CAOT Conference 2012 Congrès de l`ACE Québec June 6

CAOTConference2012Congrèsdel’ACE
QuébecJune6‐9juin
Saturday,June9samedi,le9juin
08:30‐9:30 Porte du Palais‐ Plenary / Séance plénière 09:30‐10:00 Porte du Palais‐ CAOT AGM/ AGA de l'ACE 10:00‐ 11:30 Porte Kent / Porte St‐Louis/ Foyer‐ Poster presentation /Présentation par affiche Poster Defense: Non‐specific to Client Group, Theory (Re)Locating understandings of competency and independence in occupational therapy Gail Teachman (Holland Bloorview Children's Rehabilitation Hospital, Toronto) [email protected] Introduction: Independence is a core‐framing concept in occupational therapy theory and practice but research has suggested that discourses of independence may both ameliorate and contribute to disablement. Objectives: Drawing on a critical review of literature conceptualizing ‘communicative competence’, a construct closely linked to independence in communication, I discuss ways that emerging, innovative conceptualizations of communicative competency might open spaces for reframing occupational therapists’ understandings of independence. Approach: This paper draws on critical social science perspectives where the researcher reflexively questions assumptions or ideologies that underpin everyday practices; considers power relations that are at play; and acknowledges contradiction (Eakin et al, 1996). By historically situating the reviewed literature, I examine the shifting boundaries and tensions among theoretical conceptualizations of communicative competency and relate these to occupational therapists thinking about independence more broadly. I examine opportunities to shift ways of thinking about communicative competency which tend to focus on the individual who communicates differently, toward consideration of competence and independence as shared, socially incorporated and performed constructs. Practice Implications: Critical social science perspectives can be used to uncover possible unintended sources of marginalization in healthcare practices. Literature examining implicit assumptions in rehabilitation practices has provided opportunities for consideration of ‘how things might be otherwise’ (Gibson et al., 2009; Hammell, 2006). Conclusions: Understandings of competency and independence have an important influence on the ways that researchers and practitioners in occupational therapy work toward achieving positive outcomes with clients. Poster Defense: Older Adult General, Community “Oops—that was a mistake!” Improving performance of routine tasks Nicole VanRuymbeke (University of Toronto, Toronto) Cassandra Burns, Amanda Clark, Deirdre Dawson [email protected] Rationale. Performance of familiar routines is an important part of daily life. However, action errors frequently occur during these routines, especially for those with executive difficulties. Typically, these errors result when attention is disengaged from the task. To get back on track, attentional resources need to reallocated. Several studies report that routine task performance may be improved by having people stop intermittently during task performance (McVay, Kane & Kwapil, 2009); however, research in this area is very limited. Further, most of this research has been done on experimental rather than real‐life tasks. Objectives. To further investigate whether stopping improves routine task performance and whether this technique is clinically feasible. Method. Twenty healthy older adults with age‐related executive difficulty were recruited to complete an experimental and a CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin naturalistic routine task (collating). Participants were randomized to either encounter stop cues at random intervals during the tasks or to do the tasks without stop cues. Accuracy and timing of task performance were recorded and participants were asked at the end of the task for their perception of how stopping impacted their performance. Practice Implications. Results will indicate whether stop cues improve routine task performance; whether participants are aware of this improvement; and will highlight the acceptability of this intervention for older adults. Conclusions. The proposed study will contribute to the literature, which seeks to improve everyday task performance for people with executive difficulties. As executive dysfunction is a problem for many clinical populations, including aging adults, these results may have broad applicability. Poster Defense: Child/Adolescent Psychosocial Health, Community A goal structuring menu for the goal of making friends Carolyn McDougall (, ) Amanda McCallum, Stephanie Gerhardt, Patty Rigby, Julie Osbelt Rationale: Individualized goal setting and evaluation tools are widely used by occupational therapists and other healthcare professionals. Individualized tools are useful when client goals are complex and when standardized assessments are not available or appropriate. For example, clinicians working with youth in life skills programs have reported that making friends is a commonly identified goal. This goal is difficult and time‐consuming to address, as there are no tools that provide a breakdown of making friends into functional steps. Clinicians need a goal structuring menu to address the goal of making friends in a more efficient and consistent manner. Objective: The aim of this tool development study is to collaborate with expert clinicians, and youth with disabilities who have friends, to generate a goal structuring menu for the goal of making friends. Methods: A literature review, expert consultation and qualitative focus groups will be used to generate items for the menu. Focus groups will involve sixteen youth with disabilities who have friends commenting on their experiences of friendship. Established qualitative methods will be used to sort and group the focus group data. Practice Implications: The generation of a goal structuring menu for the goal of making friends may help clinicians optimize the use of their time and decrease variability of goal breakdown. This could ultimately improve the effectiveness and efficiency of goal setting, intervention planning, and evaluation for this goal. Conclusions: The generation of a goal structuring menu will help to establish best practice guidelines for the goal of making friends. Poster Defense: Adult Physical Health, Community A novel intervention for adults with executive dysfunction post‐stroke Valérie Poulin (McGill University, Montréal) Nicol Korner‐Bitensky, Deirdre Dawson [email protected] Introduction: Disorders in executive functions are common post‐stroke and play a critical role in predicting recovery. Recent evidence supports meta‐cognitive problem‐solving training for the rehabilitation of executive dysfunction. A promising intervention is the «Cognitive Orientation to daily Occupational Performance (CO‐OP) approach», which entails guiding participants to set self‐selected functional goals, develop plans, carry out their plans and verify goal attainment. This intervention has been shown to have positive effects in different populations, but has not been specifically tested for those with executive function deficits post‐stroke. Objectives: To refine the CO‐OP intervention for use in a home‐based setting with persons with subacute stroke experiencing executive dysfunction and to explore its potential for improving functional skills and executive functioning. Methods: Structured interviews were conducted with expert researchers to inform adaptation of the intervention for the target population. The refined protocol was piloted with one participant and consisted of 16 one‐hour sessions in the participant’s home. Three of 8 goals identified by the participant using the Canadian Occupational Performance Measure were trained during the intervention; 5 were not to allow examination of transfer to untrained skills. Results: Preliminary data suggest improvements in trained and untrained functional skills. Despite executive impairments, the participant demonstrated the ability to learn, apply and transfer the CO‐OP global strategy to CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin untrained daily activities. Video clips of the intervention will be shown. Conclusions: The CO‐OP approach can be adapted for use with people with subacute stroke. Preliminary findings support the feasibility of this training in persons with subacute stroke experiencing executive function deficits. Poster Defense: Adult Psychosocial Health, Education A recovery education program evaluation for in‐patient mental health providers Shu‐Ping Chen (, ) Terry Krupa [email protected] Introduction. The transformation of the mental health system toward a recovery‐orientation has created a growing demand for training and education to equip providers with recovery competencies. Occupational therapists are frequently called upon to facilitate this changing process. Objectives. This is Phase Three of a series of studies developing a recovery competency framework and related recovery education program for in‐patient providers, including occupational therapists, nurses, psychiatrists, social workers, psychologists, recreational therapists, and managers. In the first phase, a recovery competency framework was developed. Based on this framework, an education program was developed in the second phase and tested in this third phase. Methods. A pilot study with a pre‐test post‐test design was used. Twenty‐six in‐patient providers from three hospitals were recruited. The education program consists of two parts. Part One is a self‐learning program introducing recovery concepts, the in‐
patient context, and the recovery competency framework. Part Two is a group learning program focusing on real‐
life dilemmas relevant to the in‐patient context and applying the Appreciative Inquiry approach to address these dilemmas. Outcome measures included the Recovery Knowledge Inventory, an investigator‐developed questionnaire rating participants’ sense of competencies and perceived recovery‐related dilemmas, and a group evaluation. Results. Participants showed improvement on recovery knowledge (z=‐2.55, p=.011) and sense of competencies (z=‐3.43, p=.001) after the self‐learning program. Evaluations of the group learning program were high (4.22 out of 5). Conclusions. This preliminary evidence indicated that in‐patient providers may benefit from this education program. Occupational therapists may find this program a valuable resource to promote recovery. Poster Defense: Non‐specific to Client Group, Education A window into education: Analyzing occuaptional therapy students’ fieldwork reflections Lisa Klinger (The University of Western Ontario, London) Anne Kinsella, Ann Bossers [email protected] Introduction: Reflection forms a strong basis for professional development, contributing to clinical reasoning, empathy, client‐centred practice, and ethical deliberation. Student reflection, particularly during fieldwork experience, also provides a window into the content of student learning. Objectives: This research set out to examine student reflections while engaged in fieldwork and what these reveal about student learning. Methods: Seventy‐one OT MSc students (48/57 first year and 23/54 second year) consented to participate, submitting two midterm reflections written during two placements. Students were asked to describe: (a) the placement, (b) a critical incident, (c) the influence of the incident and what they decided as a result (d) how their education prepared them to respond, (e) how the context impacted practice. The reflections were analyzed for thematic content using a constructivist, grounded theory approach, first using line‐by‐line open coding, followed by an inductive comparison of data to reveal thematic categories (Charmaz, 2006).Results: Five learning themes were identified: developing technical competence , dealing with practice challenges, working within the system, developing personal insights, and becoming prepared for placement. The large majority of students recounted specific academic content that prepared them for their placement. Students reported experiencing complex issues, such as client deaths and interpersonal conflicts, suggesting a need to consider additional curricular content.Conclusions: Findings reveal the benefits of analyzing student reflections as a window into learning experiences, as a means to understand how academic learning is translated into fieldwork education, and as an approach to identify potential gaps in the curriculum. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Adult General, Institution Acute care occupational therapy assessment of self‐awareness following acquired brain injury Priscilla Lam Wai Shun (Université de Montréal, Montréal) [email protected] Introduction: Impaired self‐awareness (SA) is a common sequel of acquired brain injury and has been associated with poor motivation for therapy, difficulty setting realistic goals and poorer rehabilitation outcome. It is crucial for occupational therapists working in acute care to identify impaired SA even in the early stages of recovery as well as to recognize the impact of impaired SA on the client’s occupational performance and ability to participate to therapy. Objectives: Compare the psychometric properties of five standardized tools measuring SA and analyze their clinical applicability for use in acute care. Method: Studies investigating the validity and/or reliability of five standardized tools were analyzed and compared. The tools were also examined to identify possible systematic biases that may occur if used with clients with acquired brain injury in acute care. Moreover, specific criteria were used to estimate clinical applicability with this population. Results: The Self‐Awareness of Deficit Interview (SADI) and the Assessment of Awareness of Disability (ADD) were found to be the least susceptible to systematic biases and have been submitted to the best process of empirical validation and reliability compared to the Patient Competency Rating Scale, the Awareness Questionnaire and the Self‐Regulation Skills Interview. However, some limits to clinical applicability in the context of acute care were identified for both the SADI and ADD. Conclusion: Standardized tools are available for evaluating SA. Recommendations will be presented to assist occupational therapists to choose the adequate tool for their practice in acute care. Poster Defense: Child/Adolescent Psychosocial Health, Community Adventure therapy: Enabling psychosocial adjustment in adolescents with chronic illness Kathryn Servais (, ) Susan Burwash Introduction: Adventure therapy uses structured outdoor challenges that are occupation‐based and intrinsically appealing to adolescents. This continually expanding field may be a new direction for occupational therapists seeking innovative interventions for adolescents with chronic illness and disability who have been found to be at higher risk for psychosocial adjustment problems due to the impact of their conditions on healthy development. Objective: To summarize the results of a literature review investigating the efficacy of adventure therapy interventions for improving psychosocial adjustment in adolescents with chronic illness and disability. Approach: This poster presentation describes the search terms and databases used in this literature review. Six articles were extracted from the evidence base and critically appraised using McMaster qualitative and quantitative review criteria. Results: Study findings indicate adventure therapy interventions can improve self‐esteem, self‐image, self‐
efficacy, peer relationships and intrapersonal awareness in adolescents with chronic illness and disability. More research with improved methodological rigour is needed to corroborate the study findings and expand the evidence base for this topic. Conclusions: Adventure therapy interventions and outcomes are congruent with occupational therapy theory and philosophy. Opportunities exist for occupational therapists to incorporate adventure therapy interventions into treatment plans for adolescents with chronic illness or disability. Poster Defense: Adult Psychosocial Health, Community An analysis of personal accounts of recreational drug use Niki Kiepek (, Hudson) Lilian Magalhaes, Sandra DeLuca, Tania Granadillo [email protected] Introduction.The purpose of this doctoral research project was to explore drug use from the perspectives of individuals who self‐identified as using drugs on a daily basis and never “had the reason or need†to attend addiction counselling. Objectives.For the purpose of this presentation, an analysis of the data was undertaken using an occupational therapy perspective to understand the perceived impact of drug use on CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin occupations. It was expected that for people who had not received counselling there would be fewer reported negative consequences on occupational performance. Methods.Six interviews were conducted with adults who self‐
identified as using drugs on a daily basis. A critical analysis of discourse was undertaken. Results.The individuals who were interviewed for this study described a deliberate self‐evaluation of the impact of drugs on their daily occupations, such as work and parenting. This self‐examination influenced what drugs they used, when, and how much. There was a perception that drugs could enhance the experience or enjoyment of certain occupations and could contribute to increased productivity. The use of drugs can be interpreted as a meaningful and purposeful occupation for the person. Conclusions.For occupational therapists who work with clients who use drugs, it is important to develop an understanding of the perceived advantages of drug use, as well as the perceived disadvantages. The finding of this research project seemed to indicate that the individuals who used drugs did so with deliberation and rationale. Poster Defense: Child/Adolescent Psychosocial Health, Community An environment‐focused approach to increasing youth participation: A single‐case study Justine Huszczynski (, ) Jana Maich, Jade North, Dana Anaby, Mary Law Introduction: Children and youth with disabilities experience restrictions to participation in leisure activities, notably community‐based activities. Despite the important influence of environmental factors on participation, previous intervention studies to improve participation have focused on changing aspects of the person or task. They have also mainly addressed performance instead of participation in leisure occupations. Objectives: To evaluate the execution and effect of an environment‐focused intervention to increase the participation of youth with disabilities in community‐based leisure activities. The results will inform the implementation of a larger study and contribute to the ongoing evolution of occupational therapy practice. Method: A single‐subject multiple baseline design was employed to evaluate the effectiveness of environmental interventions for three participation goals. Outcomes were measured multiple times using the Canadian Occupational Performance Measure (COPM). The data was analyzed using visual analysis, the celeration line approach, and consideration of clinical significance with respect to COPM score changes. Results: Improvements in COPM scores were clinically significant for all three participation goals, with an average change of 7.67 points for total performance and satisfaction scores. Results of the celeration line analysis demonstrated a significant treatment effect on performance and satisfaction in the intervention phase for all three goals. Positive results were also provided in feedback from the parent. Conclusions: The use of environmental interventions improved the performance and satisfaction of participation in community‐based leisure activities for one youth with a disability. Common barriers and environment‐focused interventions were identified. Practice implications and implications for a larger study will be discussed. Poster Defense: Non‐specific to Client Group, Education An exploration of occupational therapists’ experiences during international clinical electives Erin Douglas (, ) Erin Douglas, Lisanne Shaw, Virginie Tousignant, Maria Harewood, Matthew Hunt, Caroline Storr [email protected] Introduction: Increasing numbers of occupational therapy students participate in clinical electives in low and middle‐income countries. Though there have been studies about electives for health professional trainees in other disciplines (Petrosoniak, McCarthy, Varpio, 2010; Crawford et al., 2010), there is currently little information regarding the experiences and perceived impacts on occupational therapy students that have participated in an international clinical elective. Objectives: The purpose of this study is to explore potential benefits, challenges, and perceived impacts of participating in an international clinical elective, and explore impacts on future career choices.Approach: We will purposively recruit 8 to 12 recently certified OTs from multiple universities in Canada who completed a clinical placement in a low to medium income country during their education in the past three CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin years. Participants will take part in an in‐depth, semi‐structured interview to explore their experiences. Interviews will be transcribed. Constant comparative techniques and thematic analysis will be used following interpretive description methodology. During this presentation we will report preliminary findings from the study.Practice Implications: These findings will serve to inform university faculty and administration, as well as practicing therapists and current students, of the benefits and challenges surrounding international clinical electives.Conclusions: This study will explore if future career choices have been influenced by the international experiences, and will determine if these experiences are linked to enhanced practice cultural competency. Poster Defense: Older Adult General, Community An innovative community occupational therapy role in falls prevention Rosalie Freund‐Heritage (, ) Silke Tilroe, Linda Chan, Kathleen Hunter [email protected] Introduction Falls are one of the three largest health issues affecting older adults. With the upcoming tsunami of Canada’s aging population, it is likely that many occupational therapists (OT’s) will be working with older adults. OT’s have an essential role within an interdisciplinary falls risk management team in order to keep people as active and independent as possible. Objectives The purpose of this study is to determine if a hospital clinic without walls is effective in decreasing falls risks, decreasing the number of sustained falls, and improving confidence and ability to perform activities of daily living. Methods Data is collected by an interdisciplinary team with an in‐home, multifactorial, trans‐disciplinary falls risk assessment. The OT assesses the client’s living environment, ADL and IADL function in detail as needed. Clients are empowered to do what they can, addressing goals they choose. Following interventions, six‐month reassessments occur. Results The proposed study will examine effectiveness of a transdisciplinary approach, including OT involvement in all identified falls risks. In addition to established approaches, innovative OT interventions emphasize activities outside the home and incorporate behavioural theories to address perceived loss of independence. Conclusions Results will be used to review the model of practice and the broad approach needed by OT to address function in older adults. The contribution of OT to falls risk management is critical to impact this health issue which, if left unaddressed, will continue to impact older adults’ quality of life. Poster Defense: Older Adult General, Theory An occupational perspective on frailty: A scoping review Daria Nedilski (, ) Ron Brown, Muhammad Iqbal, Renira Narrandes, Gabriel Titianu, Sabndra Hobson [email protected] Background: As the global population ages, frailty is becoming a greater concern. There is no universally accepted definition of frailty, but it is generally described as a complex health state that increases one’s vulnerability to illness and disability. Some sources consider frailty broadly, acknowledging physical, social, cognitive, and psychological dimensions. Purpose: A scoping review of the literature was undertaken to inform an occupational perspective on the nature, meaning, etiology, prevention, and care of frailty in the elderly. Methods: The scoping review employed the methodology established by Arksey and O’Malley (2005). Seventeen databases were searched using search terms related to frailty, old age, activities of daily living (ADLs), occupation, and resilience. Inclusion criteria were English language articles published from 2005 to 2010 with participants 65 years of age and older. The literature search produced 960 articles, of which 908 lacked an occupational perspective on frailty in an elderly population. The final number of articles reviewed was 52. Findings: Although some frail elders continued to engage in occupation, frailty and ADL dependence increase an individual's vulnerability to diminished occupational engagement. Resilience was associated with continued occupational engagement, whereas frailty was associated with diminished occupational engagement.Occupational engagement was linked to physical and psychological health, longer life, and delayed functional decline. Implications: By optimizing occupational engagement, CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin occupational therapists may play a significant role in preventing and/or reducing the adverse effects of frailty. Furthermore, client‐centred factors such as self‐determination and personal mastery may reduce risk of mortality among frail elderly living in the community. Poster Defense: Older Adult General, Community An occupational perspective on social disengagement in community‐dwelling older adults' Kristy Spear (Capital Health, Halifax) Susan Doble, Grace Warner, Susan Hutchinson Introduction: The benefits of ‘staying active and connected’ are widely touted as a means of preventing cognitive decline, depression, morbidity, and mortality. However, for many older adults, this seemingly simple prescription may be challenging to fill. Even when they experience other health concerns and come to the attention of occupational therapists, the key problem may only be superficially addressed. Objectives: Participants will learn how to identify those community‐dwelling older adults at greatest risk by untangling the separate, albeit related, constructs of isolation, loneliness and social disengagement and identifying which elements of these constructs have occupational relevance. Approach: Current literature and theories of isolation, loneliness and social disengagement in relation to older adults will be reviewed from an occupational perspective. Practice Implications: An improved understanding of the problem will, in turn, help guide clinicians to not only identify older adults at risk but also guide them when developing interventions to improve older adults’ ability to be active and feel connected with others in their communities. Conclusion: Occupational therapists can play an important role in supporting positive health outcomes for Canada’s aging population. Understanding the constructs of isolation, loneliness and social disengagement will assist occupational therapists to identify older adults at risk, which will provide opportunities for prevention and early intervention. Poster Defense: Non‐specific to Client Group, Education An online self‐assessment tool for occupational therapy assistants (OTAs) Colleen McGrath (McMaster University, Hamilton) Elizabeth Steggles, Claudia von Zweck, Kelly McKnight [email protected] Introduction: This tool is intended to provide both foreign educated OTs as well as domestic students considering a career as an OTA, with the knowledge and skills required for successful Canadian practice. Objectives: The purpose of this poster is to introduce an online self‐assessment tool. This tool will be used in collaboration with an OT self‐
