structural changes in the cerebellum. Findings provide neuroscientific evidence for this occupational therapy intervention.

Kamaldeep Gill, Donna Lang, Dan Goldowitz, Jill G. Zwicker
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Promoting children’s participation through significant adults’ capacity building
Day: Friday,  Time: 16:00-16:25, Session: F101

Introduction: In a client-centered approach, occupational therapists aim to build the capacity of significant adults in the child’s life, so that they can support the child’s development and participation. The interventions used vary widely. Yet, there is limited guidance regarding how to best support these adults. Objective: The goal of this presentation is to describe the different occupational therapy interventions aimed at building capacity of significant adults to promote children’ participation. Methods: A scoping review was conducted to analyze the content and outcomes of these interventions. Interventions presented in 28 articles will be described with respect to their ability to support the individual needs of each adult. The way outcomes on children’ participation and adult’s sense of competency are measured will be discussed. Results: Analysis of the different interventions have enabled the development of a classification of seven types of interventions used by occupational therapists to build capacity of significant adults. Similarities and differences will be highlighted. A lot of studies have used a combination of these types of interventions. Their effects on children’ participation and adults’ sense of competency are mostly documented by interviews. Conclusion: This presentation clarifies the different options through which occupational therapists develop the capacities of significant adults when working to promote children’s participation. Participants will be able to question the relevance of these interventions for their clients and contexts, which will lead to discussion and reflection on their practice.

Myriam Chrétien-Vincent, Marie Grandisson, Élise Milot, Chantal Desmarais
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'Ms-Understandings'? : Troubling Stereotypical Assumptions of Older Single Women
Day: Friday,  Time: 11:00-11:25, Session: F40

Rationale: More Canadians are living ‘single’ than ever before, but singleness for women remains a stigmatized and marginalized position. In occupational therapy, single women stereotypes (e.g., lonely, sad, and vulnerable) have not been problematized as a gendered phenomenon with political and ideological dimensions that play out at interactional and systems levels. Drawing on findings from completed doctoral research that explored the identity negotiation strategies of older single women, previously unexplored key aspects of the social dynamics around singleness for women are outlined. Objectives: To examine the talk of older life-long single women for the range of interpretive resources drawn upon and how those resources were employed in singleness identity negotiation. Approach: Using discourse analysis, talk data from repeat interviews with four women was examined for patterns in the resources drawn upon and how those resources were employed. Results: Singleness talk was strongly polarized into two repertoires: the ‘deficit’ (failure, loneliness) repertoire that undermined the relatively weak ‘singleness-as-freedom’ (to do and be) repertoire. Deficit discourses were strongly refuted, but positive claims about singlehood were weakly upheld. Identity negotiation strategies included distancing from the category ‘single’, and using rhetorical maneuvers to close down conversations, rendering singleness an invisible identity. Conclusions: The study demonstrates that singleness for older women is an identity of difference and a ‘troubled’ identity (i.e. difficult to be aligned with), thus exposing a previously unidentified equity and social justice ‘blind-spot’ within OT.

Rona Macdonald & Pia Kontos
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Role of Occupational Therapy in Infant Sleep Education
Day: Friday,  Time: 13:00-13:25, Session: F59

Infant sleep is a primary concern for new parents. Information provided to families about typical sleep development and advice for resolving concerns are often not evidence-based. OTs have knowledge of infant development, a perspective of sleep as a meaningful occupation, and access to research evidence and the PEO model. This places OTs in a potential role as infant sleep educators. Furthermore, an OT’s awareness of maternal mental health and the importance of self-care means OTs can be key health care professionals for supportive parent education regarding infant sleep. Objectives: OTs will be informed of the evidence regarding current sleep practices, normal infant sleep development, and strategies for addressing sleep issues with infants. Approach: Literature and clinical evidence of normal infant sleep skill development, typical hurdles, and strategies for supporting infant sleep are reviewed. A framework is proposed for supporting parent education, parental decision-making, and changes in parent perspective regarding expectations for infant sleep development. Practice implications: OTs working with families of infants and young children can play a key role in educating parents about infant sleep, safe sleep practices, and evidence-based solutions to sleep issues. An OT can address maternal self-care and infant sleep skill development through assessment and education. Conclusions: Based on OT scope of practice, and our models of practice, OTs have a valuable role in improving infant sleep and maternal satisfaction with infant sleep through education, and emphasis on maternal self-care.

