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Lidor NH, Baloush-Kleinman V, Mazor Y, Oren O, Dudai R. When Distance Becomes Closeness: Distance Learning as a Meaningful Learning Opportunity During the COVID-19 Pandemic. Community Ment Health J 2024; 60:14-26. [PMID: 36173515 PMCID: PMC9521004 DOI: 10.1007/s10597-022-01029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 09/12/2022] [Indexed: 11/29/2022]
Abstract
The National School for Mental Health Rehabilitation, Integration, and Recovery in Israel developed responses to academic, pedagogical, and emotional needs that arose during the first wave of the COVID-19 pandemic. Despite reduced activity during the outbreak, the school continued all regular courses remotely and created new online workshops. In this article, we review the school's adjustment from being change agents on the frontal level to change agents on the virtual level, through descriptive and qualitative findings. We use the learning from success approach to examine development and implementation processes. The large number of participants who suddenly had access to distance learning and their highly positive responses indicated the creation of opportunities alongside the challenges we faced. To the best of our knowledge, this is the first description and analysis of the challenges, opportunities, and outcomes of a recovery-oriented online academic facility during a pandemic.
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Affiliation(s)
- Noami Hadas Lidor
- National School of Rehabilitation, Integration and Recovery in Mental Health, Ono Academic College, Kiryat Ono, Israel
| | - Vered Baloush-Kleinman
- Division of Medicine, Mental Health Rehabilitation System, Ministry of Health, Jerusalem, Israel
| | - Yael Mazor
- National School of Rehabilitation, Integration and Recovery in Mental Health, Ono Academic College, Kiryat Ono, Israel.
- Social Work Department of Sapir Academic College, The Hebrew University, Jerusalem, Israel.
- AMITIM Programs, IACC, Tel Aviv, Israel.
| | - Orly Oren
- National School of Rehabilitation, Integration and Recovery in Mental Health, Ono Academic College, Kiryat Ono, Israel
| | - Ronit Dudai
- Division of Medicine, Mental Health Rehabilitation System, Ministry of Health, Jerusalem, Israel
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Kaizerman-Dinerman A, Roe D, Demeter N, Josman N. Do symptoms moderate the association between participation and executive functions outcomes among people with schizophrenia? BMC Psychiatry 2023; 23:42. [PMID: 36650458 PMCID: PMC9844002 DOI: 10.1186/s12888-022-04510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Literature explains participation limitations among people with schizophrenia through the context of metacognitive limitations, specifically in symptoms and in executive functions (EF). Research has shown mixed results regarding associations between symptoms and participation, reporting association with negative symptoms, positive symptoms, or only metacognitive limitations. The aim of this study was to deepen understanding of the symptoms' impact on the association between participation and executive function among people with schizophrenia. METHODS Forty-three participants with schizophrenia received 8 group sessions of focused metacognitive intervention (MCG) aimed at promoting participation by focusing on EF components (e.g., analyzing individual cognitive strategy use). Three measures were administered: the Positive and Negative Syndrome Scale (PANSS) to evaluate symptoms, the Weekly Calendar Planning Assessment (WCPA) to assess EF, and the Activity Card Sort (ACS) to measure participation at the baseline and 12 weeks following completion of the intervention. Scores were compared to a matched control group of 41 people with schizophrenia who instead received treatment as usual. The role of PANSS as moderator was examined using multiple hierarchical regressions, entering interactions between the PANSS scores and WCPA change scores in the final regression step. RESULTS Relationships were not significant for participants with high PANSS scores. A positive relationship existed between change in WCPA and change in ACS for participants with low PANSS scores. CONCLUSIONS These results demonstrate that low PANSS scores moderate the association between EF and participation and highlight the importance of symptoms as a predictor of participation following the MCG intervention. TRIAL REGISTRATION The trial was retrospectively registered at clinical. TRIAL gov. CLINICALTRIALS gov Identifier: NCT05556941. Clinicaltrial.gov registration date: 27/09/2022.