assessment tool which was developed last year. The self‐assessment tool outlines the competencies, knowledge and skills necessary for practice in Canada as well as the education and qualification requirements across the country. The tool will allow users to reflect on whether their knowledge and skills are equivalent to Canadian practice standards and if not, to determine what additional skill or knowledge development is required. Approach: The poster will provide a rationale and purpose for developing the self‐assessment tool in addition to the content and methods used to evaluate it. Challenges and lessons learned from the development process will also be shared. Practice Implications: Providing information about the knowledge and skills required for Canadian practice will help to ensure that individuals, who are considering a career as an OTA, are able to make an informed decision. Conclusions: Understanding and reflecting on the knowledge, skills and competencies required for successful practice in Canada is an important step for both foreign educated OTs and domestic students who are considering a career as an OTA. The online self‐assessment tool provides this opportunity. Poster Defense: Non‐specific to Client Group, Theory Applying a framework of professional boundary management to occupational therapy Natalie MacLeod Schroeder (University of Manitoba, Winnipeg) Juliette Cooper [email protected] CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction: Professions are not static entities which stake out a claim to a territory that remains unchanged throughout history. Rather, professions expand and contract, shift boundaries, and evolve over time. Professions interact with other groups and respond to the context in which they are established. Failure to appropriately protect or negotiate professional boundaries can mean the demise of a profession, while successful protection and negotiation of those same boundaries can mean status, influence and power. Objective: This poster examines the management of occupational therapy’s boundaries using a framework developed by Nancarrow and Borthwick (2005). Approach: Nancarrow and Borthwick’s (2005) framework was used to review the history and development of occupational therapy in Canada. Practice Implications: The framework provides a means to track shifts in occupational therapy’s boundaries and understand its relationship to other professions. Examining how a profession develops and changes over time enables more strategic positioning and development in the future. Additionally, the framework facilitates analysis of the external environment, including other professions’ boundary changes which may pose a threat to occupational therapy. Understanding professional boundary management is imperative in a constantly shifting health environment with finite resources to avoid ineffective methods of professional growth or spreading the profession so thin so as to be unable to protect scope of practice. Conclusion: Occupational therapy has experienced a number of changes in its professional boundaries. Nancarrow’s and Borthwick’s (2005) framework provides a method of examining our past growth and development and a tool for strategic planning. Poster Defense: Adult Physical Health, Community Are the clients we return to work healed? Forget Nancy (Université de Montréal, Montreal) Geneviève Ste‐Marie, Michèle Rivard [email protected] Introduction: The pursued outcome for workers with a chronic musculoskeletal condition (CMC) is a return to work (RTW) using pain mediation techniques (Butler et al., 1995). While it has been demonstrated that pain influences worker’s productivity at work (presenteeism) (Schultz & Edington, 2007), there is no information in the literature that describes the quality of that RTW and the long term consequences on the workers’ daily life. Objectives: To describe long term (3‐4 years post‐injury) physical, psychosocial and functional aspects of CMC. Methods: Secondary analysis of data collected from a previous study will be done. Our sample is composed of workers who sustained a CMC and that were able to do a lasting RTW (Steenstra et al., 2003). Information on demographics, work and medical history, along with physical, psychosocial and functional aspects will be analyzed using mainly descriptive statistics. Preliminary results: Our sample is composed of 284 workers with 61.7% males and a mean age of 43 years. At 3‐years post‐injury, the mean pain level experienced is 39mm using a VAS. With further analysis, we suspect to observe that the consequences of the workers’ injury still have impacts on their level of functioning, especially at work, which may be described as presenteeism. Conclusions: By doing the portrait of these workers, we want to highlight the difficulties that these people might still be encountering in their everyday life 3‐4 years post‐accident. This description has never been done previously. Even if mainly descriptive, the results obtained will lead to further research to identify long‐term consequences of CMC. Poster Defense: Child/Adolescent General, Community Assessments of child and youth environments: A critical review Patty Rigby (University of Toronto, Toronto) Judy Tran, Oana Craciunoiu [email protected] Introduction: Occupational therapists acknowledge that environmental factors influence the occupational performance and engagement of children and youth in their daily lives. However, only a few formal assessments of the environment have been identified and used regularly in practice settings with children. Objective: To conduct a critical review of assessments of the environment for child and youth settings. Methods: A reference librarian was CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin consulted to help identify inclusion/exclusion criteria, search terms, search engines and relevant databases. The Outcomes Measures Rating Form (Law, 2004) was used to identify and evaluate the purpose, scale development, reliability, validity and clinical utility of each assessment. The identified assessments are also being coded and grouped by the research team according to environmental factors assessed (e.g., physical, social, attitudinal), context (e.g., home, school, community), area of focus (e.g., environmental quality/resources, child support and care, and preferences) and targeted age group. Results: Ninety‐five assessments were initially identified. After a preliminary review fifty assessments were eliminated because those tools had limited evidence to support their measurement properties, and were not considered useful within a broad definition of occupational therapy practice when scrutinized by the research team. The team is currently conducting a thorough review and grouping of the remaining forty‐five tools. Conclusions: This review will provide occupational therapists who work with children and youth with a comprehensive list of environmental assessments which they may wish to consider using in their practice. Poster Defense: Adult Physical Health, Institution Backing into infection control – managing surfaces to reduce hospital‐acquired infections Andrea Dyrkacz (, Toronto) Candy Pleasance, Alanna Davis, Ted Lowes [email protected] Introduction: An awareness of Hospital‐Acquired Infections (HAI) has recently shifted from the medical system to the community largely through media reports. Every clinical process and piece of equipment is under scrutiny to determine its role in the spread of HAI. Recently, a large acute care centre determined that wheelchair seating systems were a potential island of infection and took immediate action to mitigate this risk. Objective: To discuss the steps taken to reduce the potential spread of infection through assignment of wheelchairs from the occupational therapy equipment pool. Method: Wheelchair seating system cleaning protocols were reviewed and changes were made to ensure all product met hospital infection and control standards. This included mandating that only closed cell or sealed foam cushions were used as seating surfaces; however it was realized that wheelchair backrests were not available with the specified foam products. An experienced wheelchair vendor was approached to develop a backrest that would meet hospital infection control standards. Practice Implications: A specialized neoprene cover was developed and customized for wheelchair pool backrests. All wheelchairs were retrofit with the new backrests covered with this non‐porous, infection control fabric. The fabric is easy to wipe with hospital‐approved disinfecting agents, improving cleaning compliance. Conclusions: The cause of HAI’s are multi‐
factorial, therefore it remains difficult to evaluate if this new backrest and cover reduces the spread of infection. However, without this initiative, the conventional backrests would most certainly continue to be a contributory factor to the spread of life threatening HAI. Poster Defense: Older Adult Psychosocial Health, Community Barriers faced by older Canadians using online dating services Jackie Shaddock (, ) Mina Thomas, Julia Rozanova, Melinda Suto [email protected] Introduction: Online dating services have become a widespread medium for Canadians searching for new social or romantic relationships. However, older users are underrepresented on online dating sites compared to middle‐aged and young adults. This may indicate the presence of personal or social barriers preventing older Canadians from successfully utilizing these services, such as: stigma associated with aging and sexuality, concerns about entering late life romances, or fear of rejection.Objectives: To investigate the ways in which older Canadians experience barriers to successful use of online dating services in order to form new social and/or romantic relationships. Approach: To examine barriers associated with initiation of online dating services use, and with successful online match‐making, we will use a qualitative approach informed by grounded theory. As part of an ongoing “ROMANCE” study, the data will come from semi‐structured interviews with a purposive sample of up to 15 older CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Canadian men and women who have or are using online dating services. Transcribed data will undergo thematic analysis to identify common themes among participants. Practice Implications: Knowledge gained will help occupational therapists working with older adults to incorporate digital dating into creative educational programs to decrease loneliness and social isolation. Assisting clients in overcoming the barriers to forming new social or romantic relationships may lead to improved mental and physical health associated with regular companionship.Conclusions: Identification and understanding of barriers to online dating is essential for occupational therapists when assisting clients to achieve their occupational goals of forming new romantic and social relationships. Poster Defense: Adult Physical Health, Community Behavioural assessment in return‐to‐work: opinions of occupational therapists Tara Sardello (, ) Christy Sparling, Lori Unsworth, Bianca Yeung, Ginette Aubin, Heather Lambert, Judith L'Heureux Rationale: The process of returning to work after injury is complex. Despite the knowledge that behaviour is part of the return to work (RTW) process, there is no occupational therapy framework that can be used to assess work‐
related behaviours of clients with MSK injuries. Objective: The goal of this study is to determine the current practice of occupational therapists (OTs) in the behavioral assessment of clients with chronic MSK injuries in the RTW setting. Methods: An online questionnaire was sent to 328 OTs registered with the CAOT or a provincial regulatory body practicing in vocational rehabilitation, with a response rate of 23%. The questionnaire explored therapists’ opinions regarding the influence of pain, psychosocial, and social behaviours on the RTW process and the use of behavioural assessment tools. Results: Several behavioural aspects were found that OTs consistently consider important to address when evaluating work readiness. OTs obtain behavioural information from a number of sources including interviews, behavioural assessments, and observations during work hardening programs and functional assessments used throughout the RTW process. More than 90% of participants expressed the need for a reliable behavioural assessment tool for the MSK population. Conclusion: While OTs recognize the need for behavioural assessment tools, there are none currently available. The dimensions of work behaviour uncovered in this study may provide the basis for further study in this area and ultimately the development of a MSK‐specific work behaviour evaluation tool. Poster Defense: Non‐specific to Client Group, Institution Best practice: Infection control for occupational therapy Natalie Cleroux (The Ottawa Hospital, Ottawa) Gina Dore, Rachel Gervais [email protected] Introduction: Over the years, infections in hospital settings have become more prevalent and highly publicized. An Infection Prevention and Control Program is an essential component of any quality healthcare delivery system to protect patients, workers, and visitors from healthcare‐acquired infections. The occupational therapists and assistants in an acute care organization identified the need for a structured infection prevention and control program for the occupational therapy discipline anchored in evidence based practices. Objective: Formalize a policy for the cleaning of occupational therapy equipment, assessment tools and therapy areas to ensure the highest level of infection control and prevention within the context of existing resources.Approach: The infection control and prevention policies of the organization do not cover the type of equipment used in occupational therapy. Work was done in collaboration with the infection control and prevention department to identify if any other organization with similar needs had formal related policies and procedures. An updated policy for the cleaning of non–porous and porous occupational therapy equipment, assessment tools and therapy areas was created.Practice Implications:The standardized policy for equipment cleaning has allowed the occupational therapy department to ensure equipment and therapy areas are cleaned in accordance to best practice standards and therefore decrease the risks of transmitting healthcare‐acquired infections. Conclusion:The Provincial Disease Advisory Committee and CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Public Health Ontario are continuously working on evidence based knowledge. It is important for the occupational therapy department to keep up to date with these trends and update their policies to ensure continued best practice. Poster Defense: Non‐specific to Client Group, Community Best practices in Africa: Cameroonian experiences in developing rehabilitation guidelines Lynn Cockburn (, ) Julius Wango, Ezekiel Benuh, Emmanuel Anjonga , Mukong Nicholas, Katherine Chow, Shirin Kiani, Che Manaseh, Nyincho Samuel [email protected] Introduction and Objectives We present results from a multi‐year process of developing Best Practices in Rehabilitation (BPR) in Africa. The project aims to gather professionals to share their own practices as well as review experts’ best practices, to translate knowledge into useable forms, to increase awareness of quality services in rehabilitation, and to serve as role models. It is part of a larger project intended to improve the economic power of people with disabilities.Methods and ApproachParticipatory processes were used to choose the key issues of interest for BPR development and determine the process to be followed. Working groups were established, using several forms of communication.Results We describe the project phases including planning and establishing project goals, carrying out guideline development, and project evaluation. Strategies to increase collaboration included recruiting local and international participants, several types of meetings, focusing on working group processes. Practice guidelines are developed in five areas. Difficulties: Some local members did not understand BPR; recruiting international members was more challenging than anticipated. Successes: In‐depth workshops improved levels of enthusiasm. Many local members, and participants from Canada, the US, and Europe, have been involved over the course of the project. However, the goal of encouraging local participants by linking them with international professionals was not achieved.ConclusionsPhase 1 was moderately successful. Phases 2 and 3 were less successful from a process perspective but have resulted in guidelines. Multi‐year projects of this nature can be hard to sustain enthusiasm and workability. Continued adaptation and evaluation are required to develop effective BPR guidelines in contexts with limited rehabilitation systems. Poster Defense: Older Adult Physical Health, Institution Botulinum Toxin‐A and functional rehabilitation in management of upper‐limb spasticity Meeta Gugnani (Rouge Valley Health Systems, Toronto, ON) Chris Boulias, Farooq Ismail, Timothy Pauley, Chetan Phadke [email protected] Introduction: Spasticity is a common disabling complication of stroke that can result in loss of normal functioning in affected limbs and leads to decreased satisfaction with ones ability to participate in meaningful occupations of daily life. Of the various treatments available prescription medication, physiotherapy, occupational therapy, Botulinum toxin‐A (BTA), no single treatment alone has been shown to have consistent significant functional improvements in patients experiencing upper limb spasticity post stroke. It is uncertain whether complimentary treatments including functional rehabilitation and BTA could produce improved functional results. Objectives: To determine whether complimenting functional rehabilitation with BTA treatments will produce enhanced functional improvements for adult patients who experience upper limb spasticity post stroke, as compared to Botox treatment alone. Methods: A eight‐week single blind randomized controlled trial (RCT) to assess the efficacy of a combined functional rehabilitation and one‐time injection of BTA treatment in comparison to single treatment plans. Twenty Subjects are randomly assigned to two groups‐ BTA only and combined BTA and functional rehabilitation. Measurements are taken at baseline, two weeks and eight weeks following the injection of the Botulinum toxin.Practice Implications: A combined intramuscular injection of BTA and functional rehabilitation program may be the preferred method to reduce spasticity and increase upper limb function in stroke patients.Conclusions: CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Clinicians need to evaluate the efficacy of the treatment approaches available to them to advance their knowledge and to enhance the effectiveness of the treatment programs. Poster Defense: Child/Adolescent Psychosocial Health, Community Case study of the Bolivian Andes: Altitude and occupational profiles Ashley Whittaker (, Toronto) Kaitlynn Dewhirst [email protected] Introduction: OT’s are well educated on the role of physical, psychological, mental and cultural health in influencing occupational profiles. In this presentation we explore non‐traditional factors that may influence our clients occupational profile.Objectives: To explore the case study of three communities in the Bolivian Andes of similar longitude and latitude but different altitudes (Huanco, Acupata, and Rosario) and discuss how observations within these communities can influence clinical practice in Canada.Approach: The authors traveled to rural communities in the Muneca Province of the Bolivian Andes to explore the health and social status of school‐aged children. Communities discussed in this presentation represent three various altitudes in the Andes: high altitude (Huanco), intermediate altitude (Acupata), and low altitude (Rosario).Results: Observations and data collected demonstrate altitude specific differences influencing culture, nutrition, social engagement, occupational roles and school participation. Huanco was associated with colder, harsher weather which limited the agricultural growing season and in turn affected social interactions with children whom were less socially engaged in their communities. Acupata presented with a well tempered climate and regular agricultural seasons which required children to play an active role in the harvest whereby affecting school participation. Rosario was associated with a warmer, stable subtropical climate that produced year round agriculture and a well integrated social network of children.Conclusions: Occupational therapists need to think outside the box to consider all those factors that influence client’s, not just traditional factors such as physical, social, cultural or environmental. Poster Defense: Child/Adolescent General, Community Children’s occupations: Enhancing representativeness of the Paediatric Activity Card Sort Katelyn Jutzi (, ) Julia Pangborn, Helene Polatajko, Jane Davis Introduction: The activities in which children partake can have significant consequences on their health and well‐
being depending on type of activity and frequency of participation. Thus, having a means of characterizing children’s activity patterns, known as occupational repertoires, is important for understanding the relationship between activity patterns and various health states, such as obesity and the over‐scheduled child. At present, the Paediatric Activity Card Sort (PACS) is the only occupation‐based assessment tool designed to describe children’s full occupational repertoires. Unfortunately insufficient normative data limits the use of this important tool. Objectives: To enhance the representativeness of the normative data for the PACS. Methods: A one group descriptive study will be undertaken to collect normative data for the PACS. Approximately 160 children ages 6 to 13 will be recruited from local elementary schools, and administered the PACS. The participants will sort activity cards depicting various childhood occupations into two categories based on whether they have done the activity within the past year. Results will generate an overall occupational profile depicting the child’s occupational repertoire. Practice Implications: Having a norm‐referenced measure to examine the occupational profiles and repertoires of children will allow therapists to investigate the activity patterns of a variety of populations including obese children, slowly developing children and those who are over‐scheduled. Conclusions: Enhancing normative data will increase the utility of this promising tool and support therapists’ use of the PACS in assessment and management of children with occupational performance issues. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Child/Adolescent General, Community Client Grouping Model: A descriptive tool for children with disabilities Tanya Glencross‐Eimantas (ErinoakKids, Burlington) Heather Marrin [email protected] Introduction/Rationale: Functional classification systems have been used for over 30 years in a number of jurisdictions to describe client populations and rationalize resources. Recognizing a need to promote service coordination and consistency, staff at a childrens treatment centre in Ontario developed the Client Grouping Model in order to functionally describe the clients receiving service using the International Classification of Functioning, Disability, and Health taxonomy (WHO, 2002). Objectives1. To review the Client Grouping Model system.2.
