Background: The rise of electronic learning and digital health underscores the need for occupational therapists (OTs) to be proficient in using them. Digital training enables OTs to update their skills, while the integration of digital health tools into clinical practice enhances patient care. Thus, it is crucial to explore the factors that influence the acquisition of knowledge in occupational therapists through digital training. In response, an online educational tool about the ActiveHip + mHealth intervention (NCT04859309) was developed to enhance students' knowledge of managing digital health tools for older adults with a hip fracture.

Objectives: The primary aim of this study was to assess the feasibility of the online educational tool about the ActiveHip + mHealth intervention. The secondary aims were to explore the relationship between the knowledge after using the online educational tool and different factors (e.g., emotional status) and to inform future studies to assess the effectiveness of this tool.

Methods: A feasibility study was conducted including Occupational Therapy (OT) students who completed the online educational tool about ActiveHip + mHealth intervention. The feasibility was assessed through adoption, adherence and acceptability, while learning was assessed using a questionnaire administered before and after the use of the online educational tool. The influence of different factors (i.e., emotional intelligence, previous knowledge) on knowledge after using it was also estimated.

Results: The online educational tool demonstrated satisfactory feasibility results, with 83% adoption, 98% adherence and high overall acceptance (120.35 out of 141). Among the acceptance dimensions, performance expectancy, effort expectancy and facilitating conditions received the highest scores. While factors such as course year, effort expectancy and hedonic motivation showed independent correlations with knowledge after using the online educational tool, sequential regression analysis revealed that prior knowledge was the only significant predictor of the knowledge after using the online tool.

Conclusion: The online educational tool about ActiveHip + mHealth intervention is feasible to use for the occupational therapy students. However, we do not recommend its implementation in educational settings until well-randomised controlled trials confirm its effectiveness.

Among the deleterious effects caused by hospitalization of elderly patients in intensive care unit (ICU), delirium and impaired performance in occupations are frequent and have long-term negative outcomes. Delirium protocols described in the literature vary in frequency, intensity, and content regarding pertinent interventions. Occupational Therapy (OT) practices are heterogeneous and generally consist of non-personalized interventions. For this reason, the primary outcome of this research is to evaluate the effect of a person-centered OT protocol on the prevention of delirium and the occupational performance of elderly patients admitted to the ICU. This is a randomized clinical trial with blinded assessment of the primary outcome (delirium). A total of 114 patients will be recruited and randomized to the intervention group, where care goals will be defined according to meaningful occupations and personalized cognitive stimulation will be based on patient´s topics of interest, in addition to the institutional standard protocol (ISP); or to the control group, which will receive only the ISP. To our knowledge, this will be the first randomized controlled trial with personalized occupational therapy interventions, as well as care goals, based on patients´ meaningful occupations for the prevention of delirium and improvement of occupational performance in critically ill elderly patients. This clinical trial is duly registered on the ClinicalTrials.gov platform (NCT06479031).

Background: Assessing perceptions of occupational balance is essential in both clinical occupational therapy and research. Attempts to characterise occupational balance often arrive at multi-faceted explanations, including a variety of occupations, personal satisfaction, and time allocation.

Aim: This study aimed to deepen the understanding of occupational balance as a phenomenon and investigate the relevance and usability of the Satisfaction with Daily Occupations and Occupational Balance (SDO-OB), which assesses occupational balance from the multi-faceted perspective mentioned above.

Methods: A cross-sectional and longitudinal design was employed. Patients undergoing the treatment method Tree Theme Method^™ for depression and/or anxiety completed the SDO-OB and a background questionnaire. Conventional statistical analyses were used.

Results: Variety of occupations and personal satisfaction remained stable between baseline and follow-up, while participants' time allocation shifted from underoccupied towards balanced in the home and maintenance domain. All three perspectives of occupational balance were intercorrelated at baseline, and baseline scores on variety of occupations and on time allocation in work, leisure, and household domains were associated with personal satisfaction at follow-up.

Conclusion and significance: The three perspectives appeared to represent a unified phenomenon-occupational balance-while still offering unique insights. The SDO-OB seems relevant for both clinical occupational therapy and research.