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Affiliation(s)
- Alona Kaizerman-Dinerman
- grid.18098.380000 0004 1937 0562Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - David Roe
- grid.18098.380000 0004 1937 0562Department of Community Mental Health, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Naor Demeter
- grid.18098.380000 0004 1937 0562Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Naomi Josman
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
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Regev S, Josman N, Mendelsohn A. Looking beyond the laboratory: Exploring behavioral and eye-fixation patterns in individuals with severe mental illness during a real-life supermarket task. Sci Prog 2023; 106:368504231160415. [PMID: 36919454 PMCID: PMC10450313 DOI: 10.1177/00368504231160415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Individuals with severe mental illnesses (SMI) often have difficulty performing daily activities that require intact executive functions, such as grocery shopping. Performance-based evaluations are valuable but lack the subjects' viewpoints during task performance. This study aims to combine performance-based observation and cognitive science methods to provide insights regarding real-life behavior and problem-solving in populations with SMI. In this correlational-research study, 42 participants (10 in the SMI group and 32 in the control group) performed the Test of Grocery Shopping Skills (TOGSS) while wearing an eye-tracking device. We hypothesized that patterns in task planning, task-time use, and attention allocation to written information relevant to the task would differ between the groups during the task. The results showed between-group differences in both TOGSS efficiency outcomes (time and redundancy), duration, and number of fixations. An eye-tracking pattern analysis determined between-group differences in scanning patterns of the grocery list but similarities in task planning. The selection process was found to be significantly more accurate and efficient for the control group than for the SMI group. Our findings suggest that a combination of perspectives allows us to better understand the behavior of SMI individuals in a regular daily task.
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Affiliation(s)
- Sivan Regev
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Naomi Josman
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Avi Mendelsohn
- Sagol Department of Neurobiology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
- Institute for Information Processing and Decision Making (IIPDM), University of Haifa, Haifa, Israel
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Guaiana G, Abbatecola M, Aali G, Tarantino F, Ebuenyi ID, Lucarini V, Li W, Zhang C, Pinto A. Cognitive behavioural therapy (group) for schizophrenia. Cochrane Database Syst Rev 2022; 7:CD009608. [PMID: 35866377 PMCID: PMC9308944 DOI: 10.1002/14651858.cd009608.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Schizophrenia is a disabling psychotic disorder characterised by positive symptoms of delusions, hallucinations, disorganised speech and behaviour; and negative symptoms such as affective flattening and lack of motivation. Cognitive behavioural therapy (CBT) is a psychological intervention that aims to change the way in which a person interprets and evaluates their experiences, helping them to identify and link feelings and patterns of thinking that underpin distress. CBT models targeting symptoms of psychosis (CBTp) have been developed for many mental health conditions including schizophrenia. CBTp has been suggested as a useful add-on therapy to medication for people with schizophrenia. While CBT for people with schizophrenia was mainly developed as an individual treatment, it is expensive and a group approach may be more cost-effective. Group CBTp can be defined as a group intervention targeting psychotic symptoms, based on the cognitive behavioural model. In group CBTp, people work collaboratively on coping with distressing hallucinations, analysing evidence for their delusions, and developing problem-solving and social skills. However, the evidence for effectiveness is far from conclusive. OBJECTIVES To investigate efficacy and acceptability of