Heather Boyd
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On-line learning module development to support dysphagia assessment competency
Day: Friday,  Time: 13:00-13:25, Session: F49

Rationale: The McGill Ingestive Skills Assessment (MISA) is a validated tool designed to assist occupational therapists (OTs) in the assessment of feeding, eating and swallowing. Practice is needed to learn to use the tool and to establish competency for those new to this area of practice. Typically the mentorship is done face-to-face which places high demands on the educator’s time. Objectives: Through the on-line module, novice practitioners are taught how to use MISA and practice with a simulated client. Learners do this at a time they choose. Educator’s time is made available for further mentorship needs. Approach: This work was done based on a study using vignettes to score the MISA (Hansen, et al. 2016). An on-line learning module was designed to support OTs to learn the set-up, administration and scoring of the MISA using a video of the simulated client eating a meal. Learners score each item on the assessment and are given feedback based on the observations from clinical experts. Data is collected to ensure the module is completed by OTs. Mentorship is then provided to use the MISA to assess actual clients, analyze results and devise appropriate intervention plans. Practice Implications: This on-line module is a self-learning tool for OTs new to feeding, eating and swallowing assessment. It encourages use of the MISA, a validated assessment tool. It allows OTs timely access to this learning content. Results inform further mentorship conversations with educators. Conclusions: This module serves as a beneficial piece of a larger competency development strategy.

Sandy Leznoff, Kevin Waldorf, Judi Dueck
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'Ms-Understandings'? : Troubling Assumptions of Older Single Women
Day: Friday,  Time: 11:00-11:25, Session: F40

‘Ms-Understandings’? : Troubling Stereotypical Assumptions of Older Single Women
Rationale
More Canadians are living ‘single’ than ever before, but singleness for women remains a stigmatized and marginalized position. In occupational therapy, single women stereotypes (e.g., lonely, sad, and vulnerable) have not been problematized as a gendered phenomenon with concomitant political and ideological dimensions that play out at interactional and systems levels. Drawing on findings from completed doctoral research that explored the identity negotiation strategies of older single women, previously unexplored aspects of the social dynamics around singleness for women are outlined.
Objectives
To examine the talk of older life-long single women for the range of interpretive resources drawn upon and how those resources were employed in singleness identity negotiation.
Approach
Using discourse analysis, talk data from repeat interviews with four women was examined for patterns in the resources drawn upon and how those resources were employed.
Results: Singleness talk was strongly polarized into two repertoires: the ‘deficit’ (failure, loneliness) repertoire that undermined the relatively weak ‘singleness-as-freedom’ (to do and be) repertoire. Deficit discourses were strongly refuted, but positive claims about singlehood were weakly upheld. Identity negotiation strategies included distancing from the category ‘single’, and using rhetorical maneuvers to close down conversations, rendering singleness an invisible identity.
Conclusions:
The study demonstrates that singleness for older women is an identity of difference and a ‘troubled’ identity (i.e. difficult to be aligned with), thus exposing a previously unidentified equity and social justice ‘blind-spot’ within OT.
Abstract Summary (50 words)
An unprecedented numbers of Canadians today are ‘single’, yet in occupational therapy, older single women stereotypes (e.g., lonely, sad, and vulnerable) are commonly assumed and not questioned. Drawing on findings from doctoral research that explored the identity negotiation strategies of older single women, OT’s are invited to re-evaluate existing ‘Ms-Understandings’.

Rona Macdonald & Pia Kontos
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Une étude de l'âgisme chez les étudiants en réadaptation
Day: Friday,  Time: 16:00-16:25, Session: F106

Introduction. L’âgisme est encore bien présent dans la société et ce phénomène peut avoir des répercussions négatives sur le bien-être des aînés. Quelques études montrent qu’on le retrouve aussi chez les professionnels de la santé. Il s’avère donc crucial que les programmes de formation en santé considèrent cette réalité. Toutefois, peu d’études ont examiné les attitudes des étudiants en réadaptation à l’égard des aînés. Objectifs. Cette étude avait pour objectifs d’examiner les attitudes des étudiants en réadaptation envers les aînés et d’identifier les facteurs associés. Méthodes. Un questionnaire en ligne a été transmis aux étudiants de première année d’un programme d’ergothérapie (n=126) et d’un programme de physiothérapie (n=106). En plus de colliger des données sociodémographiques, il comportait des questions sur leurs connaissances relatives au vieillissement, la fréquence de leurs contacts avec des aînés et leur satisfaction à l’égard de ces contacts. Diverses mesures d’âgisme ont aussi été incluses. Résultats. Quatre-vingt-neuf étudiants ont répondu au questionnaire. Les analyses indiquent que leur niveau d’âgisme est généralement faible. Les analyses révèlent aussi des associations négatives statistiquement significatives entre le niveau d’âgisme et l’âge, les connaissances sur le vieillissement et la satisfaction vis-à-vis des contacts avec des aînés. Les analyses ne révèlent pas d’association entre la fréquence de ces contacts et l’âgisme. Conclusions. Les résultats soutiennent l’importance des connaissances relatives au vieillissement et de la qualité des contacts avec des aînés dans le développement d’attitudes positives envers ceux-ci. Ces résultats suggèrent des pistes utiles pour le développement d’une formation pour les étudiants en réadaptation.