Trial registration: Clinical Trials.gov: NCT01980381.

Background: Within the development of new interventions, it is of highly important to address social participation since it is associated with improved physical and mental health. Therefore, a new intervention in occupational therapy, 'The health Web' was developed.

Aim: The aim of this study was to explore and describe how older adults experienced the intervention process of 'The Health Web' provided by an occupational therapist, and whether the intervention has the potential to promote social participation.

Material and methods: An exploratory descriptive case study was designed. Five older adults and an occupational therapist were included. Interviews, self-assessments, registration forms and field-notes were used to collect data. The data were analysed using pattern-matching.

Results: The results consist of two cases: A) Continuous engagement promoted the development of strategies and: B) Uneven engagement inhibited the development of strategies. Each case is described with three categories representing the experienced intervention process of the older adults in the respective case.

Conclusions and significance: The results suggest that the intervention has some potential to support older adults' in using strategies supporting social participation. This study provides valuable insights for the continued development of the intervention.

Importance: As the aging population expands, the need to develop home modification programs that effectively support older adults living in low-income households is increasing.

Objective: To examine how an interprofessional team implemented the Older Adult Home Modification Program (OAHMP) at a specific urban site and integrated functional interventions and home modifications to address the safety, accessibility, and functional needs of older adults in low-income households.

Design: This program evaluation study used descriptive analysis to evaluate sociodemographic characteristics, pre- and postimplementation data, and home modifications.

Setting: An urban city environment.

Participants: Sixty-five participants completed the program. The average age was 72 yr (SD = 7.3); participants were predominantly women (95.4%), Black or African American (87.7%), and living alone (81.5%).

Intervention: Three in-home visits by an occupational therapist, a home modification team, and a social worker.

Outcomes and measures: A paired-samples t test was conducted to compare pre- and postimplementation functional scores on the assessments used, and Pearson's r correlation analysis was used to assess relationships between functional measures.

Results: The OAHMP implementation led to significant improvements in self-care activities of daily living (ADLs) and home safety; significant positive relationships were found between health status and improved independence in ADLs and instrumental ADLs.

Conclusions and relevance: The OAHMP enhances ADL independence and home safety for older adults in low-income, diverse communities. By addressing environmental barriers through client-centered modifications and interprofessional collaboration, the program supports aging in place. Its cost-effective approach fosters autonomy, occupational engagement, and health equity, highlighting occupational therapy's key role in safe, sustainable community living. Plain-Language Summary: This study evaluated the Older Adult Home Modification Program (OAHMP), which aims to help older adults in low-income communities age safely in place by addressing home safety, accessibility, and ADLs. Findings showed that participants experienced increased independence in ADLs and reduced home safety hazards, with 91% of personal goals met or partially met. The average cost of home modifications was significantly lower than national averages, making the program a cost-effective alternative to nursing home placement. The results highlight how tailored home modifications, combined with interprofessional collaboration, can promote ADL independence and safety in the home. This study emphasizes the essential role of occupational therapy in developing equitable, client-centered interventions that address environmental barriers, contributing valuable insights to occupational therapy research, practice, and education. Positionality Statement: The authors are one Black female therapist, one White female therapist, and two White female occupational therapy students. We acknowledge that our economic, educational, and cultural backgrounds may influence our perspectives and potential biases in this analysis.

Background: Occupational therapy (OT) and transcranial direct current stimulation (tDCS) are both important methods for promoting the recovery after stroke. There are limited researches that simultaneously apply both methods and investigate their effects on upper limb function.

Objective: To investigate the effects of OT synchronized with dual tDCS on upper limb motor function and Electroencephalogram (EEG) power in subacute stroke patients.

Methods: Forty-five subacute stroke patients were randomly assigned to control group (n = 23) and experimental group (n = 22), receiving sham and real dual tDCS concurrent with OT respectively, five times a week, for a duration of two weeks. Upper limb motor function and cortical EEG power were evaluated by Fugl-Meyer Assessment Upper Extremity (FMA-UE), Modified Barthel Index (MBI) and Action Research Arm Test (ARAT), Delta/Alpha Ratio (DAR) and pairwise derived Brain Symmetry Index (pdBSI) at baseline and two weeks.