To present the system’s validation results. Methods/Approach: A scoping review and Delphi consensus process was used to establish validation for the Client Grouping Model. Appropriateness, feasibility, face and content validity were evaluated using both qualitative (open ended questions) and quantitative (Likert scaling) approaches. Results/Practice Implications: This study validated a descriptive tool that is being used as: a multidisciplinary communication tool, a management tool for resource allocation and caseload management, a tool to develop clinical pathways and an education tool. The Client Group Model provides a validated means of functionally classifying children in a manner that informs their service requirements and improves team communication.Conclusions: This tool, using the domains of physical and cognitive function to classify children receiving service from a childrens treatment centre, has proven to be a valid classification system. It has application as an education tool, a communication tool, a resource management tool and as a tool that informs organizational policy. Further work is being undertaken to evaluate reliability as well as more rigorous validation. Poster Defense: Child/Adolescent Physical Health, Institution Clinical Presentation of Gastroesophageal Reflux Disease in Infants Caroline Tang (, ) Tamara Germani [email protected] Rationale: For infants, feeding is a primary occupation that is essential for healthy development. Occupational therapists play an important role in the assessment and treatment of infants who are experiencing feeding difficulties. Gastroesophageal reflux disease (GERD) is a common cause of feeding issues in infants. There are well‐
established signs and symptoms of GERD for older children and adults, but there is a gap in the literature on the clinical presentation of GERD in infants (Vandenplas et al., 2009). Objective: To study the clinical presentation of infants with suspected GERD to inform evidence‐based practice for occupational therapists who are managing infants with feeding issues in an acute care setting.Method: A quantitative longitudinal cohort‐retrospective chart review design will be used to study the charts of 45 infants (newborn to 12 months) with suspected GERD. Data from electronic patient charts will be collected using coding criteria to identify signs and symptoms commonly seen in infants with suspected GERD. Chi‐square tests will be conducted to analyze the data. Practice Implications: Since occupational therapists are involved in the assessment and treatment of infants with GERD, effective and reliable assessment tools are needed to identify the clinical presentation of GERD and manage the functional implications of this disease.Conclusions: The results of this study can be used to create a checklist for occupational therapists to assist them in identifying the clinical signs of GERD in infants so that appropriate interventions can be instituted. Poster Defense: Adult General, Education Clinical reasoning of an occupational therapist during an initial interview Janice Boudreau (, ) Sara Kunkel, Theresa Sullivan [email protected] Introduction: Clinical reasoning guides decision‐making in occupational therapy practice and is a primary practice competency. Reasoning varies with practice setting and therapist expertise; however, few studies have explored occupational therapists’ implicit reasoning in specific practice areas. Objective: To explore an occupational CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin therapist’s clinical reasoning process during an initial interview with a client with multiple sclerosis. Methods: A therapist‐client dyad was recruited using convenience purposive sampling from a large urban hospital. Following one video‐recorded therapy session, the occupational therapist was interviewed using video‐assisted recall and a semi‐structured interview guide to prompt description of her clinical reasoning. The interview was transcribed verbatim, checked for accuracy and independently analyzed by two researchers to identify codes, categories and a major theme. To enhance trustworthiness, interpretations were discussed with two expert occupational therapists before finalizing the analysis. Researchers also kept an audit trail and used a process of reflexivity throughout the study. Results: The over‐arching theme that guided the therapist’s clinical reasoning was being client‐centred. The therapist utilized reasoning processes of linking and hypothesizing to guide her decision‐making and to create a unique, overall picture of the client. Conclusion: Client‐centred reasoning is comprised of at least two cognitive processes, and is a significant aspect of an initial interview. Findings provide a preliminary understanding of the relationship between client‐centred practice and the complex thought processes that guide occupational therapy practice. Results of the study have implications for occupational therapy educational curricula and the growth of professional practice. Poster Defense: Adult General, Institution Clinicians’ approach to consistency of effort in Functional Capacity Evaluations Arthur Szulc (, ) Alison Woo, Leslie Johnson Introduction: Occupational therapists complete Functional Capacity Evaluations (FCEs) to inform decisions regarding clients’ suitability to resume employment, engage in vocational rehabilitation, or receive employment benefits. Consistency of effort (CE) testing is a component of several FCE protocols; occupational therapists use a range of strategies to assess whether the client’s effort represents his/her full ability. There is debate in the literature, however, regarding clinicians’ administration and interpretation of CE testing. Clinicians’ process of deciding whether or how to administer and interpret CE tests has not been explored.Objectives: The purpose of this qualitative study was to explore the clinical reasoning strategies that clinicians engage in to inform their practice of administering and interpreting CE tests when completing FCEs.Methods: Occupational therapy clinicians who conduct FCEs were selected for this phenomenological study through purposeful sampling. Five clinicians were individually interviewed using a semi‐structured format. The audio‐taped interviews were transcribed verbatim and reviewed by each investigator to generate index codes. A shared coding scheme developed through code comparison assisted to identify themes from the transcripts. Member checking confirmed the findings. Results: Several themes emerged during data analysis: the relevance of FCE and CE specific training, the wide range of experience and strategies used; the value of writing thorough reports; and the fit of CE testing with occupational therapy practice. Conclusions: The results of this study identify the client‐specific reasoning that clinicians use when conducting CE testing and interpreting the results of this complex process. This information will inform students, novice and experienced clinicians who complete FCEs. Poster Defense: Adult Psychosocial Health, Community Cognitive adaptation training implementation: Feasibility outside of clinical trials Diana Pontes (, ) Eric Quan Rationale: Outpatients with schizophrenia have significant cognitive deficits that affect their ability to perform activities of daily living (ADL). Cognitive Adaptation Training (CAT) is a compensatory approach shown to be effective for individuals living with schizophrenia, bypassing deficits in cognitive functioning. CAT is, however, a labour intensive and costly treatment and implementing CAT in clinical practice has been limited due to resource concerns. A modified version of CAT (modCAT) was developed to address this issue. Objectives: The objective of this qualitative descriptive study is to have an in‐depth understanding of the feasibility of implementing modCAT in an CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin outpatient schizophrenia treatment context, from the perspectives of the CAT therapists and case managers (CMs) who implement it. Approach: In this qualitative descriptive study, fifteen clinicians will participate in interviews and focus groups to provide information regarding the feasibility of implementing modCAT in an outpatient schizophrenia context. Content analysis will provide a rich description of the feasibility of CAT within an outpatient context. Results: The prospective results will highlight the components of CAT that are feasible and illuminate the issues that arise when implementing this intervention. This will inform practice for educating clinicians on how to implement CAT within other schizophrenia outpatient programs. Conclusions: Information collected will inform appropriate implementation of CAT to ensure that individuals living with schizophrenia within the community can improve their quality of life and achieve maximal independence. Poster Defense: Non‐specific to Client Group, Education Cognitive strategy use across the lifespan in rehabilitation Kali Jacobs (, ) Rehana Hirji, Helene Polatajko [email protected] Rationale: Cognitive strategy use, across the life span, is an important emerging area in rehabilitation. Examples of their effectiveness can be found throughout the literature. Yet, no comprehensive analysis is available, rendering much of this important information inaccessible to practitioners. A synthesis of this literature is essential to support knowledge uptake. Objective: The objective of this scoping review is to describe the nature and extent of the current literature surrounding cognitive strategy use in rehabilitation across the lifespan. Methods: Studies published between 2001 and 2011 containing aspects of cognitive strategy use in rehabilitation will be collected. The AMED, CINAHL, Cochrane, Embase, ERIC, Medline (EBSCO), Medline (Ovid), PsychINFO and Web of Science databases will be searched using keywords, MeSH headings, truncations and booleans. Studies will be extracted based on inclusion and exclusion criteria; the populations addressed, strategies used, and outcomes achieved will be characterized using descriptive analyses. Practice Implications: This scoping study will support effective knowledge uptake from the research realm to clinical settings. The study’s findings will provide therapists with an overview of cognitive strategy use and its potential importance for their client group. Conclusions: The use of cognitive strategies is a promising area in rehabilitation. The existing literature is well‐developed in some areas and sparse in others. A synthesis of this literature identifies important areas for clinical practice and for future research on cognitive strategy use to support rehabilitation. Poster Defense: Non‐specific to Client Group, Education Collaborative identity: Canadian occupational therapist assistant and physiotherapist assistant educators Dean Dickinson (Humber College, Toronto) Grace Torrence, Laura Collins Introduction: Through the collaborative organizational efforts of Canadian Occupational Therapist Assistant (OTA) and Physiotherapist Assistant (PTA) educators over the past twenty years, the role of the Occupational Therapist Assistant and Physiotherapist Assistant has grown into a significant position in the health care field. This paper chronicles the historical development, growth, and organization of Canadian OTA and PTA educators, recognizing that future promotion of the profession requires continued professional development, research and publication. Objectives. We will demonstrate the emergence of the OTA & PTA educator profession and explain its evolution, education, and endorsement vis‐à‐vis the professionalization process. Methods/Approach. Through application of sociological perspectives and theoretical practice models of collaboration we will demonstrate the professional organization and professional identity of Canadian OTA & PTA educators ‐ an operational group with an identified context, process and plan. Practice Implications. The challenges of 1) developing a professional identity and 2) continued collaboration among OTA & PTA educators will be profiled. Increased awareness of this professional group by professional associations, professional regulators, employers, colleagues and the public at large is essential and has implications for future human health resource policy planning initiatives. Conclusions. Our CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin illustration of the challenges and potential barriers to continued growth and collaboration among Canadian OTA & PTA educators reveals a need for future research on best practices/methods that encourage collaboration as well as a need to promote groups like the Canadian Occupational Therapist Assistant and Physiotherapist Assistant Educators Council (COPEC). Poster Defense: Adult General, Community Community of practice: Connecting with others in your clinical area Mary Lou Boudreau (retired, ) [email protected] Introduction: Clinicians often find that they learn the most relevant and practical information from others working in their field. Researchers, policy makers and clinicians may work in different “silos”, without the structures to connect then. A Community of Practice can bring a variety of stakeholders together to facilitate the exchange of information and practices, updates on research, identification of learning needs and planning of educational events. This presentation will discuss the establishment of a provincial Community of Practice in Fall Prevention and present some of the exciting developments in the initial 18 months. Methods: The presentation will cover: Definition and description of a Community of Practice; The history of the Community of Practice in Falls Prevention; The advantages and challenges of starting a Community of Practice and Considerations for participants who want to form their own Community of Practice. Practice Implications: Presenting the history, advantages and challenges of an existing Community of Practice will encourage clinicians in Fall Prevention to join, and clinicians in different clinical areas to consider starting their own Community of Practice. Conclusion: A Community of Practice can be an effective way to link clinicians practicing in a particular area, researchers studying the area and policy makers. It can offer the exchange of information and clinical practices, educational opportunities and the opportunity to influence policy. Poster Defense: Adult General, Community Community stroke recovery programs and participation: A qualitative study Vanessa Hunter (, ) Laura Tighe, Melinda Suto, Alison McLean, Alanna Ferguson, Tal Jarus Introduction: With increased survival rates for stroke survivors and higher numbers of these individuals living in the community, there is a need to focus on stroke recovery at the level of participation and community reintegration. Community stroke recovery programs exist across Canada and contribute to the recovery process of many individuals living with the effects of stroke; yet, there is a paucity of evidence guiding occupational therapists regarding the impact of such programs on participation and community reintegration among program participants. Objectives: This qualitative study aims to explore the experiences of participation and community reintegration for stroke survivors who do and do not attend stroke recovery programs. Methods: Researchers will conduct semi‐
structured interviews with ten stroke survivors living in the same large metropolitan community: five who have attended a community stroke recovery program for at least six months and five who have never attended. Interviews will be transcribed verbatim and thematic analysis will be used to uncover categories and describe major themes of participation and community reintegration. Practice Implications: Potential similarities and differences between the experiences of the two groups of stroke survivors will contribute to a broader understanding of stroke recovery. Themes that emerge within and between the groups could help shape recovery programs and inform occupational therapy practice within the community. Conclusions: Given the improving outcomes of stroke, continuing to explore the many factors involved in recovery and community reintegration will allow occupational therapists to better enable participation among community‐dwelling stroke survivors. Poster Defense: Child/Adolescent Physical Health, Institution Comparison of sensory processing measures with children diagnosed with Autism CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Marie‐Noelle Simard (Université Laval ‐ Centre de recherche du CHUL, Québec) Mélanie Couture, Erika Gisel, Eric Fombonne marie‐[email protected] Introduction: Prevalence of sensory processing abnormalities range between 45% and 95% in children with autism spectrum disorders (ASD). Due to this high prevalence, occupational therapists (OTs) need standardized and validated tools to assess the presence of such sensory processing abnormalities. In this perspective, two questionnaires, the Sensory Profile and the Sensory Processing Measure, have been developed. To our knowledge, these two assessments used by OTs working with children diagnosed with ASD have not been compared. Objectives: To compare results obtained with the Sensory Profile and the Sensory Processing Measure completed by parents of children with ASD, in order to assess if both questionnaires identify the same difficulties. Methods: Parents of thirty‐five children aged 4 to 7 years old completed both tools. According to the similarities in objectives and items, six sections from both tools with available total scores were retained for the comparison. Results: Raw scores of sections paired together are significantly associated (p=.037‐.001). When the results obtained by the children in each section are categorized according to the respective three categories based on standard deviation (normal, probable and definite difference), agreements between tools, qualified as “poor” to “fair to good” (k= .091‐.517), are revealed. Conclusion: Differences in the way the questionnaires assess sensory processing difficulties in a cohort of children with ASD have been pointed out. As these tools are widely used by OTs in both clinical and research settings, decision about the tool selection has to be based on the clinical and individual needs of their clients. Poster Defense: Adult General, Institution Complex chronic disease: The discharge planning roles of occupational therapists Meagan Hawkins (, ) Imran Juma , Richard Kellowan, Jane Davis Introduction: The purpose of discharge planning is to create a plan for clients’ continuing care following release from hospital. Its success requires the skills and collaboration of numerous health professionals, including occupational therapists. Discharge planning becomes increasingly difficult when clients are diagnosed with complex chronic disease (CCD). Although literature describing discharge planning is abundant, the quality of the process in actual practice is quite poor (Petersson, Springett, & Blomqvist, 2009). Researchers have explored physicians’ and nurses’ perspectives in complex discharge planning; however, an understanding of the discharge planning process of occupational therapists with clients with CCD is lacking. Objective: To explore how occupational therapists manage their discharge planning process, roles and expectations when working with clients with CCD. Methods: A qualitative design will be employed to collect data through focus groups involving six to 12 occupational therapists recruited from a facility specializing in treating clients with CCD. Thematic analysis will be used to identify, analyse and report themes within the data (Braun & Clarke, 2006). Practice Implications: The findings will provide an understanding of the complexity of the process, roles and expectations of occupational therapists in discharge planning for clients with CCD. Clarifying these aspects will improve clinical reasoning, and decrease role confusion and blurring leading to successful discharge planning, improved client outcomes and lower healthcare costs. Conclusion: Occupational therapists are key players in discharge planning for individuals with CCD. Clarifying their role will enable occupational therapists to better manage difficult discharge planning situations facilitating better client outcomes. Poster Defense: Adult Physical Health, Community Comprehensive fatigue assessment battery for spinal cord injury: Clinico‐metric properties Barbara Ann McFarlane (, ) Kristine Vaughan, Setareh Ghahari, Don Fogelberg, Susan Forwell CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Rationale: 57% of individuals with a spinal cord injury (SCI) experience feelings of fatigue severe enough to impact their ability to participate in meaningful occupations (Fawkes‐Kirby et al., 2008). Several factors have been identified that influence fatigue (Hammell et al, 2009), however there is not a comprehensive scale available to measure the complexity of the experience of fatigue. The Comprehensive Fatigue Assessment Battery for persons with Spinal Cord Injury (CFAB‐SCI) is a self‐report measure designed to collect information regarding the factors and experience of fatigue for persons with SCI. To date, only preliminary content validity of the CFAB‐SCI has been established. Objectives: To further establish content validity, and determine the clinical utility, test‐retest reliability, and criterion validity of the CFAB‐SCI. Methods: A 2‐phase design will be used. Phase one involves a questionnaire completed by a panel of experts (individuals with a SCI and health care professionals) to determine content validity and clinical utility. The second phase will incorporate 2 administrations for test retest reliability and use gold standard scales to correlate against the CFAB‐SCI to determine criterion validity. Results: We expect the CFAB‐SCI will be found to be clinically relevant in phase one and that preliminary data from phase two will show good reliability and validity. Conclusions: Fatigue affects the majority of individuals living with a spinal cord injury. The CFAB‐SCI will be a valid and reliable tool to inclusively measure the intricacies of fatigue among individuals with a spinal cord injury. Poster Defense: Adult General, Community Comprehensive fatigue assessment battery for traumatic brain injury: Clinicometric properties Michelle Lui (, ) Jaskirn Bains, Setareh Ghahari, Kathryn McKall, Shahriar Parvaneh, Susan Forwell [email protected] Rationale: Fatigue is experienced by 50‐80% of persons with traumatic brain injury (TBI) and has been shown to have a significant impact on everyday function (Bushnik, Englander & Wright, 2008). Moreover, fatigue is difficult to measure among those with TBI due to the multiple factors that influence the fatigue experience. There is no tool that evaluates or accounts for these factors to guide intervention decisions. As such, the Comprehensive Fatigue Assessment Battery for TBI (CFAB‐TBI) was developed based on a previous study that established content validity. No other clinicometric testing, however, has been completed on the CFAB‐TBI. Objectives: To determine the criterion validity, internal consistency and clinical utility of the CFAB‐TBI. Methods: The CFAB‐TBI will be administered to individuals who are more than 6 months post‐TBI. Participants will complete the CFAB‐TBI as well as other gold standard measures to determine criterion validity. Internal consistency will be determined by analyzing the items within the tool to investigate that similar constructs are being assessed. The clinical utility of the tool will be determined by eight occupational therapists from across Canada who will each administer the tool to three people with TBI and complete a questionnaire about its administration and format. Practice Implications: The results of this study will provide therapists with a reliable and useful clinical assessment to untangle the issues of fatigue in TBI. Conclusion: Fatigue is a disabling problem among persons with TBI. This study will show the reliability and clinical utility of the CFAB‐TBI to support clinical practice. Poster Defense: Adult Physical Health, Institution Content development of the Rheumatoid Arthritis Splint Adherence Measure Marina Voznyak (, Montreal) Nicol Korner‐Bitensky, Jeffrey Jutai, Sara Ahmed Introduction: Approximately 300 000 Canadians have rheumatoid arthritis(RA)(1); 75% experience inflammatory involvement of the wrist(2‐4). Despite strong evidence indicating the usefulness of splints, studies cite poor adherence to splint wear(3,5‐8). Thus, the identification of an individual’s readiness to use a splint is important. Objectives: The global objective was to create a predictive measure, the Rheumatoid Arthritis Splint Adherence Measure (RA‐SAM) evaluating readiness of individuals with RA to use a newly prescribed working splint. The specific objectives included: 1‐ generating items specific to splint use readiness; and 2‐ developing and refining the CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin measure.Methods: Items were generated through an extensive literature review and through two focus groups, one with health professionals the other with individuals experiencing RA. The preliminary version was created by the researchers and reviewed by experts in the field of rheumatology for content, clarity, and pertinence of items. Results: The identified themes were tentatively grouped around five domains: self efficacy/empowerment; engagement/willingness; social context; benefits and negative effects of splint; and, health care services. The first draft of the tool includes 45 items each rated on a visual analog scale. The RA‐SAM was translated into French and the English and French versions compared and verified for meaning and cultural similarity.Conclusion: Adherence to splint use is an important component of self‐management in rheumatoid arthritis. If patient concerns regarding splint wear are identified and addressed by the occupational therapists at the time of splint prescription, this should lead to increased adherence, opportunity for intervention, and, ultimately, better outcomes. Poster Defense: Non‐specific to Client Group, Education Creating effective interprofessional practitioners from the classroom to practice Elizabeth Taylor (University of Alberta, Edmonton) Mark Hall, Sharla King, LuAnne McFarlane, Barbara Norton, Teresa Paswlaski, Lisa Guirguis, Kent Stobart [email protected] IntroductionInterprofessional education and collaborative practice are viewed as strategies to address the current crisis in health workforce and service delivery. Interprofessional education (IPE) is taught in most health science programs and is considered important in health science professional accreditation. , Current IP educational information/concepts is fragmented across the several health science faculties at the University of Alberta. This presentation illustrates the first stage of a project undertaken by the Health Science Education and Research Commons to develop and evaluate common IP educational resources, and mechanisms to support students, instructors and practice educators.ObjectivesTo determine the impact of an introductory IP Pathway launch on student experience.ApproachThe launch is an interactive education session with first year Occupational Therapy, Physical Therapy, Nursing, Speech Pathology and Pharmacy students. It will introduce students to an IP learning Pathway philosophy, language and expectations. Participants will have a consistent approach to IP learning and an understanding of how IP education will be integrated in to their classrooms. Evaluation will comprise pre and post launch questionnaires and focus groups for both participating and non‐participating students for comparison purposes.Practice ImplicationsResults from the study will help other universities and clinical educators in considering new ideas for incorporating IP learning with students within their own sites and practices.ConclusionInterprofessional education must begin at the university and translate into clinical practice if it is to effectively make changes within service delivery. The lessons from the launch will translate into strategies essential for IP education. Poster Defense: Adult Physical Health, Institution Decongestive lymphatic therapy‐Impact on client's occupational performance Myrna King (CDHA, Halifax) Audrey Deveaux, Heather White, Daniel Rayson [email protected] Introduction: Lymphedema as a result of curative breast cancer surgery can lead to long‐term morbidity. Decongestive lymphatic therapy (DLT) is recognized as an optimalmanagement strategy for moderate symptomatologies, but there is little data regarding the most effective means of providing compression therapy within a DLTprotocol. We conducted a randomized trial of two forms of compression therapy within the initial treatment phase of a DLT protocol for breast cancer‐related lymphedema.Objectives:To assess change in affected limb volume using volumetry.To assess symptom control and upper extremity function using visual analogue scales and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire respectively. Endpoints assessed at day l0 of treatment and at 3 months were compared to baseline.Method: Subjects with mild‐moderate lymphedema (10‐