Marion Lack, Johanne Filiatrault, Joseph-Omer Dyer, David Pimenta Da Silva
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Using virtual reality as a strategy to reduce student test-anxiety
Day: Friday,  Time: 08:30-08:55, Session: F12

Introduction: Practical exams, which are frequently used to assess student clinical competencies, can be highly stress-inducing. A study in 2015 by Gerwing et al. found that 38.5% of students experience test-anxiety. Strategies are needed to help students manage stressors so as to successfully complete practical exams and demonstrate clinical competencies. This research explores the use of immersive virtual reality to help first year MScOT students better prepare for clinical practical exams and reduce their test-anxiety. Objective: To provide an immersive virtual simulation of a clinical practical examination that enables students to mentally prepare for high-stakes testing situations. Methods: This mixed methods study involves comparing the state-anxiety, test-anxiety and self-efficacy of first year MScOT students pre/post use of an immersive virtual reality clinical practical exam. Focus groups and interviews were also conducted to better understand students’ experiences of anxiety and practical exams. Results: Results pre/post exposure to an immersive virtual reality clinical practical exam will be presented, including students levels of anxiety, self-efficacy and study preparation methods. Triangulation of quantitative and qualitative results are expected to relate to students’ anxiety levels, mental levels of preparedness and exam preparation strategies. Conclusions: Immersive virtual reality has the potential to support mental preparation and psychological stress management in workplace and clinical practical exam settings. This research demonstrated how virtual reality simulations might reduce test-anxiety and contribute to the development of MScOT student clinical competencies.

Shaniff Esmail, Brendan Concannon, Susan Mulholland, Suzette Bremault-Phillips, Mary Roduta-Roberts
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Exploring Youth's Implementation of Sleep Hygiene Strategies
Day: Friday,  Time: 13:00-13:25, Session: f52


Valerie Gendron, Rose Martini
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Rethinking the assistive technology system from the human rights perspective
Day: Friday,  Time: 09:00-09:25, Session: F19

Introduction: Assistive technology (AT) is one of the key enablers of occupational performance. Occupational therapists (OTs) have expertise to assist Canadians with selecting, training and using assistive technology, which will facilitate their occupational performance. However, the current AT system is underfunded; restricted; unresponsive to the needs of the people it is intended to benefit; and lacks central engagement of its users. The current state of the AT system creates system-level barriers that prevent OTs from providing an optimal client-centered care. Objectives: This paper aims to identify the root causes behind the inadequate AT system to inform development of sustainable solutions. Methods: This paper draws on the Human Rights Based Approach, a conceptual framework that seeks to understand and address the root causes of systemic problems by analyzing implicit inequalities and discriminations within the existing systems. Results: The current AT system inadequacies are attributed to an out-dated conceptualization of disability reflected within the policies and practices of the AT system. The current AT system is grounded within the medical model of disability, which perceives disability as ‘anomaly’ requiring medical intervention. Within the AT policies and practices, AT is perceived not as an enabler of participation but as an intervention tool aiming to reduce dis-function brought about by disability to attain ‘normalcy’, therefore, systemically diminishing AT users’ active participation in decision making process and preventing OTs from efficiently supporting their clients. Conclusions: The AT system advancement requires a systemic shift towards a social model of understanding disability. OTs must understand systemic factors impeding their professional philosophy and practice to work together with their clients towards a social change within the AT system.