group CBT applied to psychosis compared with standard care or other psychosocial interventions, for people with schizophrenia or schizoaffective disorder. SEARCH METHODS On 10 February 2021, we searched the Cochrane Schizophrenia Group's Study-Based Register of Trials, which is based on CENTRAL, MEDLINE, Embase, four other databases and two trials registries. We handsearched the reference lists of relevant papers and previous systematic reviews and contacted experts in the field for supplemental data. SELECTION CRITERIA We selected randomised controlled trials allocating adults with schizophrenia to receive either group CBT for schizophrenia, compared with standard care, or any other psychosocial intervention (group or individual). DATA COLLECTION AND ANALYSIS We complied with Cochrane recommended standard of conduct for data screening and collection. Where possible, we calculated risk ratio (RR) and 95% confidence interval (CI) for binary data and mean difference (MD) and 95% CI for continuous data. We used a random-effects model for analyses. We assessed risk of bias for included studies and created a summary of findings table using GRADE. MAIN RESULTS The review includes 24 studies (1900 participants). All studies compared group CBTp with treatments that a person with schizophrenia would normally receive in a standard mental health service (standard care) or any other psychosocial intervention (group or individual). None of the studies compared group CBTp with individual CBTp. Overall risk of bias within the trials was moderate to low. We found no studies reporting data for our primary outcome of clinically important change. With regard to numbers of participants leaving the study early, group CBTp has little or no effect compared to standard care or other psychosocial interventions (RR 1.22, 95% CI 0.94 to 1.59; studies = 13, participants = 1267; I2 = 9%; low-certainty evidence). Group CBTp may have some advantage over standard care or other psychosocial interventions for overall mental state at the end of treatment for endpoint scores on the Positive and Negative Syndrome Scale (PANSS) total (MD -3.73, 95% CI -4.63 to -2.83; studies = 12, participants = 1036; I2 = 5%; low-certainty evidence). Group CBTp seems to have little or no effect on PANSS positive symptoms (MD -0.45, 95% CI -1.30 to 0.40; studies =8, participants = 539; I2 = 0%) and on PANSS negative symptoms scores at the end of treatment (MD -0.73, 95% CI -1.68 to 0.21; studies = 9, participants = 768; I2 = 65%). Group CBTp seems to have an advantage over standard care or other psychosocial interventions on global functioning measured by Global Assessment of Functioning (GAF; MD -3.61, 95% CI -6.37 to -0.84; studies = 5, participants = 254; I2 = 0%; moderate-certainty evidence), Personal and Social Performance Scale (PSP; MD 3.30, 95% CI 2.00 to 4.60; studies = 1, participants = 100), and Social Disability Screening Schedule (SDSS; MD -1.27, 95% CI -2.46 to -0.08; studies = 1, participants = 116). Service use data were equivocal with no real differences between treatment groups for number of participants hospitalised (RR 0.78, 95% CI 0.38 to 1.60; studies = 3, participants = 235; I2 = 34%). There was no clear difference between group CBTp and standard care or other psychosocial interventions endpoint scores on depression and quality of life outcomes, except for quality of life measured by World Health Organization Quality of Life Assessment Instrument (WHOQOL-BREF) Psychological domain subscale (MD -4.64, 95% CI -9.04 to -0.24; studies = 2, participants = 132; I2 = 77%). The studies did not report relapse or adverse effects. AUTHORS' CONCLUSIONS Group CBTp appears to be no better or worse than standard care or other psychosocial interventions for people with schizophrenia in terms of leaving the study early, service use and general quality of life. Group CBTp seems to be more effective than standard care or other psychosocial interventions on overall mental state and global functioning scores. These results may not be widely applicable as each study had a low sample size. Therefore, no firm conclusions concerning the efficacy of group CBTp for people with schizophrenia can currently be made. More high-quality research, reporting useable and relevant data is needed.
