A scoping review of online international student collaboration in occupational therapy education

Introduction

For occupational therapy students, international experiences and access to a global curriculum develops understanding of broad cultural and contextual determinants of health and wellbeing. International placements or study abroad opportunities are not possible for many students and many universities are developing alternative internationalisation opportunities. The aim of this review was to determine what is known from the existing literature on the use of online international student collaboration in occupational therapy curricula.

Method

A scoping review design was used to search relevant literature on online international student collaboration in occupational therapy education, following a methodological framework for conducting scoping reviews. Seven databases were searched. Search included all articles published up until November 2020.

Findings

The database searches yielded a total of 2011 results. Following screening and review of articles ten papers met the inclusion criteria and were included in the review. The studies were charted and discussed in the areas of format of the online interactions, reported outcomes of the online interactions, barriers and facilitators in implementation.

Conclusion

Findings inform curricula designers establishing online international learning and those conducting research in this area. Outcomes indicate the breadth of student learning including culture, diversity, as well as the social determinants of occupational engagement and participation.

Registration

Protocol Registered: 2020-07-06, available on Open Science Framework (OSF) at https://osf.io/wfkjy

Assessing the use of a portable time-geographic diary for detecting patterns of daily occupations

BACKGROUND

A time-geographic diary approach is of interest in occupational therapy due to the inclusion of the diarist's subjective experiences. There are several methods for detecting doing in time, but details needed for analysis are still lacking. The smartphone application POrtable Diary Data collector (PODD), a 24-hr diary based on the time-geographic diary has recently been introduced.

AIM

To test the usability of PODD as a tool for diary data collection to detect and visualize sequences of daily activities.

MATERIAL AND METHODS

An exploratory sequential design was used, where diary data was first collected and then followed by a questionnaire assessing usefulness. Thirty-one occupational therapy students participated. Usability testing was applied, exploring how participants experienced the use of the device. Data was analysed qualitatively and quantitatively.

RESULTS

The PODD visually presents activity sequences and thus assists in detecting patterns of daily occupations (PDO). The students agreed on the supportive statements concerning learnability, efficiency and memorability. Regarding errors and satisfaction, participants agreed that the device was easy to use.

CONCLUSIONS

Using a mobile application to collect data about students' daily activities was effective. However, the PODD needs to be further evaluated among other groups and contexts as well as for its usefulness for PDO analyses.

Translation and cross-cultural adaptation of the performance-based test - Evaluation in Ayres Sensory Integration®

BACKGROUND

The Evaluation in Ayres Sensory Integration^® (EASI) is a performance-based assessment tool, aiming to assess sensory perception, sensory reactivity, postural/ocular/bilateral integration, and praxis in children aged 3-12 years. These types of tests are currently not available in Swedish. A structured, multistep process of translation is crucial for maintaining equivalence between the source and target version of a test.

OBJECTIVE

Develop a culturally adapted Swedish research version of the EASI for use in the forthcoming international normative data collection.

METHOD

The translation process followed the first four stages in recommended guidelines for cross-cultural adaptation. Each subtest was translated by two occupational therapists and merged into one Swedish version. That version was reviewed by clinical paediatric occupational therapists in focus groups. The meetings were recorded, transcribed and a content analysis was conducted. One subtest was then subjected to a back-translation process.

RESULT

Some discrepancies regarding semantic equivalence were found and adapted through all stages. No discrepancies regarding idiomatic or conceptual equivalence were found. Revisions due to the translation process have been incorporated into the final research version of the EASI.

CONCLUSION

A first, culturally adapted research version of the EASI is ready for the Swedish normative data collection.

Occupational balance and sleep among women

BACKGROUND

In occupational therapy, while several studies have focussed on occupational balance, few have investigated it in the context of sleep.

AIMS

The aim of this study was to investigate the associations between sleep and occupational balance among women.

MATERIAL AND METHODS

In total, 157 women responded to the Occupational Balance Questionnaire and Karolinska Sleep Questionnaire. Linear regression was used to analyse data.

RESULTS

The median score for occupational balance was 12 (interquartile range [IQR] 9), while that for sleep was 86 (IQR 16). Sleep and sleepiness fatigue were significantly associated (p < 0.1) with satisfaction with the number of occupations during a regular week. Difficulties awakening and snoring disorders were significantly associated (p < 0.1) with balance with physical, social, intellectual, and restful occupations.

CONCLUSIONS

The majority of participants slept well and had a good sleep quality. There is an association between occupational balance and sleep. In particular, aspects related to the number of occupations, adequate time to perform them and the time spent recovering and sleeping were associated with good sleep quality. Balance among physical, social, intellectual, and restful occupations was associated with difficulties awakening and snoring.

SIGNIFICANCE

Our results support the need for occupational therapists to focus on occupational balance, to improve women's sleep.

Monitoring progression of clinical reasoning skills during health sciences education using the case method - a qualitative observational study

BACKGROUND

Outcome- or competency-based education is well established in medical and health sciences education. Curricula are based on courses where students develop their competences and assessment is also usually course-based. Clinical reasoning is an important competence, and the aim of this study was to monitor and describe students' progression in professional clinical reasoning skills during health sciences education using observations of group discussions following the case method.

METHODS

In this qualitative study students from three different health education programmes were observed while discussing clinical cases in a modified Harvard case method session. A rubric with four dimensions - problem-solving process, disciplinary knowledge, character of discussion and communication - was used as an observational tool to identify clinical reasoning. A deductive content analysis was performed.