Natasha Altin
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Exploring Perspectives on Weight-Related Communication Tools in Pediatrics: Study Protocol
Day: Saturday,  Time: 10:30-10:55, Session: S63

Introduction. Childhood obesity is a significant public health challenge and there is a great need for obesity management and prevention. Despite knowledge that education and access to resources is vital, healthcare professionals (HCPs) experience barriers to positive weight-related discussions with children and their families. Communication tools may offer non-judgmental ways to facilitate such conversations. A recent narrative review identified nine published North American weight-related communication tools; however, further research is needed to conduct a user-centred needs assessment evaluating the acceptability and perceived value of these publicly available weight-related communication tools. Objective. To determine the acceptability and perceived value of weight-related conversation tools by children and parents with experience of weight-related conversations. Approach. This study will use a qualitative descriptive design. Children and their parents will be recruited from the KidFit Health and Wellness Clinic (treatment centre for children experiencing medical complications from overweight or obesity) in Ontario. Separate child and parent focus groups will be held to explore impressions of the tools and a sorting exercise to rank the ‘best’ tools. Focus group data will be transcribed verbatim and analyzed through thematic coding. Practice Implications. The findings of this study will provide HCPs with families’ perspectives of ‘best’ weight-related communication tools to facilitate positive clinical conversations. In addition, these perspectives can provide insights into the design of a future communication tool. Conclusions. Child and parent perceived value and acceptability of weight-related communication tools will provide insight into discussions around overweight and obesity, and will inform future research.

Emma Allen, Shannon Bottrell, Kylie Homles, Laura Van Daele
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Transitional Housing in Forensic Mental Health: Considering Consumer Lived Experience
Day: Saturday,  Time: 09:00-09:25, Session: S12

For individuals involved in the forensic mental health system, access to transitional housing can offer a bridge between custody and independence. This qualitative study considers the meaning associated with such participation. In this Canadian study, data was collected via interview with six individuals (n=6) who resided, for a minimum six (6) months, in justice focused transitional housing that involved a partnership between a rural forensic mental health care facility and a nearby urban transitional housing provider.

Clark Patrick Heard; Jared Scott; Allan Tetzlaff; Heather Lumley
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L’ergothérapie en groupe de médecine familiale avec une clientèle pédiatrique
Day: Saturday,  Time: 10:30-10:55, Session: S61

Introduction : Les ergothérapeutes ont un rôle important à jouer dans le dépistage des retards de développement chez les enfants. Or, au Québec, ce dépistage s’effectue principalement dans les soins de première ligne, tel qu’en groupe de médecine de famille (GMF) où l’ergothérapeute est actuellement très peu présent. Objectif : Développer un modèle d’intégration de l’ergothérapeute en GMF pour la clientèle pédiatrique en décrivant cette pratique, en documentant les facilitateurs et obstacles à l’intégration ainsi qu’en évaluant ses impacts auprès des autres professionnels et des parents. Méthodologie : Une étude de cas unique a été réalisée. Une ergothérapeute et 7 membres de son équipe ont participé à des entrevues individuelles. Des données ont aussi été recueillies dans les documents élaborés par l’ergothérapeute ainsi que dans les dossiers cliniques. Résultats : L’intégration d’un ergothérapeute en GMF pour la clientèle pédiatrique contribue à améliorer la capacité de l’équipe à évaluer les retards de développement, identifier les besoins de l’enfant, outiller les parents ainsi qu’orienter rapidement les enfants vers les services spécialisés requis. Les facilitateurs et les obstacles à l’intégration se divisent en trois catégories : l’établissement du rôle de l’ergothérapeute, les ressources environnementales, organisationnelles et sociales ainsi que la culture et la collaboration. Conclusion : L’intégration de l’ergothérapeute favorise l’amélioration de l’expertise de l’équipe pour le dépistage des retards de développement et l’orientation des enfants vers les services ciblés requis. Ce modèle d’implantation peut accompagner d’autres GMF souhaitant intégrer un ergothérapeute.

Marie-Andrée Jarry, Brigitte Vachon, Marie-Noëlle Simard, Laurence Potvin
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How does Virtual Reality Align with Occupational Therapy?: A Scoping Review
Day: Saturday,  Time: 11:00-11:25, Session: S77

Introduction. Stroke rehabilitation guidelines encourage occupational therapists to utilize virtual reality (VR). There are many potential uses of VR and it is not yet clear how these uses align with occupational therapy goals and processes. Objectives. The purpose of this project was to determine which occupational therapy uses of VR are currently described in the research literature, and how these uses align with occupational therapy goals and processes. Methods. A scoping review was carried out. A systematic search strategy was used to identify peer-reviewed papers that described VR in occupational therapy in descriptive or research papers. Articles in English or French were included if there was an occupational therapist author or the publication was in an occupational therapy journal, or the terms occupational therapy, stroke and virtual reality were found in the title, abstract or keywords. Uses of VR were organized under Golledge’s classification of occupation: diversional activity, activity, purposeful activity and occupation. Results. Bibliographic searches resulted in 396 articles, of which 36 met the inclusion criteria. Current occupational therapy uses of VR are primarily in the context of activity in stroke rehabilitation. Of the articles retained, 27 (75%) described VR as activity and 9 (25%) described VR as purposeful activity. There were no descriptions of diversional activity or occupation. Conclusions. This paper provides an important starting point for considering whether VR in occupational therapy can be developed in ways more consistent with occupation-focused practice.