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Affiliation(s)
- Giuseppe Guaiana
- Department of Psychiatry and Department of Epidemiology and Biostatistics, Western University, London, Canada
| | | | - Ghazaleh Aali
- Institute for Health Informatics Research, University College London, London, UK
| | | | - Ikenna D Ebuenyi
- IRIS Centre, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, USA
| | - Valeria Lucarini
- Institute of Psychiatry and Neuroscience of Paris, Université de Paris, Paris, France
| | - Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Caidi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Feldhacker DR, Lucas Molitor W, Jensen L, Lohman H, Lampe AM. Occupational Therapy and the IMPACT Act: Part 2. A Systematic Review of Evidence for Functional Status, Medication Reconciliation, and Skin Integrity Interventions. Am J Occup Ther 2022; 76:23147. [PMID: 35019969 DOI: 10.5014/ajot.2022.049324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Interventions that promote function, medication reconciliation, and skin integrity assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing health care costs. OBJECTIVE In this systematic review, we focus on three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: functional status, medication reconciliation, and skin integrity. DATA SOURCES We conducted a search of the literature published between 2009 and 2019 in CINAHL, Cochrane, MEDLINE, PsycINFO, OTseeker, and Scopus. We also hand searched the systematic reviews and meta-analyses in our search results for articles that met our inclusion criteria. Study Selection and Data Collection: This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS We found 47 articles that address the three outcome areas. Regarding functional status, low strength of evidence is available for cognition and functional mobility interventions to support functional performance, moderate strength of evidence supports interventions for vision, and moderate evidence supports task-oriented and individualized interventions to promote activities of daily living (ADL) outcomes among people with neurological conditions. Strong strength of evidence supports individualized occupational therapy interventions focusing on medication adherence. Low strength of evidence was found for occupational therapy interventions to reduce pressure ulcers and promote skin integrity. Conclusion and Relevance: The evidence supports occupational therapy interventions to improve functional status in ADLs and medication management. Additional research is needed that examines the outcomes of occupational therapy interventions for other areas of function and skin integrity. What This Article Adds: We found evidence to support occupational therapy interventions that align with value-based measures in the three outcome areas of interest. The effectiveness of these interventions highlights the viability of occupational therapy as an essential profession and the worth of occupational therapy to the public, potential clients, and payers.
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Affiliation(s)
- Diana R Feldhacker
- Diana R. Feldhacker, OTD, OTR/L, BCPR, is Department Chair and Assistant Professor in Occupational Therapy, Department of Occupational Therapy, Des Moines University, Des Moines, IA;
| | - Whitney Lucas Molitor
- Whitney Lucas Molitor, PhD, OTD, OTR/L, BCG, is Assistant Professor, Department of Occupational Therapy, and Undergraduate Public Health Program Director, University of South Dakota, Vermillion
| | - Lou Jensen
- Lou Jensen, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Helene Lohman
- Helene Lohman, OTD, OTR/L, is Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
| | - Angela M Lampe
- Angela M. Lampe, OTD, OTR/L, is Associate Professor, Department of Occupational Therapy, Creighton University, Omaha, NE
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Rocamora-Montenegro M, Compañ-Gabucio LM, Garcia de la Hera M. Occupational therapy interventions for adults with severe mental illness: a scoping review. BMJ Open 2021; 11:e047467. [PMID: 34716157 PMCID: PMC8559113 DOI: 10.1136/bmjopen-2020-047467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To identify the occupational therapy (OT) interventions in adults with severe mental illness (SMI) most investigated in intervention studies and to describe their characteristics. DESIGN Scoping review. DATA SOURCES On 17 January 2020, we searched the following electronic databases: MEDLINE, Scopus, Web of Science and EMBASE. We also performed a manual search of TESEO doctoral thesis database and of the journals indexed in the first quartile of OT according to the SCImago Journal Rank. We updated our search on 10 March 2021, performing a complementary search on ProQuest database and repeating the search in all sources. The terms included in the search strategy were: schizophrenia, schizotypal personality, delusional, schizoaffective, psychotic, bipolar, major depression, obsessive-compulsive, severe mental, OT and intervention. STUDY SELECTION The study screening was peer-reviewed. Inclusion criteria were: (1) OT intervention studies in SMI: experimental, randomised, non-randomised and pilot/exploratory studies; (2) adult population with SMI: schizophrenia, schizotypal personality disorder, delusional disorder, obsessive-compulsive disorder, schizoaffective disorder, psychotic disorder, bipolar disorder, major depressive disorder; (3) OT identified as a discipline involved in the intervention; (4) English or Spanish language and (5) studies with full text available. RESULTS Thirty-five studies met the inclusion criteria. OT interventions were classified in psychosocial, psychoeducational, cognitive and exercise interventions. The most used OT intervention was psychosocial intervention. CONCLUSION Psychosocial intervention was the most investigated OT intervention in SMI, followed by psychoeducational, cognitive and exercise interventions. These interventions are usually group interventions in patients with schizophrenia, performed by a multidisciplinary team (in which an occupational therapist collaborates), with 2-3 weekly 60 min sessions and a duration of 3-6 months.