RESULTS

The results revealed the students' transition over time from reasoning based strictly on theoretical knowledge to reasoning ability characterized by clinical considerations and experiences. Students who were approaching the end of their education immediately identified the most important problem and then focused on this in their discussion. Practice knowledge increased over time, which was seen as progression in the use of professional language, concepts, terms and the use of prior clinical experience. The character of the discussion evolved from theoretical considerations early in the education to clinical reasoning in later years. Communication within the groups was supportive and conducted with a professional tone.

CONCLUSIONS

Our observations revealed progression in several aspects of students' clinical reasoning skills on a group level in their discussions of clinical cases. We suggest that the case method can be a useful tool in assessing quality in health sciences education.

Effect of an occupation-focused family intervention on change in parents' time use and children's body mass index

OBJECTIVE. This study explored factors related to changes in the time parents spent with their children with obesity and associated decreases in children's body mass index (BMI) z-scores after an occupation-focused intervention. METHOD. Parents participated in a 1-yr occupation-focused intervention to promote healthy family lifestyles. Data on 40 parents of 22 children with obesity ages 4-6 yr were collected before and after intervention and analyzed using linear and multiple regression methods. RESULTS. Parents increased time spent with their children by an average of 91 min/day. Parents' finances, perceived satisfaction in daily occupations, low BMI, and mastery at inclusion were associated with increased time spent with their children. Mothers' subjective health and high mastery and fathers' perceived occupational value and education explained 67% of the variance in children's BMI z-scores. CONCLUSION. The results indicate important factors to consider in developing interventions that facilitate occupational engagement and health among children with obesity and their families.

Changes in parents' time use and its relationship to child obesity

OBJECTIVE

The aim was to explore any change in parents' time use together with their children, changes in their perceived occupational value, and its relationship to children's body mass index (BMI) over the course of a one-year occupation-focused family intervention.

METHOD

The study sample consisted of participants in one arm of a randomized controlled trial, involving mothers and fathers (n = 30) of 17 children aged 4-6 years who were considered obese. Data were collected by time-geographical diaries during the intervention and by measuring the parents' occupational value and the children's BMI before and after the intervention.

RESULTS

At the end of the intervention, an increase was shown in the amount of time parents spent together with their children during weekdays (p = .042) and the parents perceived occupational value (p = .013). Children's BMI z-score changed with -0.11 units.

CONCLUSION

Collaboration with parents may be useful in interventions aiming at facilitating a normal weight development among children.

A family-based intervention targeting parents of preschool children with overweight and obesity: conceptual framework and study design of LOOPS- Lund overweight and obesity preschool study

Background

As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years) will have reduced their BMI-for-age z-score.

Methods/Design

The study is a randomized controlled trial, including overweight (n=160) and obese (n=80) children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of parental stress.

Discussion

The LOOPS project will provide valuable information on how to build effective interventions to influence an unhealthy weight development to prevent the negative long-term effects of childhood obesity.

Trial registration

ClinicalTrials.gov NCT00916318

Using a time-geographical diary method in order to facilitate reflections on changes in patterns of daily occupations

OBJECTIVE AND METHODS

Time-use methodologies have been proposed to be established research techniques when exploring aspects of daily occupations. In this study, two graphs illustrating the time arrangement of occupations as they appear in a continuous sequence were used in order to encourage individuals to reflect on their everyday life. The aim was to investigate the usefulness of a time-geographical diary method (using illustrative graphs) in combination with stimulated-recall interviews, to facilitate reflections on how patterns of daily occupations change over time and the causes that lie behind these changes. The study had a qualitative design. The participants were two working, married mothers, i.e. individuals considered to have highly complex patterns of daily occupations. The data analysis was performed by using thematic content analysis.

RESULTS

The results showed that the stimulated-recall interviews, based on the graphs, facilitated new insights that came to light concerning the scope of the participants' daily life. The method enabled the participants to reflect on their patterns of daily occupations and become aware of changes relevant to explain the causes for engaging in occupations the way they did.

CONCLUSIONS

The method thus seems useful in research and practice for occupational therapists working with individuals with a need to change lifestyle.

The American Paediatric Evaluation of Disability Inventory (PEDI). Applicability of PEDI in Sweden for children aged 2.0-6.9 years

The American Paediatric Evaluation of Disability Inventory (PEDI) is a new instrument for evaluating functional performance in disabled children aged 6 months to 7.5 years. It was developed to determine a child's functional capacity and performance in three domains, self-care, mobility and social function, as reflected in scores on three scales: (i) functional skills (current capability in specific tasks), (ii) caregiver assistance (i.e. provided to facilitate the child's performance), and (iii) modifications (i.e. environmental or technical modifications needed to facilitate the child's function). The present study was designed to compare results obtained using the PEDI in a Swedish sample with the American normative data, and to analyse the content and relevance of PEDI items for use in Sweden. The PEDI was administered as a questionnaire in structured interview form to the parents of 52 non-disabled Swedish children aged 2.0-6.9 years, divided into ten age groups. Correlation analysis (Pearson's r) showed scores for the Swedish sample to manifest strong correlation with the respective American normative data, both for the functional skills (r = 0.90-0.98) and caregiver assistance (r = 0.93-0.99) scales, respectively. Scores for the modification scale were not compared. Thus, the results suggest the American normative data to be appropriate for reference purposes in Sweden.