40% volume difference) acquired as a result of curative breast cancer surgery were randomized to compression CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin bandaging or garments within the initial treatment phase of a DLT protocol. Results: Twenty‐one subjects available for analysis. The group receiving bandaging experienced greater median volume reductions at 10 days (70 vs. 5 mL; p=0.387); at 3 months (97.5 vs. 50 mL; p=0.182). The bandaging group also experienced a greater increase in median DASH scores at l0 days( +20.9 vs. +5; p=0.143) and at 3 months(+ 18.4 vs. +3.3; p=0.065). Conclusion: Within the initial treatment phase of a DLTprotocol for acquired, breast cancer‐related lymphedema,compression bandaging may lead to greater volume reduction but worse upper extremity functional status (higher DASH scores) as compared to compression garments. Poster Defense: Non‐specific to Client Group, Theory Defining an occupational perspective Janet Njelesani (The University of Toronto, Toronto) Anna Tang, Helene Polatajko [email protected] Introduction: Within the profession of occupational therapy the term “occupational perspective” is a concept that is widely used to guide practice. However, when the term is used in the literature it is often neither explicitly defined nor described. Objectives: To present a definition of the term occupational perspective based on how the term is defined, described and applied within the literature and that also addresses the gaps in previous definitions. Methods: A literature review was conducted to achieve the stated objective. The following information: source and year document was published; authors’ educational background and discipline; country and type of institution with which the authors were associated; content foci; document and paper type; and definitions and descriptions of the term formed the basis of analysis, including basic counts to describe the uses of the term and content analysis to identify the key constructs in the definition and descriptions of the terms. Results: The majority of the literature that uses the term occupational perspective is based on an assumed a priori common understanding of the term; however, no single definition has, to date, prevailed. To address the need for a common understanding, this paper proposes a definition of the term “occupational perspective”. Conclusions: Having a definition based on common constructs of the term, provides an option for occupational therapists to use when framing their work in order to strengthen the theoretical clarity of their practice. Poster Defense: Child/Adolescent Physical Health, Education Detecting change in handwriting capacity Marie Brossard‐Racine (, ) Barbara Mazer, Marylise Julien, Annette Majnemer [email protected] Introduction: Clinicians often use outcome measures to evaluate change in performance before and after an intervention. However, values of change on a standardized measure do not necessarily correspond to an observable clinically important change or improvement. The construct of minimal clinically important difference (MCID) is defined as the smallest value of change on a measure likely to be important either to the clients or the clinicians. Occupational therapists commonly treat children with handwriting difficulties as handwriting is an important skill for academic success in school‐aged children. Objectives: The purpose of this study was to determine the percentage of change in handwriting scores as measured by the manuscript version of the Evaluation Tool of Children’s Handwriting that is consistently detected by occupational therapists (OTs) on visual inspection. Methods: Thirty‐four OTs compared 35 pairs of handwriting samples from children between 7‐9 years of age tested twice. Receiver Operating Characteristic (ROC) analyses were performed to determine the optimal values for total word and letter legibility scores which are representative of the MCID in handwriting scores. Results: The MCID for total word score on the ETCH was 10.0‐12.5% and for total letter score was 6.0‐7.0%. A change in total legibility score below these values would therefore be considered not clinically detectable. Conclusions: Clinicians should not consider a change in scores over time as clinically significant if that change corresponds to less than 6.0% for total letter legibility and 10.0% for total word legibility. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Non‐specific to Client Group, Education Development and implementation of a mentorship module Leah Dix (McMaster University, Hamilton) Sue Baptiste [email protected] Introduction: Mentoring is a valuable tool to facilitate occupational therapists’ continued personal growth and skill development. There are reciprocal benefits for both the mentee and mentor participating in the experience (Baptiste, 2001). Objective: This presentation will describe the process of development and implementation of a mentorship module offered face‐to‐face and online to inform others interested in participating in or creating mentorship opportunities. The unique features of online mentoring and the benefits that resulted for both mentors and mentees will be shared. Methods: The mentorship module was offered simultaneously face to face and online for internationally‐educated occupational therapists (IEOTs) seeking mentorship experiences with Canadian occupational therapists. The module was predicated on the importance of the IEOT having input on selection of a mentor to facilitate enhanced trust and relationship building. The mentor and mentee engaged in reflective exercises at the onset to enable exploration of learning needs, styles and skills both could contribute to the mentorship experience. The IEOT and the mentor worked in partnership on individualized goals specific to the needs of the IEOT during the three month mentorship. Results: The feedback received was overwhelmingly positive regardless of whether the mentorships dyads used technology to facilitate communication or met face‐to‐face. While the face‐ to‐face experience was preferred, there were clearly identified benefits for both mentors and mentees who participated in the module. Conclusion: Online mentorship opportunities allow for knowledge exchange and skill development. Poster Defense: Adult Physical Health, Institution Development of an outpatient stroke program using the "SaeboFlex" orthosis Brenda Semenko (Health Sciences Centre, Winnipeg) [email protected] Introduction: Therapy options for stroke survivors with some shoulder and elbow movement but little hand function are limited. The "SaeboFlex" orthosis is a commercially available dynamic orthosis for people with limited hand function due to neurological impairment. The orthosis positions the hand functionally and assists with thumb and finger extension so volitional grasp and release tasks can be accomplished. Objective: To determine the effectiveness of the "SaeboFlex" orthosis in upper extremity retraining post stroke. Methods: This poster reports on three clients who were identified as meeting the minimum eligibility criteria for a "SaeboFlex" orthosis from an existing outpatient stroke caseload. These clients attended an intervention group twice weekly to work on arm and hand training programs using a "SaeboFlex" orthosis and gross motor equipment. In addition, an individualized home program for each client was developed and monitored. Outcome measures of range of motion, spasticity, strength and participation were administered prior to participants receiving their "SaeboFlex" orthosis and 7 to 9 months later. Progress was also monitored through video recordings. Results: Subjective reports have been positive with participants noting increased use of their affected arm in daily activities. Results show positive changes in shoulder and elbow range of motion, grip strength, spasticity and COPM scores. Conclusions: Preliminary results using the "SaeboFlex" orthosis demonstrate positive change in arm and hand function according to subjective and objective measures. Formal research is needed to determine whether functional gains are seen with a larger sample size and are maintained over time. Poster Defense: Adult Psychosocial Health, Institution Development of the fathers’ support scale: NICU Justine Barnett (, ) Jennifer Brown, Liisa Holsti CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction: Having a premature infant in the neonatal intensive care unit (NICU) is a stressful experience for both parents. Mothers and fathers report different support needs during this time. Infants whose fathers remain involved in their care show more optimal development after discharge from the NICU. In order to provide client‐
centered strategies to help fathers cope with this unique stress, accurate assessment is necessary. Thus far, only one scale has focused on parental stress in the NICU. However, this scale does not address the more global stressors which fathers have reported recently. The Fathers’ Support Scale: NICU ([FSS]: NICU) was developed to address this need. Face and content validity have been tested but further psychometric properties need to be established. Objective: To examine the test‐retest reliability of the FSS: NICU. Methods: 100 fathers whose infants were admitted to a tertiary NICU completed the FSS: NICU on two occasions one week apart. Test‐retest reliability will be analyzed using interclass correlations (ICC). Practice Implications: The initial testing of the psychometric properties of the FSS: NICU will provide an evidence‐based approach toward identifying fathers’ support needs. Using this scale, Occupational Therapists can play a unique role in advocating fathers’ needs to the health care team to ensure support is being provided in a family‐centred manner.Conclusions: By providing accurate assessment of fathers’ support needs, targeted, client‐centred strategies can be offered to these fathers to help mitigate the stress associated with having an infant cared for in the NICU. Poster Defense: Child/Adolescent Physical Health, Community Developmental Coordination Disorder: Does focus of attention affect motor learning? Rachel Abel (, ) Shelby Fomenoff, Tal Jarus, Jill Zwicker Introduction: Developmental coordination disorder (DCD) affects a child’s ability to learn motor skills and perform daily activities (American Psychiatric Association, 2000). Assisting children with DCD to learn functional motor skills is an important goal of occupational therapy intervention; however, it is unknown whether children with DCD learn motor skills more effectively with an external focus of attention (focusing on impact of movement on the environment) or an internal focus of attention (focusing on one’s body movements). Objective: To determine how an external or internal focus of attention influences motor skill acquisition in children with and without DCD. We hypothesize that children with DCD will demonstrate better motor learning with an external focus of attention. Methods: DCD is defined as ? 5th percentile on a standardized motor assessment, scores in the DCD range on a parent questionnaire, and IQ > 80. Children with and without DCD (aged 8‐12 years) are randomly assigned to receive instructions that either focuses attention externally or internally while completing a computerized motor tracking task over three sessions; retention and transfer tasks are completed in a fourth session. Results: Preliminary results of 8 children (n=3 DCD, n=5 typically‐developing) show that children with DCD score lower on the motor task and tend to learn better using an external focus of attention. Data collection is ongoing with a target sample size of n=20. Conclusions: Results will inform occupational therapists how to influence motor skill learning of children with DCD by incorporating an internal or external focus of attention within current occupational therapy interventions. Poster Defense: Non‐specific to Client Group, Theory Disability studies in occupational therapy through time: A scoping study Nicole Thomson (, Toronto) Rona Macdonald, Michael Iwama [email protected] Introduction: Disability Studies is an academic field of study that focuses on the socio‐political‐cultural examination of disability, and grew out of the disability rights movement. A literature review outlining occupational therapy’s responses to the disability movement was published in 1996, with predictions for the future of the profession (Craddock, 1996). Over a decade has lapsed since the review, therefore, it is an opportune time to re‐examine the occupational therapy literature with respect to Disability Studies and the disability movement. Objectives: The purpose of the paper is to examine the presence of Disability Studies in occupational therapy literature. Methods: A CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin scoping study that adopted a methodological framework developed by Arksey and O’Malley (2005) was used to map the presence of Disability Studies in occupational therapy literature. Results: Findings will be discussed in terms of the nature, extent and distribution of Disability Studies in occupational therapy literature, as well as a thematic organization of the papers reviewed. The results of the scoping study indicate that Disability Studies is mostly absent from occupational therapy resources. Conclusion: Disability Studies remains in an emergent stage in current occupational therapy literature, with much promise and opportunity for future development. If occupational therapy as a profession is to remain useful and relevant, there are considerable advantages to engaging in conversation with the field of Disability Studies. More specifically, occupational therapy should consider the challenges from Disability Studies and explore the implications of adopting and implementing a Disability Studies approach on professional practice. Poster Defense: Adult General, Institution Discharge planning for bariatric clients: Identifying the common challenges in an acute care practice setting Danielle Harling (Health Sciences Centre, Winnipeg) Introduction: With an increase in prevalence of bariatric clients admitted to acute care hospitals, occupational therapists address the unique and often challenging discharge planning needs of this population with little research to support clinical decision making. Acute care occupational therapists in a tertiary care hospital found that they experienced similar challenges with this client group and a clinical question was posed: Are there commonly encountered discharge planning issues with bariatric clients? Objectives: To identify the most commonly encountered factors impacting discharge planning for bariatric clients from the perspective of acute care clinicians. Methods: A historical qualitative approach will be used to guide a retrospective chart review on discharge planning for bariatric clients of a tertiary care hospital. Inclusion criteria include clients with a body weight of greater than 250 pounds who were seen by an occupational therapist for discharge planning in the most recent three years. Inductive coding will be used to identify themes related to the factors impacting discharge. Practice Implications: With a lack of evidence‐based practice guidelines and increasing caseload demands, understanding variations in the discharge process particular to bariatric clients will enable therapists to be more effective discharge planners. Study findings will provide evidence to support clinical decision making. Conclusions: Identifying frequently‐
addressed discharge planning issues for bariatric clients will support clinical decision making, allow clinicians to anticipate and manage challenges, and assist them to advocate for their clients. This study provides a starting point for further research into the emerging role of occupational therapists with bariatric clients. Poster Defense: Older Adult General, Community Dual‐task walking speed: Effects of aging and sensory deterioration Patricia Hewston & Mika Yoshikawa (, ) Patricia Hewston, Nandini Deshpande [email protected] and [email protected] Introduction. Many activities of daily living require the ability to safely and independently navigate within the natural environment (Deshpande & Patla, 2007). The natural environment commonly imposes sensory (e.g., low light) and cognitive challenges (e.g., walking‐while‐talking). The ability to accommodate these challenges while maintaining dynamic balance and postural control during walking, relies heavily on the visual and vestibular sensory systems. Objective. To investigate age‐associated differences in walking speed during conditions of dual‐
tasking and sensory deterioration. Methods. Walking speed (m/s) of 10 young (age 24.70±2.87) and 12 healthy older persons (age=74.00±5.21) was measured during normal walking and while walking in dual‐task conditions that involved serial subtraction by 3’s from a given number. On randomly selected trials visual and vestibular inputs were compromised using blurring goggles and galvanic vestibular stimulation at threshold level, respectively. The data were analyzed using 2(age‐group)x2(walking condition)x2(sensory perturbation) ANOVA. Results. There was CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin no main effect of age‐group (p>0.05). The walking speed decreased in a dual‐task condition compared to the control (p<0.001). However, compared to the control condition, walking speed increased in deteriorated sensory condition (p=0.001). Conclusions. Decrease in walking speed in dual‐task conditions is known and can be attributed to the limited attentional resources. Increase in walking speed under deteriorated sensory condition can be attributed to a compensatory strategy for overcoming step‐by‐step destabilization by using the body momentum. Results suggest that while walking in predictable and safe environments the ability of healthy older adults to accommodate a cognitive challenge or suboptimal sensory information is comparable to young adults. Poster Defense: Child/Adolescent Physical Health, Education Educational and rehabilitation service utilization in children with cerebral palsy Annette Majnemer (McGill University, Montreal) Michael Shevell, Mary Law, Chantal Poulin, Peter Rosenbaum [email protected] Rationale: The extent and nature of service supports for children of school‐age with cerebral palsy (CP) may not be optimal. Objectives: To describe the educational and rehabilitation services provided to children with CP and factors associated with use.Methods: Parents of 93 children with CP (6‐12 years, mean:9.2±2.1) completed questionnaires regarding current educational and rehabilitation resources. Services included occupational therapy‐OT, physical therapy‐PT, speech language pathology‐SLP, psychology and special education. Demographic characteristics and developmental status were documented. Results: Half of the children were in regular schools although 20/50 required special education resources. The majority (84.6%) received at least one rehabilitation service (36.3% 3‐5 services); 63.7% receiving PT, 52.7% OT, 38.5% special education, 34.1% SLP and 11.0% psychology. Services were provided predominantly at school, typically weekly direct interventions, with 9‐11% receiving OT/PT in rehabilitation centres. Younger age, but not parent education or income, was significantly associated with receipt of services. Children with greater motor limitations were more likely to require educational supports, OT, PT (p<.001) or SLP (p=.01). Children in special classes/schools or receiving OT, PT and SLP had lower IQ, and greater limitations across Vineland domains. Receipt of psychology or special education services was not predicted by IQ or GMFM. Conclusions: Most children with CP received one or more educational and rehabilitation services. Children with greater motor or cognitive challenges were likely to receive regular, school‐based direct interventions. Consultation services offered by OT and other specialists were uncommon, although might be beneficial in optimizing adaptive functioning in the home and community. Poster Defense: Adult Physical Health, Community Efficacy of home based “Wii‐hab” on balance in Parkinson’s disease Jennifer Barnhard (University of Western Ontario, London) Emily Bilinski, Danielle Chalmers, Clare Currie, Alisha Morris, Mary Jenkins, Andrew Johnson, Jeffrey Holmes Introduction: Increasingly, media outlets are citing the Nintendo Wii gaming system as an adjunctive tool for physical rehabilitation, particularly among older adults and individuals with limited mobility. Despite this attention within the popular press, however, evidence supporting “Wii‐hab” remains predominantly anecdotal. Objective: The purpose of this study was to evaluate the effectiveness of a 12‐week home‐based exercise program designed around the Wii, in improving the balance of individuals with Parkinson’s disease. Methods: Eight individuals with Parkinson’s disease participated in this study. Participants were asked to engage in three 30 minute Wii balance sessions per week, for 12 weeks. Balance was assessed at baseline, and immediately after the exercise protocol, using a biomechanical forceplate. Four standing balance tasks were used: (1) Eyes Open Feet Apart (EOFA); (2) Eyes Closed Feet Apart (ECFA); (3) Eyes Open Feet Together (EOFT); and (4) Eyes Closed Feet Together (ECFT). The outcome variable of interest was the length of the centre‐of‐pressure pathway. Results: Results suggest that participants improved their balance from pre to post intervention on each of the balance tasks. Conclusion: “Wii‐
CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin hab” has the potential to be an adjunctive tool used by occupational therapists. Large‐scale safety and feasibility studies are, however, warranted to better identify implementation challenges. Poster Defense: Adult General, Institution Emerging role of occupational therapy assistants in acute care Cory Feenstra (Ottawa Hospital, Ottawa) Leanne Forman [email protected] Introduction. The Practice Profile for Support Personnel through CAOT as well as the advancement of formalized training has allowed this developing profession to expand their roles in many facilities. Occupational Therapy Assistants (OTA) in a multi‐site acute care setting have enunciated their emerging roles to assist Occupational Therapists in their provision of OT interventions. Objective. To expand participants knowledge of the Practice Profile for Support Personnel and transfer this knowledge to work ready skills. The purpose is to provide Occupational Therapists’ the opportunity to understand the roles and benefits of an OTA in an acute care setting. Approach. After reviewing the Practice Profile for Support Personnel we created a list of tasks that can be delegated. Statistics of OTA specific interventions were compared against statistics taken from Occupational Therapists with no access to OTA services to demonstrate the benefits of an OTA role. Practice Implications. Occupational Therapists in isolation can benefit from support personnel with specialized rehabilitation knowledge. The use of this tool would aid in the advocacy and hiring of an OTA in such circumstances. This lead us to create a document that provides all staff and students a quick reference guide to the OTA role. This guide outlines how to best utilize the assistants to their fullest potential in an organization. Conclusion. The involvement of the OTA in the daily processes of an acute care facilities were identified as key factors in the efficient and quality of care provided to our clients requiring Occupational Therapy services. Poster Defense: Child/Adolescent General, Community Enhancing the capacity of paediatric therapists to provide group intervention Jacqui Moffatt (Ridge Meadows Child Development Centre, Maple Ridge) Teresa Kwiatkowski [email protected] Introduction: Small group intervention can teach parents skills and strategies to help their child’s development at home. Parent feedback indicates that groups provide opportunities to understand their child’s needs and learn skills that help their children. Evidence has shown that the family is the most important factor in determining the lifelong outcomes for their children (Law et al 2004). For therapists, organization of materials, preparation time and lack of knowledge to facilitate groups can make running groups seem overwhelming. Objectives: To increase the knowledge and skills of parents to address the needs of their young children and to develop a handbook to better equip therapists to implement group intervention in their communities. Approach: The rational, objectives, benefits and challenges as well as the process to plan and facilitate groups will be presented in the poster presentation. Practice Implications: Small group intervention can be highly motivating for children and can help facilitate connections and friendships. The group format encourages parent participation and teaches them practical skills to apply in the community and at home. The poster presentation will include highlights from the handbook, such as, a detailed guide for planning groups, sample lesson plans, home activity handouts and outcomes measures. Conclusions: The handbook will be a reference manual providing clinicians with the essential information required to plan and implement therapy groups for their clients. Poster Defense: Older Adult General, Institution Evaluating an interprofessional discharge planning program within inpatient geriatric rehabilitation Bonnie Thai (, ) Imelda Chan, Rachel Devitt, Sapna Ramanan, Jessica Casey Rationale: Discharge planning, with the primary goal of returning to community living, is an important focus for occupational therapists, healthcare teams and their clients . However, healthcare trends to minimize hospital costs CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin have led to patients being discharged at an intermediary stage of their recovery. Studies show that discharge education and training can improve patient outcomes after hospitalization (Jack et al., 2009), and that interprofessional (IP) interventions can lead to positive changes in healthcare (Zwarenstein, Goldman, & Reeves, 2009). Currently, there is limited research on interventions related to discharge planning for clients in geriatric rehabilitation. Objectives: This study aims to 1) modify an existing occupational therapy discharge planning program with IP collaboration, and 2) evaluate the new program’s impact on perceived discharge readiness of older adults from inpatient geriatric rehabilitation. Methods: A mixed methods approach will be used, and will include a literature review on chronic disease self management, adult learning theory, and IP best practice. Key informant interviews (N=10) of healthcare professionals from the inpatient geratitric rehabilation service will be conducted. Patient perceptions of discharge readiness (N=8) will be evaluated using pre‐post ratings of the Goal Attainment Scaling. Practice Implications: IP planning programs may be found to enhance the perceived discharge readiness of older adults, thus inform occupational therapy and IP practice of discharge planning within the rehabilitation hospital setting. Conclusions: By understanding the patient perspective of readiness and engaging patients in discharge planning through a discharge planning program, the transition from hospital to the community may be improved. Poster Defense: Non‐specific to Client Group, Education Evaluating an on‐line mindfulness course with occupational therapy students Denise Reid (University of Toronto, Toronto) Geoffrey Hen, Amy Gerwurtz [email protected] Introduction Opportunities for e‐learning have increased over the past decade and are offering support to business, health, education, and other sectors. A new on‐line mindfulness course was developed as a self‐care strategy for enhancing personal health and well‐being. While the course was designed for busy occupational therapy practitioners, it has the potential to be appropriate for many health and social service professional groups. Objective This initial study was designed to evaluate 1) the effectiveness of the web‐based mindfulness course on learning about mindfulness, and 2) the clinical utility of the on‐line approach with a group of occupational therapy students. Approach Students in occupational therapy volunteered to participate in an 8‐week self‐paced mindfulness on‐line course. The course was available through a dedicated website at a Canadian University. Content was posted on a weekly basis. Readings, reflective exercises, and guided meditations were used. On‐line surveys (pre, post, follow‐up) were used for evaluation. Results We will report the degree of mindfulness based on our outcome measures “Philadelphia Mindfulness Scale PHMS” (Cardaciotto, Hebert, Forman, Moitra, & Farrow, 2008) and the “Mindfulness Attention and Awareness Scale MAAS” (Brown & Ryan, 2003). Usability and commitment to use mindfulness data will also be reported. Conclusion This course has the potential to be extended and accessed by students in health care and other social service professions. It also has the potential to be a continuing education program for practicing health professionals. Poster Defense: Adult Psychosocial Health, Institution Evaluation of a Spinal Cord Injury Community Reintegration Therapeutic Service Nicole Digout (, ) Alana Zinman, Patricia Bain, Sylvia Haycock, Debbie Hébert, Sander Hitzig Rationale: Research has demonstrated that sustaining a spinal cord injury (SCI) causes significant challenges for community participation (Whalley‐Hammell, 2010). There is limited evidence for the utility of community reintegration programs in improving the well‐being and participation of individuals with a SCI living in the community.Objective: The purpose of this study is to evaluate the effectiveness of an inter‐professional community reintegration out‐patient (CROP) service for promoting well‐being and community participation in persons with SCI. Methods: Eleven individuals within 3 years post‐SCI living in the community participated in a 12‐week CROP service at a tertiary SCI rehabilitation hospital. A pretest‐posttest design was used to evaluate if participating in the service CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin promoted positive changes in community participation (Impact on Participation and Autonomy measure), quality of life (World Health Organization Quality of Life scale), coping ability (Coping Inventory for Stressful Situations measure), affect (Positive and Negative Affect Scale) and self‐efficacy (SCI Moorong Self‐Efficacy scale). Data was collected on the sample prior to participation and at completion. Data will also be collected at 3‐months post‐