Sarah Hunt, Kayla McDonald, Jacklyn Upchan, Mary Egan, Heidi Sveistrup & Patrick Duong
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How does virtual reality align with occupational therapy? A scoping review
Day: Saturday,  Time: 11:00-11:25, Session: S77


Sarah Hunt, Kayla McDonald, Jacklyn Upchan, Patrick Duong, Heidi Sveistrup, Mary Egan
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Rhythmic movement-based interventions for acquired brain injuries: A systematic review
Day: Saturday,  Time: 10:30-10:55, Session: S57

Summary: This work will investigate literature concerning the use of rhythm and movement occupation-based interventions, to determine whether they benefit activity and participation outcomes among adults experiencing acquired brain injuries. Following PRISMA guidelines, the results of this review will integrate information regarding the implementation of these interventions with acquired brain injuries.

Rationale. Individuals who experience acquired brain injuries often experience an array of symptoms, which can affect activity and participation in daily living. Evidence exists supporting the use of rhythm and movement occupation-based interventions in the rehabilitation of these issues, however this evidence has not been synthesized in any reviews. Objective. To determine whether rhythmic movement-based interventions have benefit for activity and participation outcomes among adults experiencing acquired brain injuries. Methods. Using a search strategy that follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, five online databases will be searched using subject headings and text words related to population, interventions, and outcomes of interest. Abstracts and titles of the articles retrieved will then be reviewed for relevance by two reviewers, and information regarding the use of various rhythm and movement-based interventions will be gathered from selected articles, and synthesized using a narrative analysis. Practice Implications. The results of this review will integrate information regarding the implementation of rhythm and movement occupation-based interventions for acquired brain injuries. Conclusions. This will be the first review to examine the benefits of rhythm and movement occupation-based interventions on activity and participation outcomes in adults with acquired brain injury. The synthesized evidence will be a valuable resource for clinicians and researchers working with this population and will help to inform decisions on the use of these interventions in practice.

Madeleine Cox, Mark Lavoie, Deirdre R. Dawson
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Scoping Review on Occupational Patterns of Families with a Member Living with a Health Condition
Day: Saturday,  Time: 11:30-11:55, Session: S89


Stéphanie Bossé, Marie-Christine Ranger and Rose Martini
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The Process of Developing Educational Materials for Patients and Families
Day: Saturday,  Time: 11:30-11:55, Session: S62

: The Stroke Occupational Therapy (OT) Leadership Committee was established in 2012 to gather clinicians from acute care sites across the city in an effort to standardize OT best practice. The group provides a forum for sharing resources, and aims to resolve the gaps that exist between current practice and best practice. In recent group meetings, participants have identified a lack of evidence-based educational handouts to provide to patients and caregivers. Objective: To develop standardized educational materials on cognition and perception based on the Canadian Stroke Best Practice Recommendations to provide to patients and families at various acute care facilities. Method: The group identified left-neglect, apraxia, and visual field cuts as the topics for the educational handouts. The materials were developed by gathering information from evidenced-based resources, clinician experience and groups’ consensus. Handouts were piloted at multiple acute care sites across the city. Feedback from patients, families/caregivers and members of the inter-professional team was collected via questionnaires and incorporated. Members of the Stroke OT Leadership Committee submitted the final handouts to their respective communication departments for final approval. Practice Implications or Results: The handouts developed will ensure that patients at various acute care sites receive standardized educational materials. Additionally, a protocol has been developed to enable this group as well as other similar groups to develop further educational items. Conclusion: The development of evidenced-based materials for patients and caregivers will further the mission of Stroke OT Leadership Committee to standardize OT practice in acute care.

Alena Mandel, Michelle Mohan, Fatima Quraishi, Nicola Tahair, Elizabeth Linkewich
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Caregiver's preparedness to manage cognitive deficits post-stroke
Day: Saturday,  Time: 09:00-09:25, Session: S30