Results: Finally, a total of 39 patients completed the study and were included in the analysis. The results revealed that participants in the experimental group showed a significant better evolution for FMA-UE (p < 0.001), MBI (p = 0.034), DAR in the primary motor cortex (M1) area (p = 0.022) and pdBSI (p = 0.025) compared to the control group.

Conclusions: In subacute stroke patients, the central-peripheral combined stimulation approach, which involves dual tDCS (central stimulation) and synchronous OT (peripheral sensory-motor stimulation) enhanced the effects of OT alone, leading to greater improvements in upper limb function and normalization of brain activity.

Trial registration: This trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2400082749).

Introduction: Occupational therapy is underpinned by the belief that occupation facilitates health and wellbeing. However, evidence suggests that occupational therapists encounter challenges to implementing occupation-centred practice. The aim of this study was to investigate the uptake, acceptability and impact of a workplace intervention designed to enhance occupation-centred practice of occupational therapists in an acute adult physical context.

Methods: A concurrent mixed methods study using a pre-post design was employed. The setting was a regional and rural health service in Queensland. Data were collected using an online survey of occupational therapists' knowledge, attitude and confidence regarding occupational therapy models, an audit of medical charts and focus group discussion and in-depth interviews. Quantitative data were presented using descriptive statistics, and discussions were thematically analysed.

Consumer and community involvement: No involvement.

Results: Survey results revealed minimal difference between pre- (n = 8) and post- (n = 8) interventions. The medical chart audit (pre = 40, post = 28) revealed an increase in occupational language over medically based language. Four themes were identified from the qualitative data (pre = 5, post = 6): change in theoretical awareness and acceptance of occupational therapy models; facilitators for adoption of occupational therapy models in the acute setting; what it takes: the qualities and efforts required of individuals; and enhanced professional identity. The themes revealed that participants varied in their knowledge and implementation of occupation-centred practice pre-intervention and could feel constrained by the workplace context. Post-participants recognised that actively practising occupation centredness impacted positively on their practice.

Conclusion: Participation in an initiative to increase occupation-centred practice resulted in changed behaviours and beliefs for occupational therapists in this study. Participants recognised that their individual contribution and the concerted efforts of their occupational therapy peers led to increased professional identity and understanding of occupational therapy contribution in the acute adult physical setting.

Plain language summary: Occupational therapists promote health and wellbeing by working with people of all abilities to participate in the everyday occupations of life. However, within some hospital settings, occupational therapists face a number of challenges to implementing their desired approach due to time restrictions and dominance of other professions. Because of this, consumers and health colleagues in hospitals are unclear on the role or value of occupational therapists, and occupational therapists feel misunderstood. This may impact on job satisfaction, retention of staff in this setting and missed opportunities for identifying needs for consumers. In a regional and rural setting, this may be further complicated by occupational therapists working in isolation from direct professional support. In this project, occupational therapists in a regional and rural health service participated in an activity aimed to enhance their communication and confidence in their unique approach. The activity involved developing and using tools and resources for a hospital context that were 'occupation-centred' or were based on 'occupational therapy models'. Despite occupational therapists reporting that making this change required effort, they recognised that with persistence and collaboration, there was an improved understanding of occupational therapy contribution in the setting and better job satisfaction for occupational therapists. The tools and resources that were developed can be easily adopted by other organisations. These findings show that occupational therapists working in hospitals can alter their behaviours and beliefs to be more true to the profession. And that this benefits occupational therapists, consumers and the broader health-care team.

Aim: This scoping review aims to describe the literature about the experiences of family caregivers and persons living with dementia transitioning into residential care facilities; and to identify missed opportunities for occupational therapy to support this transition.

Methods: The methodological framework proposed by Arksey and O'Malley guided the review. Six electronic databases were systematically searched for peer-reviewed studies published between Jan 2017 and June 2024 including people with dementia aged 65+ years prior to, during and post-admission to a residential care facility and/or family caregiver.