intervention. Practice Implications: There is a need for effective interventions for improving community participation and quality of life post‐SCI. The outcomes of this evaluation may validate the occupational therapy (OT) role within the implementation of this service as enablers of occupation, health and well‐being. Conclusions: This study will inform OT practice on the effectiveness of an inter‐professional therapeutic community reintegration service for persons with SCI, which can be used to establish best‐practice standards for similar interventions at other rehabilitation settings. Poster Defense: Non‐specific to Client Group, Education Evaluation of an innovative interprofessional student run clinic Donna Drynan (University of British Columbia, Vancouver) Corey Stock, Hymen Gee [email protected] Introduction All health professional academic programs are examining ways to develop interprofessional clinical learning opportunities. One example involves expansion of a Physical Therapy student‐led clinic to include other health care provider students. In 2010 Occupational Therapy and Medicine introduced students to the clinic so that a truly interprofessional learning experience could be tested.ObjectivesThe objectives of the clinic include: to significantly enhance student teaching and learning by providing an innovative interprofessional clinical placement site; to combine teaching and learning within and between health professions that are naturally aligned in clinical practice; and to evaluate the feasibility of sustaining a clinic that is truly interprofessional. Methods A pilot study evaluating this interprofessional student led model for its effect on student's knowledge and beliefs related to interprofessional teamwork and on preceptor experiences was completed.Data collection consisted of Likert scale surveys and open ended questions. The process included:1. Pre and post student self‐assessment 2. Observer assessment 3. Student Post Placement Evaluation 4. Observer Post Placement Evaluation Results Preliminary review of the results indicates that on self ‐assessment students have a marked improvement in Role Clarification and a possible improvement in Client Centred Care. Change in communication is variable across professions. Particular attention will be given to the differences between the professions and a comparative analysis between two cohorts will be presentedConclusionLessons learned can be applied to a variety of clinical settings where there is an opportunity to incorporate interprofessional activities and reflection." Poster Defense: Older Adult General, Institution Evolving complexity in older adult hip fractures: Occupational therapy perspective Paula Szeto (Toronto Rehab ‐ UHN, ) Young Eun Russell, Joanne Kwong, Haleh Alehaidar Introduction: Traditionally older clients with hip fractures combined with cognitive and/or complex medical challenges may be refused admission to a rehabilitation program because of their risk of poor outcomes (McGilton, 2007). As a result, these individuals are often maintained in the more expensive acute care settings with limited access to rehabilitation. One musculoskeletal rehabilitation program assisted in pioneering a new fractured hip model of care to address this issue. The model allows older adults with hip fractures to access rehabilitation services more quickly – regardless of cognitive or other significant medical challenges. Objective: Occupational therapy has played a key role in developing this service approach. This poster will present how the occupational therapy team in this MSK program adapted and evolved their role to service this challenging population. Approach: Through this new fractured hip model of care, the OT team identified areas where practice change in musculoskeletal occupational therapy assessment and service delivery would be required. Practice Implications: At a macro level, this model of care is currently helping to reduce acute care hospital length of stay, increase CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin rehabilitation access and optimize resource utilization. For occupational therapy, the process changes made are currently ensuring that this population is receiving timely and greater access to OT services than ever before. Conclusion: Through continued reflection, evaluation and practice adaptation, this service approach is allowing occupational therapy to access a population group that was previously not considered “optimal” for a rehabilitation program. Poster Defense: Adult Psychosocial Health, Community Examining the effectiveness of yoga as a therapeutic tool for anxiety Neha Chugh‐Gupta (, ) Brenda Vrkljan Introduction: Emerging evidence suggests yoga can have particular benefits for those suffering from anxiety. Occupational therapists often address anxiety with their clients, which can challenge participation in daily life and overall health (Sabel & Gallagher, 2007). Yoga can serve as a valuable tool for clinicians, but when, how, and with whom it might be used in our practice has yet to be determined. Objective: This systematic review evaluated the utility of yoga as an intervention for individuals with anxiety and examined how it can be used within clinical practice. Methods: Major health and rehabilitation databases (e.g., CINAHL, Medline) were searched from the years 1990‐2011 for randomized controlled trials, non‐randomized controlled prospective comparative studies and systematic reviews. To minimize bias, two investigators independently reviewed each study for inclusion then evaluated its quality using predetermined criteria. Results: The 13 studies selected (of 591 reviewed) indicated that yoga is most effective when used as an adjunct with other common approaches for anxiety (e.g., cognitive behavioral therapy [CBT]). ‘Hatha’ yoga, which includes meditation, breathing, postures, and relaxation techniques, was particularly effective when anxiety occurred due to other health issues (e.g., cancer, cardiac). Conclusion: Our systematic review of the best available evidence indicates that yoga is a valuable tool for addressing anxiety, particularly under circumstances of extreme stress, such as a critical illness (e.g., cancer). Yoga provides a healthy coping strategy. This strategy should be part of our clinical toolkit but further evidence of its direct utility within occupational therapy practice is warranted. Poster Defense: Adult General, Theory Executive function, self‐regulation, and attribution in acquired brain injury Anne Hunt (, ) Gary Turner, Helene Polatajko, Deirdre Dawson [email protected] Introduction: Impairments in executive function, self‐regulation and attribution have all been individually implicated in reduced participation in daily life in individuals with brain injury. There is minimal literature that explicitly addresses the relationship between constructs or how it is affected by brain injury. Objectives: The main objectives of this study were to determine what is known about the relationship between executive function, self‐
regulation and attribution in goal directed behaviour and how this relationship is affected by brain injury. Participants & Methods: A scoping review methodology, as described by Arskey & O’Malley (2005), was performed. The review encompassed cognitive neuroscience, neuropsychology, rehabilitation, educational and social psychology literature from 1985 to 2011. Data from qualitative and quantitative papers was summarized and examined for inter‐relationships. Results: Of 593 papers identified, 53 were chosen for more in‐depth review. These provided definitions of the constructs and insight into the relationships between them according to neural underpinnings and conceptual models. These data were used to develop a model that illustrates the relationship between the constructs. Conclusions: This review and the model developed, Model of Performance Self‐Regulation, provide unique insight, into the influence that attributional factors have on executive function and self‐regulation. Attribution appears to be of considerable importance for individuals with acquired brain injury as they are prone to making misattributions contributing to impaired self‐regulation, executive function and reduced participation in CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin daily life. Interventions that enable these individuals to make appropriate attributions should be considered in addition to training in self‐regulation and executive function. Poster Defense: Adult General, Institution Exploring age‐appropriate housing for adults with severe neurological disabilities Pnina Cohen (University of Toronto, Toronto) Chelsea Rogers, Debbie Hebert, Jo‐Anne Howe Introduction: Neurological disabilities severely impact an adult’s (18‐64 years) ability to live in the comforts of his/her home. There are very few living environments that offer supportive care for adults with neurological disabilities, and thus many are compelled to move to residential care facilities designed for the elderly. The lack of age‐appropriate resources for this population leads to diminished occupational performance and overall quality of life. Objective: The aim of this study is to determine where care‐dependent adults with non‐congenital neurological disabilities live within an urban setting and whether any enablers to occupational performance are available to them. Methods: This cross‐sectional study will distribute an online questionnaire to one representative (nurse educator, directors of nursing, social worker, and/or recreational therapist) from each of 200 residential care facilities within an urban setting. The questionnaire will consist of closed‐ended questions to address the number of adults with non‐congenital neurological disabilities currently living in residential care facilities, and the enablers to occupational performance offered in these environments. Descriptive statistical analysis will be used to analyze the data. Practice Implications: Findings will inform occupational therapists of the living environments that are available for their clients with neurological disabilities, as well as the nature of these environments. Occupational therapists will become aware of what they need to advocate for on behalf of their clients with neurological disabilities. Conclusion: This study will identify the need to improve and/or expand age‐appropriate services to promote occupational performance and quality of life for adults with non‐congenital neurological disabilities. Poster Defense: Non‐specific to Client Group, Education Exploring occupational therapist’s clinical reasoning in group therapy Pamela Wener (, ) Ian Maclennan [email protected] Introduction: Clinical reasoning is essential to the art and science of occupational therapy practice but is difficult to develop in students because of its tacit nature. Illuminating experienced therapist’s clinical reasoning process may inform occupational therapy curriculum aimed at developing this skill. However, few studies examine therapists’ clinical reasoning process when facilitating group therapy sessions. Purpose: This descriptive qualitative study explored occupational therapist’s clinical reasoning process when leading group therapy sessions to inform curriculum aimed at developing clinical reasoning in student occupational therapists. Methods: Researchers recruited six occupational therapists that routinely conducted group therapy with clients. Data were collected using individual semi‐structured interviews. Two researchers independently coded the first three interviews to develop a coding scheme that was then used to analyze the remaining interviews. Next, researchers explored the utility of the Person‐Environment‐Occupation Model (Law, et al., 1996) to interpret the data. Subsequently, member checking was conducted and this feedback was integrated into the final interpretation of the data. Results: Emergent themes included setting and processes, decision‐making strategies, and therapist attributes and perceptions. Therapists confirmed that the Person‐Environment‐Occupation Model (Law, et al., 1996) framed their reasoning process, enabling them to be client‐centred when conducting group therapy sessions. Using the Person‐Environment‐
Occupation Model1 as a framework, a set of occupational therapy curriculum recommendations was developed. Conclusions: Understanding therapist’s clinical reasoning process in group therapy informs how educators may support students to develop their clinical reasoning. Furthermore, the Person‐Environment‐Occupation Model (Law, et al., 1996) frames the clinical reasoning process, providing structure for students to develop this tacit skill. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Adult Psychosocial Health, Community Exploring occupational therapy roles in primary care mental health teams Pamela Wener (University of Manitoba, Winnipeg) Roberta Woodgate [email protected] Introduction: Occupational Therapy national and provincial position papers establish the profession as an essential component of the delivery of mental health and primary care services. However, to date few occupational therapists have been included in mental health primary care teams. Identifying primary‐care‐provider’s (PCP’s) needs for interprofessional collaboration may contextualize gaps in existing in service. This identification of needs provides an opportunity for occupational therapy to align role development with expressed needs. Objectives: This qualitative study explored PCP’s self‐identified need for interprofessional collaboration and discerned the occupational therapy roles that address gaps in mental health services in primary care. Methods: Twenty PCPs, from a wide variety of practice settings, participated in a single in‐depth semi‐structured interview. Analysis consisted of an inductive process of constant comparison where transcripts were read several times and compared with one another to development emergent categories. To explore opportunities for occupational therapy in primary care, emergent categories were subsequently analyzed using the Occupational Therapy Profile (CAOT, 2007). Results: Emergent categories included: co‐location as a pre‐condition to interprofessional collaboration, role of formal and informal structures, procedures and tools that facilitate interprofessional communication, and interprofessional education as an unrealized resource. Opportunities for occupational therapy role development included: enabling occupational engagement and performance, facilitating client‐centred practice, and facilitating interprofessional education. Conclusion: Understanding PCP’s need for interprofessional collaboration enables occupational therapy to align role development with identified needs. Aligning occupational therapy role development with the identified service gaps may increase the number of occupational therapists employed on mental health primary care teams. Poster Defense: Older Adult Psychosocial Health, Community Exploring recovery from the perspectives of older adults Laura Blackadar (, ) Ewa Kowalska, Sue Stanton, Staci Kalmek [email protected] Introduction: A recovery‐oriented framework has become central in today’s mental health system, and occupational therapy has played a key role in facilitating recovery research and practice. However, as the number of older adults with serious mental illness increases dramatically, little is known about their unique needs and perspectives on recovery. Objectives: With the goal of facilitating a recovery vision for an older adult psychosocial rehabilitation program, this study sought to answer: How do clients of an older adult psychosocial rehabilitation program envision recovery, and how does the program facilitate this vision? Methods: Four older adults from one community‐based psychosocial rehabilitation program were recruited using purposive sampling. Individual semi‐
structured interviews explored participants’ recovery perspectives and experiences. Interviews were digitally recorded and transcribed verbatim. Data was analyzed using a descriptive phenomenological approach, with codes and themes cross‐checked between research investigators. Findings were member‐checked in order to best capture lived experiences regarding recovery. Results: Thematic analysis of qualitative data revealed that the human connection (companionship, support, inspiration, wellness), taking action (keeping busy, self‐worth, coping), and life perspective (quality of life, locus of control, self‐acceptance) were important facilitators of recovery for participants. Themes highlighted the multidimensional nature of recovery and the importance of social inclusion and occupation. Conclusions: This study offers occupational therapists insight into the needs and recovery visions of older adults with serious mental illness. Results may guide program design and evaluation of occupational therapy programs that aim to facilitate recovery within an older adult population. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Non‐specific to Client Group, Education Exploring the enablers and barriers to community of practice sessions Gwenyth Roberts (Alberta Heatlh Services, Calgary) [email protected] Introduction: It is imperative that therapists keep pace with relevant knowledge and reflect on their practice. Community of Practice sessions (CoPs) provide clinicians with a forum to interact on a regular basis and participate in shared practice stories about their clients, exchange information and expertise, and foster scholarly practice. Several programs have been using CoPs however studies on the subject are scant.Objectives: The purpose of this project is to explore the barriers and enablers to knowledge transfer and participation in a community of therapists who are encouraged to attend CoPs.Methods: Mixed methods were employed with occupational and physical therapists in a school health program. A questionnaire using descriptive analysis (n = 18) and semi‐structured interviews (n = 14) using phenomenological analysis were utilized. Results: Results from the questionnaire highlight the importance of: hearing about new knowledge and sharing experiences; improving expertise; developing new ideas; receiving ideas to resolve problems; saving time in finding information; and helping newcomers. High ratings were scored on sense of belonging and trust in the community, as well as contributions of ideas and methods to the organization. Interviews revealed several benefits to attending CoPs such as social connectedness, development of clinical skills, and awareness of diverse perspectives. Barriers such as caseload pressures, information overload, or intimidation were identified. Themes resulting from the qualitative analysis will be presented. Conclusions: This study explores the enablers and barriers to community of practice sessions to advance understanding in the ways to support staff for best practice. Poster Defense: Non‐specific to Client Group, Theory Exploring the experiences of cultural humility in Canadian occupational therapists Angela Lee (, ) Ana Talag, Lynn Cockburn Introduction: Cultural humility is a lifelong process of self‐reflection that involves building partnerships amongst health care professionals and clients. The practice of cultural humility proposes that clients must be active partners and regarded as experts in their care which parallel the values inherent within the profession of occupational therapy. However, the complexity and subjectivity of the construct has yet to be explored. As Canadian occupational therapists work within increasingly multi‐cultural settings, practicing cultural humility will help to provide culturally sensitive, client‐centred care. Objectives: The purpose of this study is to explore the construct of cultural humility and how it emerges throughout the life‐course of Canadian occupational therapists working in multi‐cultural settings. Methods: In this qualitative study, occupational therapists who have worked in the profession for at least ten years within multi‐cultural settings will be recruited. The participants will be interviewed using an in‐depth, semi‐structured approach, focusing primarily on key experiences that have shaped their professional identities while working in multi‐cultural settings. A narrative story based on each participant’s cultural experiences will be composed. The collective narratives will be compared to uncover common themes and interpretations of cultural humility. Practice Implications: Through gaining insight from the narratives, occupational therapists will be able to reflect on their own professional identities as well as their practice of cultural humility in cross‐cultural interactions. Conclusions: As more occupational therapists promote their professional growth through the practice of cultural humility, clients will benefit from receiving client‐centred care. Poster Defense: Older Adult General, Community Factors that influence occupational performance amongst seniors with vision loss Colleen McGrath (, ) Debbie Laliberte‐Rudman [email protected] CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction: The majority of vision impairments affect older adults aged 65 years and older, and as the population ages, there will be an increasing number of seniors with age related vision loss (ARVL). There is a wealth of information to demonstrate that older adults with low vision experience significant changes to their self‐care, leisure and productivity, however, the existing research does not specifically address the factors that lead to these changes. Objective: The purpose of this poster is to add to the existing research literature by exploring the factors which contribute to the occupational performance issues experienced by older adults with ARVL. Method: The author completed a scoping review of the literature to identify the factors which contribute to the occupational performance issues experienced by older adults with low vision. Using the established inclusion criteria, the review yielded 18 quantitative articles and 18 qualitative articles which were included in analysis. Results: Using the Person‐Environment‐Occupation (PEO) model as a framework for understanding participation, the scoping review highlighted a number of personal, environmental, and occupational factors which influence the performance of older adults with vision loss. Conclusions: Substantial research evidence has demonstrated that older adults’ occupational performance is significantly impacted as a result of their vision loss. In order to better inform occupational therapy practice, however, what is needed is a more comprehensive understanding of the factors which contribute to these changes in occupational performance. This poster will provide a comprehensive overview of those factors. Poster Defense: Adult Psychosocial Health, Institution Finding the fun in daily occupation: An investigation of humor Michelle Elliot (University of Southern California, Los Angeles) [email protected] Introduction: Humor has long been explored for its perceived therapeutic benefits. Occupational therapy’s contribution to this exploration however, has been primarily peripheral. Is humor relevant to occupational therapy practice and occupational engagement? Objectives: This playful paper discusses humor as a biologically, socially, and contextually grounded aspect of the human experience and thus can affect the subjective nature of participating in occupation. By deconstructing humor from its affective representations to its neural foundation, humor as an intrinsically human phenomenon is explored. Approach: Literature on the therapeutic benefits of humor and laughter from an interdisciplinary perspective will be presented. The translation of humor and fun into daily activity through clinical examples from an eating disorder clinic will be introduced, along with examples of the potential for using fun to erect social, emotional, and behavioral change. Barriers and limitations to the application and investigation of humor will be acknowledged. Practice Implications: Introducing humor into therapeutic practice invites a rich collaborative exploration of: how humor is present or absent in daily life, how humor can be accessed and nurtured, the role of humor as a coping strategy or tool for social connection, and methods by which humor can be a motivating force in creating change. Conclusions: Taking humor seriously invites a larger translation of its therapeutic utility beyond the clinical realm into everyday life. Occupational therapists have much to contribute both to the study and integration of humor in practice with the perspective of how humor may alter the experience of occupational engagement. Poster Defense: Child/Adolescent General, Community Gaining the perspectives of youth with disabilities about research priorities Jennifer Ancheta (Occupational Therapist, Winnipeg) Gillian Ronson, Gayle Restall Introduction: Opinions of youth are not often sought when determining research priorities. Childhood rehabilitation research priorities are typically based on the opinions of experts such as researchers or healthcare providers. Involvement of youth with disabilities in research priority development can bring unique perspectives resulting in research of greater relevance, particularly to those directly impacted by the research. Objectives: The objectives of this pilot study were to: 1) gather perspectives of youth with disabilities about priorities for childhood rehabilitation CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin research and 2) identify themes that could inform a future project to engage a larger sample of youth in developing research priorities.Methods: Two youth with disabilities, aged 18 to 25 years, were recruited through a rehabilitation facility. Individual interviews were conducted using a semi‐structured interview guide, audio‐