Introduction : Caregivers play a central role to support their relatives with cognitive deficits post-stroke, but they are confronted to several issues during return to home, as they face an important occupational transition. Objectives : 1) to explore caregivers’ perceived educational and support needs during this transition, and 2) to compare those needs with recommendations of best practices addressed to caregivers after a stroke. Methods : Descriptive qualitative study, including semi-structured interviews with 10 caregivers. Thematic content analysis, validated by two team members, was based on the Framework Approach (Ritchie and Lewis, 2003). Expressed needs were compared to Canadian recommendations (Cameron and al., 2015) and continuum of stroke services (Government of Quebec, 2017). Results : Caregivers wish to be better informed before transition to understand daily impacts of cognitive deficits, but they also express the need to experience real life situations in order to benefit from follow ups by healthcare professionals or peer support after rehabilitation. Perceived needs also support the relevance of a partnership of care, to allow for shareddecision making et development of caregivers’ competencies. Those needs are consistent with recommendations of best practices. Some needs are still partially met, especially individualized follow up post-rehabilitation, and seem even more salient for caregivers providing constant supervision. Conclusion : This study suggests some avenues to be explored for improving services, where occupational therapists could play a key role for empowering caregivers across this transition. Key words | Mots clés : Stroke, Teaching/education

Jean, Alexandra ; Poulin, Valérie and Viscogliosi, Chantal
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How does virtual reality align with occupational therapy? A scoping review
Day: Saturday,  Time: 11:00-11:25, Session: S77

Introduction. Stroke rehabilitation guidelines encourage occupational therapists to utilize virtual reality (VR). There are many potential uses of VR and it is not yet clear how these uses align with occupational therapy goals and processes. Objectives. The purpose of this project was to determine which occupational therapy uses of VR are currently described in the research literature, and how these uses align with occupational therapy goals and processes. Methods. A scoping review was carried out. A systematic search strategy was used to identify peer-reviewed papers that described VR in occupational therapy in descriptive or research papers. Articles in English or French were included if there was an occupational therapist author or the publication was in an occupational therapy journal, or the terms occupational therapy, stroke and virtual reality were found in the title, abstract or keywords. Uses of VR were organized under Golledge’s classification of occupation: diversional activity, activity, purposeful activity and occupation. Results. Bibliographic searches resulted in 396 articles, of which 36 met the inclusion criteria. Current occupational therapy uses of VR are primarily in the context of activity in stroke rehabilitation. Of the articles retained, 27 (75%) described VR as activity and 9 (25%) described VR as purposeful activity. There were no descriptions of diversional activity or occupation. Conclusions. This paper provides an important starting point for considering whether VR in occupational therapy can be developed in ways more consistent with occupation-focused practice.

Sarah Hunt, Kayla McDonald, Jacklyn Upchan, Patrick Duong, Heidi Sveistrup, Mary Egan
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Further development of the Big Store Multiple Errands Test
Day: Saturday,  Time: 10:00-10:25, Session: S45

Introduction: Individuals with acquired brain injury (ABI) can experience executive functioning impairments that impact their ability to engage in instrumental activities of daily living. The Multiple Errands Test (MET) is a tool that occupational therapists use to assess this construct with clients. The Big Store MET was created to increase availability for use across many clinical settings. This tool has not yet been validated with adults with ABI.
Objectives: This study aims to (1) further establish the inter-rater reliability of the Big Store MET and (2) to determine known group validity on performance on the Big Store MET between adults with ABI and matched healthy controls (HC).
Methods: Ten participants, including adults with ABI and healthy matched controls, were included in this cross-sectional study. Participants were administered a neuropsychological battery and the Big Store MET. Statistical analyses included descriptive statistics and a select two-way mixed effects model for ICC.
Results: This study found that the Big Store MET is able to discriminate between adults with ABI and healthy controls and that inter-rater reliability was excellent (ICC=>0.99) for most summary scores.

F. Gallant, A. Leonardelli, K. Antoniak, J. Clores, M. Morton, J. Wilcox, D. Jensen, E. Nalder, S. Rotenberg, D. Dawson
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HEALTH OF CANADIAN FIREFIGHTERS: THE IMPACT OF SLEEP AND WORK
Day: Saturday,  Time: 11:30-11:55, Session: S88

Introduction: Shift work, including night shifts, rotating schedules, and extended hours, places workers at a greater risk for disordered sleep and subsequent health risks. In addition to dealing with the impact of shift work, up to seventy five percent of public safety personnel (PSP), including firefighters, police officers, correctional workers, and paramedics, are also faced with potentially traumatic events on a regular basis. Irregular, lengthy hours and increased trauma exposure causes greater risk of disordered sleep, which elevates their susceptibility to both physical and mental health concerns. The occupation of sleep is central to daily life rhythm and structure; while there is ample research on shiftwork and health, there is limited research on the impact of shiftwork in relation to Canadian firefighters’ health. Objectives: This study was conducted to explore how Canadian firefighters’ sleep is affected by their work and the impact it has on their physical and mental health. Approach: An online survey was made available in English and French from September 2016 to January 2017. The survey assessed current symptoms of mental disorders, and participation was solicited from national PSP agencies and advocacy groups. Results: Quantitative and qualitative data from firefighter respondents will be presented. Conclusions: This study is the first to examine Canadian firefighters and the impact of their work on sleep and health. Occupational therapists may work with these vulnerable populations to address sleep issues; results can inform occupational therapy interventions and health policy for these workers.