Results: Twenty-three studies met the inclusion criteria, reporting research from Australia, Europe and North America. Family caregivers and people with dementia face multiple challenges prior to, during, and after admission to a residential care facility. Four overarching themes were identified; (1) Factors during the transition process with two subthemes: caregiver perceptions and heightened emotions; (2) Trying to get help; (3) Effectiveness of transition interventions; and (4) Unmet needs. Families feel overwhelmed, uncertainty about accessing residential care, guilt about relinquishing care and role loss post-admission. Persons living with dementia report experiencing a loss of autonomy and connection with their family, staff and co-residents. The understanding of dynamics and relationships during transitions can impact health and well-being, highlighting the importance of tailored support from various healthcare professionals, including occupational therapists.

Conclusion: Findings suggest that the transition into a residential care facility is complex and filled with emotional, psychological, familial and functional changes. Navigating these changes represents a unique opportunity for occupational therapists to utilise their distinctive skill set to navigate this transition and support the health and well-being of caregivers and persons living with dementia.

Introduction: The provision of sensory processing information is one aspect of occupational therapy involvement in diagnostic assessment for autism spectrum disorder and attention deficit hyperactivity disorder. The aim of this study was to retrospectively compare SHORT Sensory Profile 2 results of children with suspected diagnoses and assess the discriminatory ability of modified scales of SHORT Sensory Profile 2 to identify diagnostic criteria.

Method: This study involved a retrospective chart audit of SHORT Sensory Profile 2 results and paediatrician letter of diagnosis (N = 92) for children aged 6-13 years who had multidisciplinary diagnostic assessment through outpatient paediatric service.

Consumer and community involvement: No consumers participated in the study design or analysis. Study involved retrospective analysis of de-identified results from caregiver assessments.

Results: Forty nine per cent of children in study sample had confirmed diagnosis of attention deficit hyperactivity disorder, and 26% had diagnosis of autism spectrum disorder. Average percentage scores for both behavioural and sensory components of the SHORT Sensory Profile 2 were highest amongst children with a diagnosis of autism spectrum disorder, as well as higher classification for avoiding and seeking quadrants. In relation to modified scales, Cronbach's alpha indicated high internal consistency for inattention (0.84) and social communication and interaction (0.86). Based on the ROC analyses, the discriminatory ability when all the modified scales are used in combination ranged from poor (original four quadrants to distinguish ADHD vs no diagnosis: AUC = 0.59) to good (ASD vs ADHD; AUC = 0.82; ASD vs no diagnosis (AUC = 0.81).

Conclusion: Results of this study highlight the need for more rigorous investigation for validation of modified scales and consensus within occupational therapy and multidisciplinary team in relation to reporting of sensory processing information and contribution to diagnostic criteria.

Plain language summary: Many children with attentional difficulties or autism require information from occupational therapists about their sensory issues to help inform and identify behaviours of concern. This study looked at how a sensory processing screening tool can identify traits related to attentional difficulties and autism in children. Seventy-eight medical charts of children from a community hospital were reviewed. This study showed that information from the sensory processing screening tool related to attention and social communication traits. Clinicians can consider using information from a sensory processing screening tool in combination with other assessments to contribute to the identification of attention difficulties and autism in children.

Aim: To understand the extent and type of evidence available on a joint service between occupational therapy and paramedics in a community falls early response service (FERS).

Method: Three databases and Google Scholar were searched for published and grey material that combined occupational therapy and paramedicine community FERS. Two independent reviewers screened citations and then assessed articles for selection. Data extraction was performed by a third researcher and verified by the two reviewers.

Results: Fourteen sources were included from the initial 6,432 screened, and 128 were subsequently assessed. The 14 sources were published between 2010 and 2023, with over 50% published after 2019. The number of participants in the studies ranged from 23 to over 35,000, with a variety of combinations of healthcare professionals.

Conclusions: This review suggests that a combined occupational therapy and paramedicine FERS would benefit people who fall, the ambulance service and hospital care providers from a cost and resource point of view. A pilot study to further evaluate the cost and benefits of this kind of service is being explored based on the results of this scoping review.