recorded, and transcribed verbatim. Researchers completed qualitative data analysis to identify themes. Participants received a summary of the results for member checking.Results: Interviewees highlighted priority research topics including access to occupations, accessibility to computer technology, delivery of client‐centred and family‐centred care and transitioning from child to adult services. Similarities and differences with priorities developed during an earlier forum attended by researchers and clinicians were noted. Conclusion: This study increases understanding of research priorities that youth with disabilities feel are important and the best methods for gathering these opinions. Themes that were identified will inform development of future opportunities to engage youth with disabilities in developing research priorities. Understanding of youth’s perspectives on research priorities will increase the relevance of future childhood rehabilitation research. Poster Defense: Adult Physical Health, Institution Group gardening and quality of life Kim Butler (, ) Rachel Butcher, Melinda Suto Introduction. Group leisure activities represent one significant way of improving quality of life (QOL) in residential care facilities. Occupational therapists have historically been involved in planning and promoting meaningful activities as a way to enhance the participation of individuals living in such facilities (Martin, Miranda & Bean, 2008). Gardening is a popular leisure activity that has demonstrated positive health outcomes in a variety of populations, both when practiced individually or in a group setting. To date, there is insufficient evidence concerning how participation in a gardening program contributes to the QOL of individuals with complex physical disabilities. Objective. To explore the lived experiences of individuals with complex physical disabilities who participate in a community gardening program at a residential care facility, specifically asking how this occupation affects their perceived QOL. Methods. Data were gathered through single, semi‐structured interviews with four gardening program members. Participant observation during several gardening sessions was performed in order to enrich the understanding of the program. Thematic analysis was informed by the principles of descriptive phenomenology and concepts of occupation. Results. Researchers identified three major themes: A sense of community; Watching the garden grow; and Learning. Conclusions. The findings of this study reflect the dimensions of meaning, specifically doing, being, becoming, and belonging that Hammell (2004) proposed are necessary for understanding how client’s occupations influence their QOL. Furthermore, these findings may assist occupational therapists in understanding how to engage individuals with complex physical disabilities in meaningful leisure with the ultimate goal of improving QOL. Poster Defense: Adult Physical Health, Institution Hypnosis as a tool to enhance mental practice Julien Voisin (U Laval, Québec) Matthieu Gagnon‐Villeneuve, Claire Gane [email protected] Introduction: Mental practice, the repetition of imagined motor acts, is gaining an increasing interest as a training approach in neurorehabilitation [1,2]. Little is known, however, about which strategies could be used to maximize the beneficial effects of motor imagery [3]. Objectives: To determine whether hypnosis could increase the benefit of motor imagery. Methods: Control participants (n=8) were instructed to perform physical and imagined movements both before and after a hypnotic induction using (a French translation of) Standford scale C procedure. Behavioral data were collected, both objective (time to perform a movement) and subjective (5‐point scale of how close imagery was from physically doing the movement). Results: The hypnotic state systematically decreased movement speed and increased subjective perception that the imagined movements were close to the physical CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin ones. Conclusions: Hypnosis is a promising tool to enhance immersion during motor imagery. Further studies will be needed to extend the finding to clinical population, and evaluate therapeutic effects of mental practice during hypnotic state. Poster Defense: Older Adult General, Community Impact du vieillissement cognitif normal sur la réalisation d’un budget Sophie‐Andrée Gagnon‐Raby (, Montréal) Guillaume Paquette, Nathalie Bier, Carolina Bottari [email protected] Introduction : Les fonctions exécutives sont parmi les premières fonctions cognitives à subir les effets du vieillissement. Un déclin de ces fonctions peut avoir de nombreux impacts lors de la résolution de situations complexes ou inhabituelles. Ainsi, la gestion financière chez les aînés est un enjeu d’une grande importance actuellement. Objectif : Explorer l’impact du vieillissement cognitif normal sur la réalisation d’un budget annuel visant un objectif d’épargne pour l’achat d’une automobile. Méthodes : Des personnes âgées sans trouble cognitif ont réalisé la tâche du budget du Profil des Activités Instrumentales (PAI). Leur performance a été analysée selon le cadre du PAI soit par opération et par niveau d’indépendance allant de dépendance (score de 0) à indépendance sans difficulté (score de 4). Résultats : La moyenne générale de l’ensemble des participants (n=23; A=75,1 ± 5,9 ans; S=11H; MMSE=29,2 ± 1,0; scolarité= 12,1 ± 3,0) à la tâche du budget est de 2,7 ± 1,1. Les principales difficultés rencontrées se situent au niveau de l’élaboration des dépenses, de la réalisation des calculs et de l’identification d’un montant d’épargne pour l’achat d’une automobile. Conclusion : Dans l’ensemble, une assistance verbale est requise pour réaliser cette tâche. Ainsi, la gestion financière est une tâche complexe qui n’est pas à négliger pour les personnes âgées ayant un vieillissement cognitif normal. Poster Defense: Child/Adolescent General, Community Impact of motorized wheelchairs on social interactions and leisure participation Agnes Piat‐Corson (, ) Esther Rottenstreich, Katherine Priestley, Stephanie Dubreuil, Viviane Trinh Introduction: There is a growing interest in social and leisure participation among children and adolescents with disability, yet the factors that facilitate or detract from participation are not well understood. This pilot study aims to examine the influence of mobility, specifically powered mobility, on social and leisure participation. Objectives: 1. Determine the extent to which powered mobility impacts level of leisure and social participation in children and adolescents with motor impairments. 2. Determine level of satisfaction regarding social and leisure participation. Methods: The study uses a two‐group comparative cross sectional design, with a convenient sample of children and adolescents (mean age of 15 years) recruited from a paediatric rehabilitation centre. Study participants had a diagnosis of cerebral palsy or degenerative disease. Participants were categorized as either having access to powered wheelchairs at school only (w/c school), or having access at school, home, and in the community (w/c school/home/community). The main measurement tool was the Assessment of Life‐Habits for Children. The Functional Independence Measure for Children and a homemade demographic questionnaire were used to collect baseline information. Results: The "w/c school/home/community” group’s score of leisure and social participation is significantly higher than the “w/c school” group (p =.008) whereas levels of satisfaction between the two groups do not differ significantly. Conclusions: Access to powered mobility contributes to increased leisure and social participation among children and adolescents with motor impairments. However, further research is needed to understand the complex interaction between powered mobility and other factors that affect social and leisure participation. Poster Defense: Child/Adolescent Physical Health, Institution Infant car seat safety: Pilot study of an educational module CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Brenda Vrkljan (McMaster University, Hamilton) Heather Boyd, Jana Danziger, Rebecca Jenkins, Catherine Moher, Jessica Lee [email protected] Introduction: Many premature infants are at a high risk of cardiorespiratory events that may cause morbidity or mortality. These risks are compounded when infants are in an upright or a semi‐reclined position like a car seat . Hospitals require high risk infants to pass a car seat ‘test’ of their cardiorespiratory status prior to discharge home. However, front‐line staff conducting this test have indicated they lack sufficient knowledge and education on the safe use of car seats (Moher et al., 2011). Development of an educational module targeting staff can improve the consistency of car seat testing, and infant safety upon discharge. Objective: This pilot study evaluates the utility of an online, educational learning module (e‐module) on car seat safety. Methods: Pilot‐testing of the e‐module with staff in neonatal intensive care unit and level two nurseries evaluated knowledge translation and perceived confidence using pre and post tests of car seat safety. Practice Implications: Occupational therapists are involved with improving car seat safety for high risk infants prior to discharge by addressing seating issues, educating parents, and making adaptations. This pilot study extends this role to include development of an e‐module to educate frontline staff, including tools to evaluate its effectiveness. Conclusions: Development of an online, educational tool for frontline staff is an innovative means to improve the safety of high‐risk infants in car seats. Inclusion of an evaluative component for users is key to ensuring the knowledge translation cycle is complete. Strategies that can be used when developing other e‐modules are highlighted. Poster Defense: Non‐specific to Client Group, Administration Health Policy Innovative program aiming evidence‐based occupational therapy Anne‐Martine Lafaille (, Ottawa) Chantal Sylvain [email protected] IntroductionAs scholarly practitioners, occupational therapists have a duty to base their work on the best evidence (CAOT, 2007). Given the rapid development of health knowledge and conditions of practice marked by a lack of resources, continuous updating of this role in practice is a difficult challenge. Solutions that address the development of strategies tailored to the barriers and facilitators related to the context of practice seem most promising.ObjectiveDevelop a program that supports evidence‐based practice of occupational therapists working in a university affiliated pediatric hospital.MethodsDifferent data collection methods were used: individual and group interviews with occupational therapists and managers and a literature search. A thematic content analysis of the data collected helped to define the outline of the program. A logic model of the program was created and subjected to a validation step with key informants.ResultsThe program has three components: 1) leadership training, 2) reflective and collaborative professional development and 3) pilot projects. It meets the needs expressed by the occupational therapists, takes into account the barriers and facilitators of the context and is based on best practices.ConclusionThe program represents an innovative solution developed to support excellence, through time, in the daily practice of occupational therapy. The approach used to develop the program is exportable and can inspire clinicians in other health facilities. Poster Defense: Non‐specific to Client Group, Education Integrating interprofessional education (IPE) into occupational therapy curriculum Sylvia Langlois (University of Toronto, Toronto) Lynn Cockburn [email protected] Introduction: International and national government and health organizations are increasingly promoting the need for health professionals to work collaboratively to promote quality client care. As universities explore innovative methods to develop comprehensive interprofessional collaboration curricula to meet this need, occupational therapy programs have an opportunity to respond and provide significant leadership.Objectives: This poster will demonstrate how the Occupational Therapy Department has developed and integrated interprofessional education CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin into its core program. IPE competencies are linked to the development of the Communicator, Collaborator and Professional roles. Approach: The Occupational Therapy Department has provided leadership in the development a competency‐based IPE curriculum based on core and elective learning activities provided to eleven health science programs at the university. Learning activities include a variety of innovative curricular opportunities that provide an interface between the core academic and clinical settings to promote future collaborative practice. Student assessment and program evaluation are built into the curriculum.Results: Examples of how the developmental IPE program has evolved over the years to become more integrated into core Occupational Therapy curriculum will be provided. Key challenges and solutions will be presented, as well as future implications for program development.Conclusions: An integrated IPE program assists students to develop key competencies as Communicator, Collaborator and Professional. Poster Defense: Non‐specific to Client Group, Community Interprofessional collaboration to explore work challenges and ergonomic strategies Leslie Johnson (University of Manitoba, Winnipeg) Lisa Diamond‐Burcchuk, Laura MacDonald, Laureen Bellows [email protected] Background: Interprofessional education is encouraged in classroom environments, however helping students recognize these experiences as relevant can be a struggle. An initiative in a university‐based dental hygiene clinic has resulted in an innovative learning experience where dental hygiene (DH) and occupational therapy (OT) students collaborate to understand and address the work‐related challenges of DH practice. Objectives: The objectives of this presentation are to: outline a successful collaborative learning experience; describe the challenges and lessons learned from facilitating, revising and evaluating this learning opportunity; and discuss future project directions.Approach: Faculty members from the OT and DH programs facilitated students meeting together in the clinical teaching setting. In small, interprofessional learning groups, students began by discussing their role in health care delivery. Then, DH students provided services to a simulated patient, while OT students completed a job demands analysis. In the follow‐up discussion, students shared their observations and discussed ergonomic interventions. Practice Implications: Students report positive collaborative experiences. OT students valued the opportunity to practice job demands analysis and explore ergonomic strategies in a controlled setting with engaged learning partners. DH students indicated increased awareness of ergonomic challenges, and that strategies related to working more safely were helpful and relevant. Conclusions: Students gleaned new knowledge about, from and with each other. Students engaged in collective problem solving which led to a richer understanding of work challenges and solutions in the clinic. The experience is component of an emerging interprofessional education culture that promotes engaged, participatory learning. Poster Defense: Adult General, Education Interprofessional mental health care team collaboration process: An exploratory study Brad Snyder (FASD Life's Journey Inc., Winnipeg) Pam Wener, Shannon Ross [email protected] Introduction: The mental health care field recognizes that when a health care team works interprofessionally to deliver services there are improved patient outcomes. Current research describes the advantages and disadvantages of interprofessional mental health care teams; however, little is known about the collaboration process used by interprofessional mental health care teams to make health care decisions. Objectives: This presentation will explore the collaboration process of an interprofessional mental health care team. Methods: Study participants included six members from an interprofessional mental health care team from the professions of nursing, registered dietician and occupational therapy who participated in a single 90‐minute focus group. The focus group was audio‐recorded and transcribed verbatim. Three researchers independently read the focus group transcript and completed open coding. Researchers then met to agree upon the open codes and combine them. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Two researchers then re‐read the transcript to ensure all data was included and collapsed emerging categories into themes. Results: Emergent themes included: 1) Structures and processes that facilitate interprofessional collaboration 2) The process of becoming an interprofessional team and 3) Personal and professional attributes of the practitioners. The interprofessional mental health care team’s use of the recovery model underpinned the three emergent themes. Conclusions: Results from this study contribute to our understanding of the collaboration process used by an interprofessional mental health care team to make health care decisions. Further research is required to develop a model of the interprofessional mental health care team collaboration process used when making health care decisions. Poster Defense: Child/Adolescent General, Institution Involvement in leisure activities among children and youth with arthritis Sabrina Cavallo (, ) Annette Majnemer, Ciarán Duffy, Ahsan Bandeali, Debbie Ehrmann Feldman Introduction: It is recognised that children and youth with arthritis are likely to be less socially and physically active than their healthy peers; however the reasons for this are not completely known.Objectives: To describe leisure activities in terms of diversity, intensity and enjoyment, as well as to identify potential socio‐demographic and disease‐related determinants. Methods: Fifty children and youth aged 8 to 18 years diagnosed with juvenile idiopathic arthritis (JIA) completed the Children’s Assessment of Participation and Enjoyment (CAPE), which measures involvement in leisure activities (recreation, physical, social, skill‐based, self‐improvement). The disease characteristics were abstracted from the child’s medical file (disease severity and age of diagnosis). Parents completed questionnaires on socio‐demographic data and family structure. Results: The most popular activities(>90%)were playing board games, playing computer/video games, watching television, hanging out with friends, doing chores and doing homework. Least popular activities were (<10%) martial arts, horseback riding and fishing. The level of enjoyment was highest for social activities (mean: 4.2 ±0.5). Involvement in informal leisure activities showed a significant negative association with age (?= ‐0.421, 95% CI= ‐0.148,‐0.032, p=0.003), and with disease activity (?= ‐0.401, 95% CI= ‐0.732,‐0.133, p=0.006). Conclusion: Greater disease activity may dissuade children and youth from participating in more active pursuits, which places them at greater risk for adopting sedentary lifestyles. The identification of determinants of leisure activities in children and youth with arthritis may allow healthcare professionals to assess children’s health needs with more precision and promote a healthier lifestyle. Poster Defense: Child/Adolescent Psychosocial Health, Community Leisure preferences for adolescents with cerebral palsy (CP) Keiko Shikako‐Thomas (, ) Annette Majnemer, Michael Shevell, Lucy Lach, Mary Law, Norbert Schmitz [email protected] Introduction: Leisure is one of the main domains of occupational performance. Adolescents with disabilities may experience decreased participation in leisure. Occupational therapy practice has evolved from a focus on necessary occupations to occupations that are meaningful to the client. Greater appreciation of adolescents’ leisure preferences may influence goals and interventions in occupational therapy practice.Objectives:To describe leisure activity preferences of adolescents with CP and their relationship to participation and to identify factors associated with greater interest in particular leisure activities. Methods:This cross‐sectional study included 107 adolescents (65 males; mean 15.3 + ‐ 2.01 years) with CP (GMFCS levels‐ I 40%, lII 33%, III–IV 26%) who could complete the Preferences for Activities of Children (PAC) and other self‐report questionnaires.Results:Social and physical activities were most preferred, and self‐improvement activities were least preferred. Mastery motivation was positively associated with interest in recreational (r=.25) and physical (r=.31) activities. Family active‐recreational orientation was related to preference for physical (r=.25) and self‐improvement (r=.20) activities, whereas decreased self‐worth CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin was related to greater preference for skill‐based activities (r=‐.25). Higher functioning levels was related to less preferences in recreational (r=‐.37), skill‐based (r=‐.26) and self‐improvement (r=‐.37) activities. High preference for certain activities was not always associated with actual involvement in these activities.Conclusions: Family factors, personal factors and functional abilities influence leisure preferences. Occupational therapy interventions should consider adolescents’ preferences and family dynamics to minimize barriers to leisure participation, such as low motivation or environmental obstacles, so as to promote engagement in leisure activities. Poster Defense: Child/Adolescent Psychosocial Health, Community Managing media use of adolescents with Autism Spectrum Disorders Melissa Kuo (University of Alberta, Edmonton) Joyce Magill‐Evans, Lonnie Zwaigenbaum [email protected] Introduction: Adolescents with an autism spectrum disorder (ASD) spend considerable leisure time engaging in media activities, including watching television, playing video games and surfing websites (Orsmond & Kuo, 2011). Parents play an important role in shaping adolescents’ responses to media. We know little about parents’ perspectives on adolescents’ media use, the strategies they employ to mediate media use, and ways occupational therapists can support these parents and adolescents. Objectives: This mixed methods study investigates how parents of adolescents with an ASD manage their child’s use of media, concerns about media use, and perceived benefits of media use as a primary leisure occupation. Methods: Parents of 30 adolescents (ages 12 to 19) with an ASD are completing a questionnaire package. It contains a television mediation measure, a videogame mediation measure, and demographic questions. Open‐ended questions are asked about parents’ concerns and perceived benefits of media activities for the adolescent, and whether and to what extent parents feel stressed when managing the adolescent’s media use. Data will be analyzed using descriptive statistics (questionnaires) or qualitative deductive content analysis (open‐ended questions). Practice Implications: Management of media use is a major issue. A better understanding of parents’ perspectives and mediating strategies will help other parents and occupational therapists assess concerns about youth’s media use as well as identify effective monitoring and intervention strategies. Conclusions: This study will generate new insights into the family environment associated with media use by adolescents with ASD and highlight opportunities to support families in managing this issue. Poster Defense: Older Adult General, Education Manual wheelchair skills training to improve confidence in older adults Melanie Souza (, ) Viara Nikolova, Brodie Sakakibara, William Miller Introduction: Confidence with using a manual wheelchair is conceptualized as the belief individuals have in their ability to use a wheelchair. It is an emerging research area that can significantly impact healthy aging, occupational engagement, and health services aimed at maintaining functional autonomy among older adults. Because low confidence is a remediable condition, highly influenced by performance accomplishments, training programs used to enhance manual wheelchair skills may influence confidence with using awheelchair. Objective: To investigate the efficacy of the Wheelchair Skills Training Program (WSTP) on improving confidence with using a manual wheelchair in older adults (>65 years) who are inexperienced with using a manual wheelchair. Hypothesis:Gains in confidence with using a manual wheelchair will be significantly greater in persons assigned to the WSTP compared to persons assigned to the control group. Methods: Twenty older adults living in the community with no previous manual wheelchair experience were enrolled in this single‐blind, parallel‐group randomized controlled trial. The WSTP‐
intervention group received two 1‐hour wheelchair skills training sessions. The control group received one socialization contact.Confidence with using a manual wheelchair was measured with the Wheelchair Use Confidence Scale (WheelCon). A one‐way between groups analysis of covariance (controlling for baseline scores) was used to compare changes. Results: Intervention group scores were significantly greater than the control group scores [F(1,17) = 10.9, p=0.004, partial eta squared = 0.39].Conclusion: Two hours of wheelchair skills training CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin improves confidence with using a manual wheelchair with a moderate effect size in older adults who are inexperienced with using a wheelchair. Poster Defense: Adult Psychosocial Health, Community Meaning in occupation for people who live with schizophrenia Regina Casey (, ) [email protected] Introduction: Reed (2008) asserts that in OT, the concept of meaning has been overshadowed by defining and defending practice. Whalley Hammell (2004) notes that Occupational Therapists often consider meaning and purpose as one and the same thing; extolling meaning in occupation but actually focusing on purpose as opposed to meaning. Objectives: Workshop participants will understand the kinds of occupations that a small group of people living with schizophrenia are involved in, the meanings these occupations hold for them, and the kinds of meanings that participants feel are missing in their occupations. Methods: During the session findings from a recently completed in‐depth study involving the voices of 10 participants using hermeneutic phenomenology to guide data collection and analysis will be presented. The goal of the study is to offer conceptual clarity regarding the concept of meaning in occupations from the perspective of people who live with schizophrenia Practice Implications: It is proposed that we need to know how meaning is generated and what steps can be taken to facilitate meaning making (Doble as cited in Reed, 2008) in occupation. Data from this study will provide insight into both these issues and will shape future directions in enabling truly meaningful occupation for people who live with schizophrenia Conclusions: Therapists interested in developing their enablement skills with people who live with schizophrenia and their families will benefit from considering the meaning(s) of occupations (experienced and aspired to) in the lives of people with schizophrenia. Poster Defense: Child/Adolescent General, Institution Mothers managing acute pain in the neonatal intensive care nursery Sarah Russell (University of British Columbia, ) Jerica Ditson, Liisa Holsti Introduction: In the neonatal intensive care unit (NICU), preterm infants repeatedly undergo painful but necessary medical procedures, such as blood collection. Repeated painful experiences in early life can alter brain development (Bouza, 2009). Current interventions (e.g. maternal skin‐to‐skin contact and oral sucrose) reduce pain in preterm infants by only 10‐50% (Johnston et al., 2008). Breastfeeding, an infant occupation, reduces pain by 80% in preterm infants capable of breastfeeding (Holsti et al., in press); however, most preterm infants are unable to breastfeed effectively. Assessing a modified application of breastfeeding is needed so that less mature infants can benefit from its pain relieving effects. Objective: To determine whether or not modified breastfeeding reduces pain in preterm infants. Methods: In this randomized controlled pilot trial, 15 infants born 30‐35 weeks gestational age were assigned randomly to receive a soother while in their cot (Standard Care) or to receive breastmilk through a soother trainer during maternal skin‐to‐skin contact (Intervention). Outcome measures included changes in the Behavioural Indicators of Infant Pain scale and in mean heart rate across three stages of blood collection (baseline, lance/squeeze, recovery). Data analysis will be descriptive with a focus on variance and confidence intervals. Practice Implications: Early exposure to repeated pain interferes with normal infant development. Discovering new occupation‐based interventions that reduce pain and that promote optimal brain development in high‐risk preterm infants supports best‐practices in the NICU. Conclusion: This study will provide the first indication of whether or not a modified approach to breastfeeding mitigates pain in preterm infants. Poster Defense: Child/Adolescent General, Community Occupation and executive functioning: A competency framework for school‐based practitioners CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Heidi Cramm (Queen's University, Kingston, Ontario) Terry Krupa, Cheryl Missiuna, Rosemary Lysaght, Kevin Parker [email protected] Rationale: School‐aged children and youth may struggle to participate successfully in occupations that involve learning due to problems with executive functioning skills that impair their ability to initiate tasks, organize, plan, and monitor their efforts. Objectives: This research project seeks to understand the knowledge, skills, and abilities required for occupational therapists to intervene with children and youth to support their ability to engage in occupations involving learning. Method: The Knowledge To Action framework (Graham et al., 2006) guided this project. In‐depth qualitative interviews captured distinct occupational therapist, benchmark, and stakeholder perspectives. Knowledge synthesis was subsequently completed using a scoping study methodology (Levac, Colquhoun, & O'Brien, 2010). The competency framework completed the knowledge creation phase and focus groups were conducted to validate both the model and the competency framework. Results: Executive functioning in childhood is poorly understood in occupational therapy. Occupational therapists need knowledge about: trajectories of executive functioning development; how executive functioning impacts on learning how to learn; types of occupations that commonly exceed executive functioning levels; and how to enable occupational performance in children with executive dysfunctioning. Occupational therapists need the skills to systematically explore how executive skills, self regulation, cognition, and task‐specific knowledge converge to facilitate engagement in occupations in context. Participation analysis and mediated learning skills are also critical for occupational therapy intervention. Conclusions: This research synthesized current evidence and interview data to conceptualize an occupational therapy model of executive functioning. Key occupational therapy competencies are identified and described. Poster Defense: Adult General, Community Occupation based programs for international development Shelley Vaisberg (, ) Ruheena Sangrar, Janet Njelesani, Helene Polatajko [email protected] Introduction: Sport‐for‐development programs are currently using sporting activities as a vehicle for international development through strengthening education, public health, and social cohesion in low and middle‐income countries. Despite sporting activities being used, little is known about the role the specific sporting occupations play in these programs. Bringing an occupational perspective to examining sport‐for‐development programs could provide insight into this role. Objectives: The aims of this study are to (1) examine the choice of centering sport‐for‐
