Conducting Systematic Reviews to Inform Occupational Therapy Practice

The role of occupational therapy for the self-management of rheumatoid arthritis: A protocol for a mixed methods systematic review

BACKGROUND

Occupational therapists can support people with rheumatoid arthritis to self-manage their disease symptoms and engage in daily activities. This protocol reports a review to broaden understanding of what is known about the role of occupational therapy in the self-management of rheumatoid arthritis.

METHODS

Studies involving adults with rheumatoid arthritis, having participated in self-management involving occupational therapy, will be included. Patient involvement will help develop the search strategy by identifying patient-centred interventions and outcomes to complement those identified by researchers. An electronic search will be performed using several bibliographic databases, including grey literature from subject-specific, health-related, and social care databases. Searches will run from the database inception until the date that the search is conducted (December 2021-May 2022). Retrieved studies will be de-duplicated, and the remaining titles and abstracts will be screened by three reviewers. Full texts of all eligible studies will be independently reviewed by the reviewers to select papers for data extraction and quality assessment. Outcomes are function, pain, fatigue and lived experience. For quantitative studies, data will be synthesised using descriptive statistics in text and tables, whereas for qualitative studies, data will be synthesised using thematic synthesis.

DISCUSSION

This review will synthesise current evidence on how occupational therapy can help the self-management of rheumatoid arthritis. It will include evidence of best practice, including advice, education and training provided by occupational therapists. These findings can inform future research and the selection of strategies to promote quality of life for people with rheumatoid arthritis.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022302205.

Systematic Review of Apraxia Treatments to Improve Occupational Performance Outcomes

The objective was to assess effectiveness of apraxia treatments using a systematic review. In contrast to previous reviews, each study was rated as to its applicability to occupational therapy practice and its focus on occupational performance using the FAME rating system (defined by four categories: Feasibility, Appropriateness, Meaningfulness, Effectiveness). This systematic review included eight studies: four randomized controlled trials (level 1 evidence) and four pre-post designs (level 3 evidence). Three treatment approaches were reported: errorless learning with training of details; gesture training; and strategy training. FAME scores ranged from A to C. All studies reported significant treatment effects, but only one demonstrated an impact on observed occupational performance that transferred from clinic to home.

Systematic Reviews of Occupational Therapy Interventions: Summarizing Research Evidence and Highlighting the Gaps

As services are commissioned based on effectiveness, occupational therapists are under pressure to demonstrate the efficacy of their interventions. Occupational therapists also need to know that the interventions they are providing are effective. Robertson et al (2013) demonstrated that the occupational therapy literature is important for clinicians and is an essential part of their practice. However, as more research is published, it can be increasingly time-consuming and confusing for clinicians to keep abreast of the current literature. Occupational therapy-related research may be published in different forms, in a range of locations, and be of varying methodological quality. Furthermore, readily available published studies that investigate occupational therapy efficacy may not be sufficiently powered, or may lack external validity, when applied to different clinical settings. When well conducted, systematic reviews provide a useful way of synthesizing and evaluating the evidence on a particular topic and, to some extent, provide a solution to this problem. This paper focuses upon reviews of randomized controlled trials, as these provide the highest quality of evidence on the question of a particular intervention's effectiveness. The merits of reviews of qualitative studies are also considered, together with the possibility of combining more than one type of review.

Systematic Reviews Informing Occupational Therapy

OBJECTIVE. We sought to identify and describe the number, topics, and publishing trends of systematic reviews relevant to occupational therapy indexed in the OTseeker database.

METHOD. We performed a cross-sectional survey of the systematic reviews contained in OTseeker in December 2011.

RESULTS. Of the 1,940 systematic reviews indexed in OTseeker, only 53 (2.7%) were published in occupational therapy journals. The most common diagnostic categories were stroke (n = 195, 10.1%) and affective disorders (n = 204, 10.5%). The most common intervention categories were consumer education (n = 644, 33.2%) and psychosocial techniques (n = 571, 29.4%). Only 390 (20.1%) of the 1,940 systematic reviews specifically involved occupational therapy.

CONCLUSION. Occupational therapists need to search broadly to locate relevant systematic reviews or, alternatively, to use databases such as OTseeker. Clarity about the involvement of occupational therapy in reports of future research will improve the ability to identify occupational therapy research for all stakeholders. Finally, occupational therapy practitioners need to read systematic reviews critically to determine whether review conclusions are justified.

A systematic review of occupational therapy interventions with homeless people

ABSTRACT A systematic review of the occupational therapy literature 1990-2008 was undertaken with the aim to assess the quality of evidence that supports the role of occupational therapy with homeless people. Forty articles were initially identified and critically appraised, including 16 research studies. Seven quantitative articles were included in this review and demonstrated the effectiveness of occupational therapy in providing interventions that increase employment and education prospects, money management, coping skills, and leisure activities. The literature suggests that occupational therapy has an appropriate role with people experiencing homelessness.

Perceptions and Attitudes toward Conducting Research: A Nuclear Medicine Student Perspective

One of the well-established hallmarks of a profession is its ability to generate research to expand its unique professional knowledge base. Health care professionals in today's rapidly evolving, highly technological work environment also need the skills to use research findings in their practice. Practitioners, therefore, need to have the knowledge and skills to competently engage in research activities. There have been a number of studies investigating how health care professionals perceive their role in regards to research. However, little is known about how nuclear medicine (NM) students perceive research and if they see themselves playing a role in the future research in their field.

OBJECTIVES

To determine the attitudes and perceptions of NM students toward conducting research and to explore factors that influence NM students' perceptions of conducting research.

METHODS

Seventy surveys were sent out via e-mail to NM students studying at the University of Toronto and Michener Institute joint degree-diploma program in Medical Radiation Sciences; 21 completed surveys were collected.

RESULTS

The majority of students reported having no intention of engaging in research in the future. General disinterest in research was the most common reason stated for not engaging in research.

DISCUSSION

Though the results of this preliminary study cannot be generalized to all NM students, it does reveal a negative attitude toward conducting research among the NM students surveyed. It has also been shown that general disinterest in research seems to be one of the most important barriers for students. Further studies with more in-depth analysis and a larger sample size are necessary to determine whether students feel they have a role to play in the future research in the NM field and to further explore barriers to research participation.