Heidi Cramm, Megan Edgelow, Dianne Groll, Amanda Roi, Paula Campbell, Rachel Richmond
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Navigating changing social relationships: Seniors’ perceptions of occupational therapy’s role
Day: Saturday,  Time: 11:00-11:25, Session: S75

Title: Navigating changing social relationships: Seniors’ perceptions of occupational therapy’s role.
Introduction: Socialization affects occupational wellbeing. People experience changes in the nature, meanings, and functions of social relationships as they age. Transitions to new occupational roles and identities may be required. For example, grandparenting, experiencing the loss of a loved one, and/or disability may change the way seniors build or maintain social relationships. This transition may put seniors at a greater risk for social isolation leading to poorer health outcomes. While occupational therapists have been active in enabling the socialization of seniors, there is limited understanding by occupational therapists as to how seniors perceive their enabling role.
Objectives: Informed by a life course perspective on aging, this study serves to better understand: 1) how seniors experience changes regarding the development and maintenance of their social relationships, and 2) how seniors perceive occupational therapy’s role in enabling their navigation through these social transitions.
Methods: Informed by narrative inquiry, using semi-structured interviews, and arts-informed strategies (e.g., story writing, photos) will be used to co-construct narratives of up to eight seniors. Findings will be thematically analyzed using NVivo for organizational purposes.
Practice Implications: Results from this study will better inform occupational therapists about ways to meaningfully articulate the occupational therapy role for seniors.
Conclusions: Preliminary reflection suggests that the relevance of occupational therapists role will become more evident with a greater explanation of how they support senior social relationship transitions. Findings also detail how therapists support seniors’ experiences of loss and barriers to building and maintaining social relationships.

Marisa Rostek, Hilary Walsh, Lynn Cockburn, Barry Trentham
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The Effect of Productivity-Based Wages on Employment Participation – A Scoping Review
Day: Saturday,  Time: 11:30-11:55, Session: S28

Introduction: Persons with intellectual disabilities (ID) face a number of challenges to labour market entry. The legal requirement for employers to compensate workers at fair market wages, regardless of their ability to perform at competitive levels, has been cited as a barrier to hiring of workers with ID. Productivity-based wage systems (PBWS) are a possible alternative. Objectives: This scoping review sought to answer the questions: 1) What theoretical and practical arguments have been advanced for and against PBWS? 2) What is the impact of PBWS on employment participation? Methods: The review followed the procedures outlined by Arksey & O’Malley (2005). The initial search identified 63 papers published since 2012 that addressed the central concept of PBWS and ID. Further review relative to selection criteria reduced the pool to 34 papers. The three authors independently conducted thematic analysis of the papers, and used a consensus-building process to identify final themes. Results: PBWS exist in only Australia, Israel, and the U.S., and their implementation is a source of great controversy. Positions against PBWS include the opportunity for exploitation of vulnerable workers, and the inequity of basing the wages of workers with IDD on productivity when such standards are rarely applied to other workers. Arguments in favour of PBMS cite opportunity for increased inclusive productivity options and the potential for greater wage fairness. Conclusions: There exists little empirical evidence concerning the impact of PBWS on the employment of persons with ID. Ongoing research is needed to inform debate on this contentious issue.

Lysaght, R., Bobbette, N. & Ciampa, A.
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Beyond Silence: Advancing Workplace Mental Health in Healthcare
Day: Saturday,  Time: 09:30-09:55, Session: S31

Introduction: Mental health problems are experienced by many healthcare workers, but they are often surrounded by a web of stigma and silence. Customized, evidence-based approaches are needed to overcome the unique barriers to psychological health and safety in the context of healthcare work. The need is particularly acute in small, under-resourced healthcare organizations.

Objective: To evaluate an innovative approach to workplace mental health training for healthcare workers in small, community-based organizations.