development programming around sporting activities, (2) explore the experiences of beneficiaries participating in an sport‐for‐development program in a low and middle‐income country, and (3) explore the organizers’ perspectives of the value, benefits, and risks of using sporting activities in sport‐for‐development programs in a low and middle‐income country. Approach: This qualitative case study was conducted from an occupational perspective and a critical theory paradigm. Data collection occurred at one sport‐for‐development program and included observations, in‐depth interviews of 6‐10 program participants and organizers, and document analysis. Thematic analysis was used to guide data analysis. Practice Implications: The findings will enable occupational therapists to better understand how occupations may be used in international development programs in different contexts, thus enabling our profession to become further involved in the world’s political, economic and social agendas. Conclusions: Examining sport‐for‐development programming from an occupational perspective provides insight into how sporting occupations are being used as a means of achieving international development outcomes. Poster Defense: Non‐specific to Client Group, Education Occupational therapists as leaders in the future of assistive technology Shelby Fawcett (, ) Lina Carter, Christy Taberner [email protected] CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction: The current role of occupational therapists in assistive technology occurs after the technology has been developed; occupational therapists are involved in the assessment, prescription, and training of assistive devices (Miller Polgar, 2002). However, Lansley (2006) argues that, to realize the full potential of assistive technology, occupational therapists should be involved in the design process of these technologies. This new and exciting role of occupational therapists in the innovation and design process of assistive technology was explored through the creation of a prototype healthcare application for juvenile diabetes management. Objective: To demonstrate the role of occupational therapists in designing and creating evidence‐based assistive technology to enable occupations. Approach: The session will provide an overview of the process of designing an evidence‐based assistive technology for juvenile diabetes management. A literature review was conducted to understand current issues in diabetes management, key features to be included in the technology were conceptualized, and a prototype solution in the form of an engaging Iphone application was created. Practice Implications: The future of healthcare practice is ever evolving and this demands that healthcare professionals continue to advance clinical practice to meet client demands for innovative and engaging treatment options. Rather than becoming involved after assistive technology has been developed, occupational therapists possess the skills to design and build assistive technology. Conclusion: Occupational therapists can become innovative leaders in the 21st century by assuming key roles in both designing and implementing assistive technology to enable occupations. Poster Defense: Non‐specific to Client Group, Institution Occupational therapists' role in program development within their practice context Heidi Hatch (VIHA, Victoria) Christine Symonds, Susan Stanton Introduction. Program development is integral to occupational therapy practice yet there is little research on the clinical implementation of this skill. Objectives. To determine how occupational therapy program development is occurring and occupational therapists’ perceptions about their roles in program development within practice. Methods. In this qualitative phenomenological study, researchers interviewed seven occupational therapists to gain insight into their involvement in program development. Results. Themes identified include variable understanding of program development, difficulty meeting expectations, self‐directed participation, change occurs at different levels, and importance of evidence‐based practice and program evaluation. Conclusions. Supervisors and practicing clinicians have different understandings of program development and their roles in the process. As well, restricted healthcare budgets limit the amount of evidence‐based program development occurring within practice. This study identified a need for further program development training for practicing and future therapists as gaps in current practice and discrepancies surrounding practitioners’ roles were identified. Poster Defense: Adult General, Community Occupational therapists’ role in pelvic floor health management Julie Flemming (, ) Jennifer Seida, Shaniff Esmail Introduction: Pelvic floor dysfunction (PFD) is a complex issue that affects approximately one third of women during the course of their lives (Lukacz et al., 2007). Beyond prevalence rates PFD can have significant negative effects on quality of life, with symptoms that can range from mild to severe. Additionally, PFD can impact activities of daily living (ADL). Occupational therapists (OTs) have an established role in ADL facilitation; however, there is paucity in the literature regarding occupational therapy (OT) in pelvic floor health (PFH). Cognitive behavioural therapy (CBT) can be used as a theoretical framework to structure OT interventions, thereby optimizing treatment outcomes. Objectives: To describe the vital role OTs can have in PFH, and promote awareness regarding current themes, issues, and active treatments in this area. Specifically, treatment outcomes of pelvic floor muscle (PFM) strengthening activities can be improved when framed within a CBT approach. Approach: The results of a systematic review and two critical reviews will be combined to demonstrate how a CBT approach, along with CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin strengthening activities, can play an integral role in PFH. CBT can be used to address PFD with a variety of OT interventions. Practice Implications: A CBT approach fits within OT practice, allowing the therapist to actively engage the client. Furthermore, PFM strengthening activities are well suited to fit within the CBT model. Conclusion: CBT and PFM strengthening activities have been shown to be effective approaches in areas of PF management. OTs can play a pivotal role in the improvement of outcomes in PFH. Poster Defense: Non‐specific to Client Group, Theory Occupational therapy, knowledge translation and social‐constructivism: A scoping review Aliki Thomas (McGill University, Montreal) Sara Ahmed, Anita Menon , Jill Boruff, Ana‐Maria Rodriguez [email protected] Introduction. Knowledge translation research has grown exponentially in the last decade. Researchers use knowledge utilization theories to examine how occupational therapists integrate research into practice; however, no research to date, has examined how learning theories such as social constructivism can identify the specific learning processes involved in the application of evidence in practice and how clinicians integrate new knowledge to inform their practice. The core assumptions of social constructivism are: 1) learning is a result of the individual’s interaction with the environment, 2) cognitive conflict is a primary stimulus for learning and 3) the social environment plays a critical role in the development of knowledge. Purpose: Evaluate the application of social constructivism in designing and assessing knowledge translation interventions for occupational therapists. Methods. A scoping review using the Arksey and O’Malley framework of the health sciences literature including terms such as social constructivism, healthcare professionals, occupational therapy and knowledge translation was conducted. Results: The search yielded 217 articles. A preliminary synthesis of the 44 studies that met inclusion criteria revealed that the social constructivist framework is used in knowledge translation research for 1) the design and delivery of interventions aimed at optimizing research utilization, 2) for evaluating how new learning occurs in practice and 3) for supporting the use of different learning resources for shaping learning and impacting on practice. Conclusion: The social‐constructivist perspective is applicable to developing and assessing knowledge translation interventions. The theory can be used to support the design of effective knowledge translation strategies for occupational therapists. Poster Defense: Adult General, Community Occupation‐based interventions for impaired self‐awareness following traumatic brain injury Corinne Nadeau (, ) Priscilla Lam Wai Shun [email protected] Introduction: Impaired self‐awareness (ISA) can persist long after a traumatic brain injury (TBI) and considerably affect participation and social reintegration. Clients with ISA have difficulty to formulate realistic goals or cannot recognize the impact of their deficits on daily activities. Fostering partnership is key to a client‐centered practice in occupational therapy and is essential in achieving optimal outcome but can prove to be challenging with this clientele. Objectives: Examine the effectiveness of occupation‐based interventions for ISA following a TBI and highlight key components of these interventions for clinical practice in social reintegration. Method: Literature review with article search conducted in various databases with the keywords "brain injury", "head injury", "self‐
awareness," "awareness," "intervention," "treatment" and their combination. Six studies using occupation in the treatment of ISA were included and analyzed qualitatively. Results: Occupation‐based interventions are effective in improving both on‐line awareness and the client’s ability to set realistic goals as well as facilitating client’s involvement in the rehabilitation process. Such interventions also contribute to the improvement of occupational performance, while the impact on occupational participation needs further investigation. The following elements have been found to contribute to intervention effectiveness: use of techniques addressing on‐line awareness, occupations selected by the therapist according to specific criteria and optimal treatment intensity. Conclusion: CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Occupation‐based interventions aimed at improving ISA positively contribute in optimizing rehabilitation outcome and functional independence. Incorporating key elements in this type of intervention will allow clinicians to create a partnership with clients through realistic goal setting, therefore fostering engagement and social reintegration. Poster Defense: Older Adult General, Community Older adults’ engagement with a video game training program Patricia Belchior (McGill University, Montreal) Michael Marsiske, William Mann [email protected] Introduction: Recent studies with older adults (Belchior, 2007 & Basak et al., 2008) have shown that the playing of video games can boost cognitive skills, which can attenuate progressive losses that occur with age. However, little is known about older adults’ engagement with this type of entertainment. Objective: This study used the Flow theory (Csikszentmihalyi, 1990) to measure older adult’s engagement with a video game‐based training program. Methods: Forty‐five participants (mean age = 74.7 years, SD = 7.0; 24 women) who were mostly college‐educated took part in this study. Participants were randomized to receive practice with an action video game (Medal of Honor), a puzzle‐like game (Tetris), or a gold‐standard Useful Field of View (UFOV) training program. Training consisted of six one‐on‐one 90‐minute sessions administered over 2‐3 weeks. Results: Mixed between‐within ANOVA was used and was followed by a post hoc analysis. Both Medal of Honor and Tetris participants reported significantly higher Flow rating at the conclusion, relative to the onset of training. Conclusion: Findings from this study were consisted with the Flow theory (Csikszentmihalyi, 1990). Participants were more engaged in games that can be adjusted to their skill levels and that provide incremental levels of difficulty. There is a definite role for occupational therapists in this new arena. Video games are for most older adults, novel and novelty can be harder for older adults to adjust to. However, occupational therapists know how to adapt a task to individual skills levels and make it successful. Poster Defense: Older Adult General, Community Older adults’ experiences of power mobility: A longitudinal mixed‐methods study Andrea Chamberlain (, ) Shelly Zonneveld, Ben Mortenson, William Miller, Paula Rushton, Louise Demers Introduction: Research has indicated that power mobility can positively impact quality of life for older adults, by increasing participation in meaningful activities (Auger et al., 2008). However, few studies have explored how power mobility users’ engagement in occupation, confidence using their devices, and subjective experiences change over time. Objectives: 1) To explore older adults’ experiences of using power mobility over time. 2) To examine concomitant changes in frequency of occupational engagement, confidence using a powered wheelchair, and perceived difficulty in taking part in daily activities. Methods: This ongoing study employs a mixed‐method approach in which participants are assessed at enrolment, 3 months, and 1 year. Qualitative interviews are being conducted and standardized measures are being administered at each time point. Assessments include the Late Life Disability Index (measures frequency of participation), the Wheelchair Use Confidence Measure (measures confidence with power wheelchair use), and the Assistive Technology Outcome Profile (measures difficulty performing tasks with and without a wheelchair). Results: Data from 8 participants currently enrolled in this exploratory study will provide insight into quantitative and qualitative outcomes of power mobility use over time.Conclusions: By developing a better understanding of the longitudinal impact of power mobility, the study may assist clinicians to improve how these devices are prescribed, focus training on client’s needs, and lobby for change in the way power mobility devices are provided and funded. These changes may facilitate occupational engagement among older adults who use power mobility. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Child/Adolescent General, Institution Parental experiences of observing their children during sensorimotor group therapy Chrystelle Robinson (, ) Veronica Gershenzon, Emily Ho, Joan Vertes Rationale: Family‐centred care proposes that the involvement of parents and other family members in the planning and evaluation of intervention, results in therapy outcomes that are more relevant and meaningful to both the child and family (Hanna & Rodger, 2002). An occupational therapy (OT) group sensory motor approach has been implemented, in which parents can observe their children through a one‐way mirror and receive education as a group from the occupational therapist at the end of each session. To date, no research exists on the experiences of parents in this active observation‐room setting. Objective: The objective of this qualitative study is to determine the parental experiences of waiting, observing, and receiving education as a group regarding their child’s participation in sensory motor group therapy. Methods: A sample of eight to ten parents, whose children attended the sensory motor group therapy program, will participate in focus groups discussing their experiences. Thematic qualitative content analysis will be used to analyze transcribed focus group data to determine themes. Practical Implications: Findings gained from this research may help provide support for the use of sensory motor therapy groups, as well as provide information about the benefit of a group observation room and group education for parents. Conclusions: It is hoped that this study will help clinicians to better tailor OT intervention for children and families. Poster Defense: Adult General, Community Participants' perspectives of a song and dance class for Parkinson’s Disease Aislinn Braun (student, Montreal) Lori Isaif, Joliane Jutras, Meghan Rivers, Fang Wang, Patricia McKinley, Stefani Novick Introduction: Parkinson’s disease (PD) is a neurodegenerative disorder impairing both cognitive and physical functions, often leading to a detrimental loss of social interactions, community participation and quality of life. Recent quantitative studies support the use of song and dance to target physical and emotional symptoms in people with PD [1,2]. However, few qualitative studies have explored the participants’ perspective of adapted song and dance programs for PD. Objective: To explore the subjective experience of participants in an adapted song and dance program for PD.Methods: This is an interpretive phenomenological study. Data were gathered through observations, field notes and interviews. Interviews were recorded, transcribed and coded to uncover themes.Results: Three main themes emerged: 1) the positive aspects of participation in the program, including emotional wellbeing, a feeling of group belonging and physical benefits 2) the negative aspects related to the structure and instability of the class and the need to include gradations in class components to allow for the just right challenge 3) the participants’ anxieties about living with PD and their uncertainties about whether the class will truly benefit them.Conclusions: The participants noted an overall improvement in physical and psychological wellbeing. Being able to socialize and participate in activities with other people with PD was important for reducing isolation and generating a feeling of belonging. The participants’ perception enriches our knowledge about people living with PD, and their suggestions will help improve similar programs in clinical and community settings. Poster Defense: Child/Adolescent General, Community Participation and environment measure for children and youth: Psychometric findings Dana Anaby (McGill University, Montreal) Wendy Coster, Gary Bedell, Mary Law, Mary Khetani , Rachel Teplicky, Kendra Liljenquist, Kara Gleason, Ying‐Chia Kao [email protected] Introduction: Children and youth with disabilities are often restricted in their participation in occupations, due in part to environmental barriers. The Participation and Environment Measure for Children and Youth is a new, CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin innovative measure that links assessment of participation with environmental supports and barriers. The PEM‐CY measures participation frequency, extent of involvement, and desire for change within 25 occupations and across three settings: home, school, and community. Concurrently, perceived environmental supports and barriers to participation are assessed. Objectives: The purpose of this study was to examine the PEM‐CY’s psychometric properties. Methods: Data were collected online from 576 caregivers of children and youth with and without disabilities, aged 5 to 17, in Canada and the United States. Test‐retest reliability was examined on a subsample over a 1‐4 week period. Construct validity was established by examining the differences between children with (n=282) and without (n=294) disabilities and across age groups using ANOVAs. Results: Internal consistency was moderate to very good (0.59 to 0.91) and test‐retest reliability (n=34) was moderate to very good (ICC = 0.58 to 0.95). There were significant differences between children with and without disabilities on all participation and environment scales. Differences across age did not follow a consistent pattern. Conclusions: Results support using the PEM‐CY to better understand participation and the impact of environmental factors. In clinical practice, the PEM‐CY encourages occupational therapists and parents to focus on the child’s participation and to identify a broader range of environmental supports and barriers, thereby facilitating environment‐based interventions. Poster Defense: Adult Psychosocial Health, Community Participation in the context of stigma and Bipolar Disorder Melinda Suto (University of British Columbia, Vancouver) James Livingston, Sara Lapsley, Erin Michalak [email protected] Introduction: Stigma differentiates people in a negative way and can precipitate social exclusion and discrimination (1). Research suggests that stigma experiences are common in bipolar disorder and that perceived stigma can have serious implications for behaviors and well‐being outcomes (2,3). Specifically, stigma can restrict opportunities for people to engage in necessary and/or preferred occupations. Objective: To learn about the experiences of stigma from the perspectives of individuals with bipolar disorder and their family members. Methods: This study was embedded within a community engagement event. A sample (n=46) of adults with bipolar disorder and family members were recruited from the community. They participated in one of five co‐facilitated focus group interviews that posed open‐ended questions. Data were audio recorded, transcribed and analyzed inductively by the research team. Network thematic analyses were completed individually by team members and analyses were refined through group meetings. Results: The thematic findings reveal the following: 1) experiences of self‐stigma and their impact on people’s lives; 2) how the foundation of social stigma is maintained and shapes quality of life and; 3) exclusionary practices that restrict people’s opportunities at the structural stigma level. Conclusions: Stigma constrains the expected participation of people with bipolar disorder in social relationships, employment, and education. Stereotypes and discrimination play a major role in creating a ‘less‐than’ experience of desired occupations. Individuals, institutions and society contribute to these injustices and are thus sites of potential changes. Community‐based research is a credible approach to exploring stigma and is compatible with occupational therapy principles. Poster Defense: Non‐specific to Client Group, Education Peer role‐playing to improve occupational therapy students' communication skills Jill Stier (University of Toronto, Toronto) Heather Carnahan, Catherine Walsh, Laura Jane Nelles [email protected] Introduction: While the use of standardized patients (SPs) to train health care professionals in a variety of clinical scenarios is well established, the use of SPs in Occupational Therapy (OT) practice is relatively new, and its use is limited largely due to lack of funds to support this educational resource. Peer role‐playing, a potential alternative to standardized patient based education, is a method of experiential learning and as such, allows students to gain CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin insight into, and reflect upon the roles they portray, thus providing benefit for both the peer actor as well as the learner. The use of peer role‐playing has been shown to enhance motivational interviewing skills as effectively as standardized patient based education. Objectives: The development of a workshop on role playing, acting and feedback skills that aimed to improve OT students’ communication and interviewing skills with peers will be described.Approach: The presenter will discuss how the participants learned to perform specific client roles for the purposes of training each other. Additionally, the OT students’ perceptions of the workshop will be discussed including the educational benefits. Practice Implications: Communication and interviewing skills are essential competencies of OT practice. It is important that novel methods of training that can help to optimize learning and improve resource utilization are developed. Conclusion: Incorporation of the peer‐learning strategies demonstrated to be effective in our curriculum can help to enhance the educational benefits of peer‐based training and ultimately OTs’ communication skills. Poster Defense: Adult Psychosocial Health, Institution Place and the psychiatric hospital Bice Amoroso (, ) Helene Polatajko, Bonnie Kirsh [email protected] Introduction: The psychiatric hospital as a “place” of recovery for people with severe mental illness has been debated (Bachrach, 2001, Turton et al., 2010). However, little research has explored the meaning of the hospital from the perspectives of people with severe mental illness living long term in hospital. A focus on “place” in occupational therapy facilitates treatment by understanding the meaning of occupations in relation to the places clients experience (Hasselkus, 2002). Objectives: By the end of this session, participants will have examined the application of place by: 1. Identifying the ways to apply the concept of place in enabling occupational performance for people with severe mental illness 2. Exploring the use of place in the recovery paradigm. Methods: This extended discussion will include a brief presentation on the concept of place, and the findings from a phenomenological study exploring the lived experience of place for eight people living long term in a psychiatric hospital. Further, the presenter will facilitate a discussion with prepared questions, and participants will share ideas and experiences from their practice areas. Practical Implications: Participants will become familiar with the concept of place and its application to mental health practice and recovery. Further, participants will consider the relationship between place and occupation in planning treatment goals. Conclusion: The concept of place has a useful role in understanding the recovery and treatment of people with severe mental illness and the challenges and experiences of living in a psychiatric hospital. Poster Defense: Adult Psychosocial Health, Community Predicting resource needs for successful community integration of forensic clients Elizabeth Taylor (University of Alberta, Edmonton) Suzette Bremault‐Phillips, Roberto Peterson, Sharon Brintnell [email protected] Introduction. A housing program that provides both integrated residential care and community outreach for adult male forensic psychiatric clients is located in a large urban area. The programming teaches life skills to allow for successful re‐integration into the community. The outreach program provides follow up supports to those completing the residential component of the program to ensure community living sustainability. Information is gathered related to clients who utilize program services. Objectives1.To determine the efficacy of community reintegration/life‐skills training programs offered by the program, and their impact on outcome measures.2.To identify current and future housing and resource needs of this population that might improve both the quality of life and effectiveness of service delivery. Approach. A systematic review of previously collected data from 2000 through 2011 will be completed (length of stay, life skills development, residential housing options upon completion, and activities engaged in post‐discharge). The review will identify elements in the program that predict successful CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin outcomes . Interviews with staff members and current and transitioned residents will be conducted to understand other elements required. Data will be analyzed using NVivo software. Practice Implications. Results from this study will help occupational therapists determine effective resources and critical skills required in their work with these complex clients as they help them negotitiate between hospital and community. Conclusion. Results of this research will help identify potential gaps and determine future directions of service delivery for community‐dwelling forensic clients experiencing severe and persistent mental health challenges. Poster Defense: Adult General, Community Private practice/non‐profit organization/university partnerships: Addressing occupational justice Carolyn Bergen (Bergen and Associates Counselling, Winnipeg) Margaret Anne Campbell Rempel, Ellen Davis [email protected] Introduction: Our profession has long challenged Occupational Therapists to incorporate occupational justice concepts into our practice and to mentor our future colleagues in fieldwork opportunities. These are challenging tasks for busy private practice therapists. Partnering with a university and a homeless shelter enables a therapist to actively embrace both concepts by being a volunteer student fieldwork educator in a non‐profit setting. Additionally this partnership can have a profound impact on the lives of occupationally challenged individuals. Objectives: ? This presentation will focus on how an average therapist, busy both professionally and personally, can implement occupational justice concepts through providing fieldwork opportunities. Pragmatic and feasible solutions which will enable other therapists to enter into similar partnerships will be described. Approach: Drawing on lived experience this presentation will highlight one therapist’s application of occupational justice concepts. Practical example of how a therapist’s limited resources can be significantly leveraged by working with students in a not‐for‐profit organization will be provided. Practice Implications: This partnership model has the potential to concurrently positively impact the lives of occupationally deprived individuals, and provide therapists enriched volunteer opportunities while providing fieldwork education opportunities. Conclusions: Partnerships between therapists who volunteer time to supervise students, non‐profit organizations, and Occupational Therapy programs can produce wide reaching and positive results for all the partners in the process. Poster Defense: Non‐specific to Client Group, Education Problem based learning in an online environment Sue Baptiste (McMaster University, Hamilton) Leah Dix, Colleen McGrath, Shami Dhillon [email protected] Introduction: Problem based learning (PBL) has been shown to be effective in preparation of reflective occupational therapists capable of complex problem solving (Salvatori, 1999). Learner‐centered pedagogies, such as PBL have traditionally been successfully delivered face‐to‐face. As curriculum is increasingly offered online, it is necessary to ensure the essential characteristics of PBL remain when technology is used for curriculum delivery. Objectives: This presentation will describe a program that was able to successfully preserve the active, self‐directed, learner‐