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Affiliation(s)
- María Rocamora-Montenegro
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
| | - Laura-María Compañ-Gabucio
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Comunidad Valenciana, Spain
| | - Manuela Garcia de la Hera
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Comunidad Valenciana, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Bernardo LD, Pontes TB, Souza KID, Ferreira RG, Deodoro TMS, Almeida PHTQD. Activity card sort e o repertório ocupacional de idosos: uma revisão integrativa da literatura. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2021. [DOI: 10.1590/2526-8910.ctoar2130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução O Activity Card Sort (ACS) é uma ferramenta desenvolvida para avaliar a participação de idosos em atividades instrumentais de vida diária, sociais e de lazer de baixa e alta demanda. É considerado um instrumento de avaliação útil para o processo terapêutico ocupacional utilizando uma abordagem baseada nas ocupações e centrada no cliente. Objetivo Analisar as principais características da produção científica sobre a utilização do ACS na população de idosos. Método Foi realizada uma revisão integrativa da literatura. Para a seleção dos registros bibliográficos, foram selecionadas seis fontes de informação, sem recorte temporal. Na organização e análise dos dados, foi criada uma coleção dos registros bibliográficos para realizar a análise descritiva e, na construção e visualização de redes bibliométricas, foi aplicado o VOSviewer. Resultados A amostra foi composta por 67 artigos. Os objetivos das pesquisas eram direcionados a examinar as propriedades psicométricas do instrumento, utilizar o ACS para comprovar o impacto das deficiências na participação e engajamento em atividades ou usar o ACS como medida de desfecho em diferentes intervenções. Conclusão O instrumento se apresentou como uma opção que enriquece o processo avaliativo na terapia ocupacional, uma vez que apresentou boas propriedades psicométricas, foi capaz de capturar o nível de participação em diferentes populações, assim como pôde ser usado como medida de desfecho para intervenções que se preocupam com o engajamento em ocupações.
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Toglia J, Lee A, Steinberg C, Waldman-Levi A. Establishing and measuring treatment fidelity of a complex cognitive rehabilitation intervention: The multicontext approach. Br J Occup Ther 2020. [DOI: 10.1177/0308022619898091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction This article describes the process of establishing and measuring treatment fidelity of a complex cognitive rehabilitation intervention that uses a metacognitive strategy framework (the multicontext approach). We adapted treatment guidelines for use within an inpatient rehabilitation setting for people with acquired brain injury; explored training methods and therapist perspectives; developed and examined inter-rater reliability of a fidelity measure; and examined adherence to and proficiency of treatment methods. Method Therapist perspectives of the intervention and training were obtained from written questionnaires and reflections. Inter-rater reliability of 21 treatment components across 22 video-recorded treatment sessions was assessed by examining absolute agreement between two raters using Cohen’s kappa. The proportion of treatment components implemented in individual sessions as well as average proficiency ratings was calculated. Results The fidelity measure demonstrated good inter-rater agreement, ranging from 91–100% for treatment adherence and kappa of .77 to .94 for therapist proficiency. Adherence and proficiency varied between therapists but increased to nearly proficient levels with adjustments to training and procedures. Therapists highlighted the critical importance of video review as a training tool. Conclusion The fidelity measure provides a clinical tool for therapist self-reflection, supervision and training, as well as a tool for future research.
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Affiliation(s)
- Joan Toglia
- School of Health and Natural Sciences, Mercy College, New York, USA
- Department of Rehabilitation Medicine, New York-Presbyterian/Weill Cornell Medical Center, New York, USA
| | - Alyson Lee
- Department of Rehabilitation Medicine, New York-Presbyterian/Weill Cornell Medical Center, New York, USA
- MOTION Sports Medicine, Bronx, New York, USA
| | - Chelsea Steinberg
- Department of Rehabilitation Medicine, New York-Presbyterian/Weill Cornell Medical Center, New York, USA
| | - Amiya Waldman-Levi
- Department of Occupational Therapy, Long Island University, Brooklyn, New York, USA
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