Method: The RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) evaluation framework (Glasgow et al., 1999), was adopted to track both process and outcomes of the two-day training. Eight training programs, co-led by peer educators, included approximately 100 attendees from small, under-resourced healthcare organizations across Ontario. Pre, post, three and six-month follow-up questionnaires included standardized tools to track mental health literacy, stigmatized beliefs, and help-outreach behavior. In addition, process data included participant characteristics, attendance rates, and fidelity evaluations.
Results: Multilevel regression models will highlight changes over time on primary outcomes (behavior change) and secondary outcomes (mental health literacy and stigmatized beliefs). In addition, mixed effects models will track predictors of the program outcomes. Qualitative process data will illustrate key issues shaping program implementation and impact.

Conclusion: In the rapidly growing field of workplace mental health, there is a need for high quality, evidence-based programs to meet the needs of vulnerable healthcare workers. Findings from this study will inform recommendations for therapists engaged in workplace mental health promotion, particularly in healthcare settings.

Sandra Moll, Sheila Addanki, Luciana Macedo
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Client-informed implementation: Engaging clients to improve Ontario's addiction sector
Day: Saturday,  Time: 10:00-10:25, Session: S48

Title: Client-informed implementation: engaging clients to improve Ontario’s addiction sector Rationale: Since 2015, the Staged Screening and Assessment (SS&A) process has been implemented to enhance quality of care in Ontario’s publicly funded addiction sector. The SS&A process, including the mandated Global Appraisal of Individual Needs (GAIN-Q3 MI ONT) assessment, represents the latest evidence on how to accurately screen and assess clients coming into service. A growing number of occupational therapists will use SS&A tools to assess, treat, and refer clients to addiction services. While service providers are involved in implementation efforts, direct client engagement in the implementation process is limited. Objectives: To a) apply a client-centred approach to quality improvement implementation efforts, and b) engage addiction service users and integrate their feedback on the SS&A process. Approach: Publicly funded addiction agencies across the province in advanced stages of implementation were selected to distribute surveys to clients about their experience with the GAIN-Q3 MI ONT assessment. Four focus groups were conducted to obtain richer, qualitative data. Results: 70 completed surveys were returned and data from the four focus groups were analyzed. Themes that emerged included the significance of the client-clinician relationship, flexibility in assessment administration, and the assessment as a “gatekeeper” to services. Conclusions: Involving clients in quality improvement efforts reflects client-centred principles and is useful in shaping large scale implementation efforts. Client feedback allows implementers and clinicians to modify quality improvement and service-delivery processes to maximize access, equity, and efficacy of services delivered. Opportunities exist for occupational therapists in the addiction sector to champion client-centred initiatives based on these results.

Season Kam, Tayla Smith
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Mindfulness-Based Cognitive Therapy and Everyday Functioning in a Psychogeriatric Population
Day: Saturday,  Time: 10:00-10:25, Session: S47

Depression and anxiety are becoming increasingly common in the older adult population and can negatively impact level of functioning [1][2][3][4][5][6]. Mindfulness-Based Cognitive Therapy (MBCT) has shown preliminary evidence of its effectiveness in reducing symptoms of late life depression and anxiety. However, there is no evidence evaluating its effectiveness in improving everyday functioning in the older adult population with mental health diagnoses. Objectives: To explore whether older adults with mental health diagnoses of depression and/or anxiety perceive a subjective improvement in everyday functioning after participating in an 8-week MBCT group. Methods: Using qualitative methods, our study consisted of a two-hour focus group with 7 participants, with mental health diagnoses, who completed an 8-week MBCT group, facilitated by an occupational therapist. The group was audiotaped and transcribed verbatim. Thematic analysis was used to analyse the data. Practical implications: The experiences of older adults in MBCT courses were represented by three major themes; “perceived improvement in occupational engagement”, “perceived benefits of implementation of mindfulness foundations in daily life” and “perceived improvement in symptoms of depression and anxiety”. Our discussion reflects on how our results fit within the current literature and the use of MBCT as a potential tool to be incorporated during occupational therapy intervention. Conclusions: The 8- week MBCT intervention has the potential to promote activity engagement and decreased symptoms of anxiety and depression. Further research with more rigorous methodologies should be conducted to test MBCT’s effectiveness and its impact on everyday functioning of older adults with mental health diagnoses.

Sevia Raelson, Veronika Svistkova, Angélique Tran, William Maccaul, Allana Goodman, Patricia Belchior
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Further development of the Big Store Multiple Errands Test
Day: Saturday,  Time: 10:00-10:25, Session: S45


F. Gallant, A. Leonardelli, K. Antoniak, J. Clores, M. Morton, J. Wilcox, D. Jensen, E. Nalder, S. Rotenberg, D. Dawson
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Exploring occupation in a prison setting: The OT student experience
Day: Saturday,  Time: 09:30-09:55, Session: S25


Tammy Bickmore
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