focused features of PBL in an online learning environment. Approach/Method: The process of developing, delivering, and evaluating an online PBL learning experience will be shared. The tenets of PBL will be discussed and the strengths and challenges associated with offering PBL through use of online large group classrooms and small group tutorials will be delineated. Practice Implications: Offering an online PBL course fosters participation for those who may otherwise be excluded from learning as a result of their geographical location. By enabling the participation of individuals who may have previously been excluded from PBL, a richer learning experience can occur. This approach can be replicated by other programs seeking more inclusive communities of learning and that wish to use virtual classrooms for curriculum delivery. Conclusions: When delivered online, problem based learning remains an effective method of knowledge acquisition and self‐directed learning. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Adult Physical Health, Institution Promoting self‐care independence for a client with Central Cord Syndrome Dianna Mah‐Jones (Vancouver Coastal Health, Vancouver) [email protected] Introduction: Central cord syndrome (CCS) is an incomplete spinal cord injury characterized by more motor impairment in the upper extremities than the lower extremities. Understandably, clients with CCS have very low Motor Functional Independence Measure scores when admitted to a rehabilitation program (1). Objective: This case study will share the iterative process for enabling participation in self‐care tasks for a client with significant restrictions in upper limb range of motion and strength and minimal hand function. Approach: Once the client was able to stand, alternative techniques for lower extremity dressing, including socks and shoelaces, and toileting were devised. Brushing teeth and combing hair were achieved through a unique grooming station. Feeding was a particular challenge as the client was unable to bend his elbows. With collaborative input, a feeding tower was designed utilizing pulleys and a lever thus ending five months of being fed. Practice Implications: The presentation will demonstrate novel techniques and equipment to stimulate therapists towards creative problem solving for clients with CCS. Conclusion: At first glance, clients with minimal arm function seem destined for a life of total dependence. Capitalizing on the strengths and determination of the client and ability of the occupational therapist to think imaginatively, solutions can be found to make “doing” possible. Poster Defense: Adult General, Institution Psychological preparation for lower‐limb amputation and implications on functioning Laura Stephenson (, ) Sara Wexler, Carly Charach, Graham Roche‐Nagle, Naomi Eisenberg, Sherry Harburn, Katrina Lehrner‐Bennett, Dorina Baston, Rima Styra Rationale: The experience of undergoing a lower‐limb amputation for individuals with peripheral vascular disease (PVD) is life altering. These individuals must learn to adjust to a variety of challenges, such as difficulties carrying out everyday activities, mobility issues, coping with depression, and struggling to accept a new identity. Psychological preparation prior to surgery has been found to have a significant impact on post‐surgical outcomes. Little is known about how individuals undergoing a lower‐limb amputation perceive their pre‐surgical psychological preparation, and how this relates to their post‐surgical functional outcomes. Objectives: The aim of this proposed study is to determine how individuals with PVD who have undergone a lower‐limb amputation perceive their psychological preparation prior to surgery and the impact it has on their post‐operative functional status. Methods: 20 individuals who have undergone an elective lower‐limb amputation will participate in this mixed methods study. Data will be collected using semi‐structured interviews, the Canadian Occupational Performance Measure, and the Functional Autonomy Measurement System. Grounded theory will be used to analyse qualitative data, while quantitative data will be analysed using descriptive and inferential statistics. Practice Implications: Occupational therapists play an important role in vascular surgery and rehabilitation departments. The results of this study could provide occupational therapists with evidence on which to base their practice. Conclusions: Information collected from this study could be used to create a pre‐surgical protocol with the aim of improving the psychological preparation for patients undergoing a lower‐limb amputation, and reducing the length of their post‐surgical hospital stay. Poster Defense: Non‐specific to Client Group, Education Quantifying the outcomes of internationally educated occupational therapists (IEOTs) Marie‐Christine Beshay (Canadian Association of Occupational Therapists, Ottawa) Sue Baptiste [email protected] CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction: The occupational therapy examination and practice preparation (OTepp) project aims to facilitate the transition of internationally educated occupational therapists (IEOTs) to Canadian practice. Through the provision of exam and practice preparation courses, practicum experiences and mentorship opportunities, IEOTs are provided with the required tools and strategies to succeed in their transition. Objectives: This poster will present data on the transition of IEOTs into Canadian practice as measured by the IEOTs’ outcome on the CAOT national certification examination, their completion of the OTepp core curriculum, their registration with a regulatory organization and their ability to obtain and maintain employment in occupational therapy. Methods: Quantitative data were collected from participants upon their completion of each course and at the end of their participation in the OTepp core program. CAOT exam results were also obtained from CAOT, as agreed by participants on their consent forms. Practice implications: IEOTs who complete the first three courses of OTepp are more likely to succeed on the CAOT national certification examination than those who do not. IEOTs report that OTepp courses meet their learning needs and mend gaps in knowledge of Canadian practice. Conclusions: Participation in OTepp can be associated with successfully transitioning into Canadian occupational therapy practice. Poster Defense: Adult Psychosocial Health, Institution Recovery realized through interprofessional collaboration: occupational therapist facilitating the integration Catherine Clark (camh, toronto) [email protected] Introduction: Recovery is best realized when it is integrated with interprofessional collaboration. Recovery from an interprofessional perspective includes: respect, trust, shared decision making, and partnerships. OT’s are currently taking a leadership role in the implementation of recovery in mental health. An innovative program was developed incorporating on‐line tutorials, team based learning and a web based community of practice that can provide OT’s with skills to integrate recovery with interprofessional collaboration. Objectives: The purpose of the program was to evaluate the unique blended learning curricula that integrated technology and team based learning to promote the adoption of recovery‐oriented clinical practice. Methods: Five on‐line tutorials provided best practice recovery knowledge and opportunity for self‐reflection and evaluation. The workshops provided team based learning opportunities to integrate recovery knowledge and addressed such topics as: dignity violation, care planning, power dynamics, and community integration. Strategies utilized in the training were: self‐reflection, debates, role play, projects and community exploration. Results: The evaluation tools included: surveys, performance appraisals, and the Recovery Knowledge Inventory (RKI). The quiz average was 91% and the (RKI) indicated a statistically significant change in clinician’s knowledge and attitudes and strong endorsement for the course. Conclusion: Recovery is truly realized when practiced in interprofessional teams. Clinicians and educators will learn about how to implement this integration using electronic educational tools and interprofessional team based activities. Participants will also learn about competencies needed to design and evaluate a participatory education process to best enhance practice change. Poster Defense: Child/Adolescent Physical Health, Institution Redefining the benefit of occupational therapy in paediatric hand surgery Jocelyne Copeland (Sick Kids Hospital, Toronto) Introduction: Parents and health care providers often make negative assumptions about the psychological and functional status of children with congenital hand anomalies, yet studies show that children with limb deficiencies do not experience greater hassles or less self esteem than the general population (Miechelson et al., 2010). In the past children with congenital hand anomalies were almost always advised to have surgery to change their malformed anatomy, regardless of their functional capabilities or psychological well being. As society has grown more tolerant of visual differences and more educated about options and adaptations, occupational therapists play a key role in bridging old attitudes and new expectations. Objectives: Participants will understand how CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin occupational therapy can provide key information and guidance to families and the health care team in surgical decision making. Participants will learn how the occupational therapy role has shifted from a post surgical rehabilitative role to that of a valued collaborator in surgical decision making and treatment planning in the management of children with congenital hand anomalies. Approach: This poster will present the benefits of occupational therapy in a paediatric surgical setting. Practice implications: Negative assumptions can lead children to unnecessary surgery. By shifting our own perceptions, occupational therapists have become fundamental contributors in eliminating the barriers of attitudes and assumptions in the management of congenital hand anomalies. Conclusions: Occupational therapists use functional assessment, education and support groups to empower patients and families to actively participate in treatment planning and decision making Poster Defense: Non‐specific to Client Group, Education Reflection in occupational therapy education and practice: Mapping the terrain Elizabeth Anne Kinsella (University of Western Ontario, London) Shanon Phelan [email protected] Introduction: Various bodies of literature have called attention to the importance of reflection for the cultivation of professional knowledge in occupational therapy. Nonetheless there continues to exist confusion surrounding conceptualizations of reflection and conflation of various terms in the literature. Objective: The aim of this paper is to advance conceptual clarity by critically examining and distinguishing between different types of reflection, and considering the implications for occupational therapy education, practice and scholarship. Methods: This study examines theoretical underpinnings of various conceptions of reflection, to illuminate distinctions between different “types” of reflection in occupational therapy education and practice. Results: Six types of reflection were identified, and presented as a continuum: (a) Phenomenological reflection generates knowledge from the “lifeworld” of practitioners, and takes into account the lived experiences of phenomena; (b) Pragmatic reflection focuses on intentional cognitive reflection and practical outcomes on action in professional life; (c) Embodied reflection is revealed through intelligent action, and does not necessarily involve a separate cognitive operation. This type of reflection is revealed in action; (d) Critical reflection involves examination of everyday taken‐for‐granted assumptions and is concerned with emancipatory aims; (e) Reflexivity involves interrogation of how one’s situatedness in society may shape one’s values, morals, and judgments at individual and social levels; and (f) Epistemic reflexivity denotes reflection on the social conditions under which knowledge comes into being and gains credence. Conclusion: Recognition of the distinction between different types of reflection has the potential to advance education, practice and scholarship in occupational therapy. Poster Defense: Adult General, Community Repercussions of impaired planning on independence following traumatic brain injury Priscilla Lam Wai Shun (Université de Montréal, Montréal) Julie Arseneault, Carolina Bottari [email protected] Introduction: The behavioural and cognitive disturbances associated with impaired executive functions are leading causes of decreased independence following a traumatic brain injury (TBI). The ability to plan is a component of executive functions and a prerequisite to independence in instrumental activities of daily living (IADL).The impact of planning deficits on the ability to accomplish IADL in real‐life situations remains poorly documented. Objective: Explore the repercussions of planning deficits on independence in IADL by analysing behaviours and verbalizations related to planning an IADL in real‐life context. Method: Case study. PC, aged 49, sustained a moderate TBI following a work accident 15.5 months prior. The IADL Profile was administered. PC’s performance on two tasks, preparing a hot meal and obtaining information, was analysed. Results: PC was dependent to prepare a hot meal. He was unable to identify menus, he did not elaborate a sequence of actions and was unable to multitask. Much assistance from the examiner was required and he needed 30 minutes to plan as well as 90 minutes to carry out the CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin task. For the second task, PC was able to identify a suitable alternative but he initiated the execution quickly without elaborating a sequence of action beforehand (planning: 2 minutes) which considerably slowed his execution (25 minutes). Conclusion: Such qualitative analysis, inherent to the IADL Profile, provides essential information regarding the repercussions of planning deficits on daily life as well the type of assistance required and may prove useful when tailoring interventions to a client’s needs. Poster Defense: Non‐specific to Client Group, Education Research training in an occupational therapy program Johanne Desrosiers (Université de Sherbrooke, Sherbrooke) Louisette Mercier, Annick Bourget [email protected] Introduction: With the raising of the program to the master's level and the importance of evidence‐based practice, occupational therapy students must be trained in research. Objective: Describe the main learning resources and outcomes of research training in an occupational therapy program. Approach: Research training, spread over all four years of the program, was introduced in 2007 and has been refined since then. Many resources and methods have been defined to support students learning. Results: Self‐study modules in epidemiology and statistics, lecture courses and exercises on research concepts and methods, guided reading, research seminars and close supervision by researchers/mentors are the main learning resources used in the program. They equip the students to conduct original research in their area of interest as part of a team of four or five over a period of more than two years. This research ends with writing a research article and presenting a poster at a scientific day, in which the clinical community is invited to participate, at the end of their 4‐year curriculum. Conclusions: Students do not become independent researchers but they have enough knowledge to make an active contribution to the development and use of evidence‐based data, which are essential to the future development of the profession. Poster Defense: Adult Psychosocial Health, Community Resilience in early psychosis: The role of ‘therapeutic’ occupations Shalini Lal (, ) Melinda Suto [email protected] Introduction: Psychotic symptoms typically emerge during the critical developmental period of adolescence and transition to adulthood. Little is known about how a young person develops resilience (the capacity to cope) when faced with the challenging circumstances associated with an early onset of psychosis. Objectives: The purpose of this study is to explore how youth recently diagnosed with psychosis develop their resilience through occupations. Methods: The study applies a qualitative, interpretative approach that is emergent in design, and it combines narrative, arts‐based, and grounded theory methods at different stages of the research. An estimated sample of 15‐
20 participants, between the ages of 16‐24 are recruited from a specialized early psychosis program and a psychiatric program for street involved youth. Each individual is interviewed two times and then invited to participate in a modified application of the Photovoice method which involves participant‐elicited photography and group discussion. Results: The study is in its final stages, with analysis underway. Thirty interviews and three Photovoice meetings have been conducted. Findings will be ready for presentation at the time of the conference. Preliminary analysis indicates that participants engage in self‐initiated healing occupations that serve to affirm their strengths, give meaning to their circumstances, alter their mood, and create a sense of normalcy. Conclusions: It is anticipated that findings will advance theoretical understanding of the relationship between occupation and resilience. Moreover, findings will be discussed in relation to their implications for planning occupational therapy services that support and enhance resilience in youth experiencing early psychosis. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Child/Adolescent General, Education Resource teachers’ perceptions of school therapy services Barb Borton (, ) Sibusisiwe Musiiwa, Ashley Holmes [email protected] Introduction: With 155, 000 Canadian children with disabilities in mainstream schools, occupational therapy services are becoming widely used in the school environment. Various studies indicate that improved teacher awareness of the role of occupational therapy benefits students’ performance outcomes. However, little is known about teachers’ overall perceptions of school therapy services. Objectives: The objectives of this study are: (1) to explore teachers’ perceptions of the occupational therapy process, occupational therapy outcomes, and teacher‐
therapist communication; (2) to compare research findings as well as the response rate between the current study and a 2004 study that utilised a paper‐based survey. Methods: Using a quantitative methodology, an on‐line survey was distributed to resource teachers from two urban school divisions. This survey was a replica of one previously administered in 2004. Results: Preliminary results suggest that teachers are generally satisfied with the school therapy services they receive. Further analysis will include a comparison of current and previous survey results as well as the identification of trends in service satisfaction based on teaching experience, school division, and gender. Conclusion: The use of a consultative model has demanded an alliance between occupational therapists and teachers. By understanding teachers’ perceptions of school‐based occupational therapy services, occupational therapists can ensure that they are providing services that will satisfy the needs of both children and teachers, which will ultimately lead to improved student outcomes. Poster Defense: Adult General, Institution Role of occupational therapy in identifying mild traumatic brain injury Anousha Jackson (, ) Anousha Jackson, Julia Czyzo, Jane Topolovec‐Vranic, Angela Colantonio Rationale: Mild traumatic brain injury (mTBI) can result in long‐term functional deficits, yet it is difficult to detect and often goes undiagnosed. Early identification of mTBI is critical for the delivery of appropriate clinical and rehabilitation services to improve long‐term functional outcome. However, misidentification occurs in the acute stage as mTBI symptoms are often overshadowed by injuries to other body systems and there is a lack of emphasis on the screening of cognitive functioning among trauma patients. Objectives: The primary objective of this prospective study is to examine the cognitive functioning of acute multi‐system trauma patients in an urban trauma center to inform incidence estimates of undiagnosed mTBI among these patients. A secondary objective of this study is to determine the occupational performance issues (OPI) of individuals with undiagnosed and diagnosed mTBIs at three months post‐injury. Methods: Ninety adults will be recruited from the Trauma and Neurosurgery ward at a hospital and assessed by an occupational therapist using the Montreal Cognitive Assessment to examine cognitive functioning. A three‐month follow‐up will be conducted to determine OPIs using the Community Integration Questionnaire and the Short‐Form (36) Health Survey. Practice Implications: The results of this study will address the role of occupational therapy in the screening and treatment of mTBI in acute care to improve the delivery of timely and appropriate rehabilitation services. Conclusion: This study will provide an estimate of the incidence of undiagnosed mTBIs at an urban trauma centre and will substantiate evidence that early identification and treatment for mTBI results in improved functional outcome. Poster Defense: Adult Psychosocial Health, Institution Role perceptions of mental health rehabilitation team members experiencing transition Petrina Calder (, ) Arwen Caines, Neva Shemilt, Alex Tytus, Laurie Macdonald, Katherine Stewart, Sue Delamere, Joyce Tryssenaar CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction: Changes in local health service delivery systems will result in the amalgamation of two existing mental health inpatient programs to create a single mental health rehabilitation program in a new facility to be built within the next three years. Objectives: The purpose of this study was to explore role perceptions of team members on two interdisciplinary inpatient mental health rehabilitation programs and anticipated role changes with program transition. Methods: A qualitative case‐study design was completed to carry out an in‐depth exploration of a bounded system. Following semi‐structured, one‐time individual interviews, constant comparative analysis of the interview transcripts was used to identify themes. Results: Three main themes, complexities of client‐centered care, continuum of effective collaboration, and responses to pending change, were identified. It was evident that within the interdisciplinary teams there is a united focus on client care, that collaboration exists on many levels with varying results, and that team members respond differently to the pending change and information about that change. Conclusions: Through exploring the role perceptions of inpatient interdisciplinary mental health team members as they approach a significant change in location and program, an understanding of the primary issues with regard to program transition within this setting was developed. Results highlighted the complex nature of providing care on interdisciplinary mental health programs experiencing transition. Future directions for research may include the development and evaluation of a mechanism to enhance team communication and feedback, thus providing a means to capitalize on the human resource potential of the team itself. Poster Defense: Older Adult General, Community Safe house program evaluation: Social networks and elder abuse Jennifer Lee (, ) Vivien Hollis [email protected] Introduction. Safe House, run by a seniors’ association, is a temporary shelter in for victims of elder abuse. Objectives. As part of a wider evaluation this paper reports findings regarding the short term outcome, “to increase capacity to access resources for socialization”; specifically whether Safe House increases capacity of seniors to access resources for: (1) establishing social networks; and (2) the barriers and supports to establishing social networks. Methods. A programme evaluation determined if short term outcomes were achieved (as identified in a logic model) and recommendations made for improvement. Safe House clients were interviewed and staff members completed questionnaires. The resulting data was analyzed using the constant comparative method (Glaser & Strauss, 1967). Results. Five themes emerged: history of isolation; history of poor family relationships; possibilities for socialization; control over socialization; and importance of staff attitudes and availability. Findings indicate that supports to establishing social networks include: (1) providing possibilities for socialization within Safe House; and (2) giving clients control over their socialization. A positive staff attitude, and increased staff availability contributed to clients’ ability to build social networks. Potential barriers to establishing social networks include a history of isolation and poor family relationships. Overall, Safe House is effective at achieving this outcome, although there are some areas that need to be addressed. Practice Implications. Findings have important implications for front‐line health and social care professionals in detecting abuse or who have management and treatment responsibilities for individuals who have experienced elder abuse. Poster Defense: Older Adult General, Community Scatter mats, an old problem with a novel approach Silke Tilroe (, ) Rosalie Freund‐Heritage, Linda Chan, Kathleen Hunter [email protected] Introduction One third of community dwelling older adults fall annually. Falls with and without injury affect one’s performance of daily living tasks. Occupational therapy (OT) interventions in this area include assistance with lifestyle changes, such as removing scatter mats, and equipment provision. Yet clients complete only 50% of home modifications recommended by OT [Cumming, 2001]. Motivational interviewing (MI) addresses ambivalence and CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin resistance to change in medical and public health contexts. Motivational interviewing in falls risk management has received little attention to date. Objectives To explore the role of MI used by OT in falls risk management. Approach This poster will outline an OT’s use of MI, guiding clients to make changes in order to decrease their risks and number of falls. Practice Implications Many OT interventions include providing information on environmental and lifestyle changes that can reduce falls risk factors. Yet, some advice about risk reduction may be regarded as common sense and potentially patronizing [Yardley, 2006]. Using MI to guide clients through the process of change rather than giving advice is a more respectful approach, which could improve uptake of OT recommendations. Knowing the concepts in MI may also challenge the concept of patient compliance and facilitate a broader understanding of change. Conclusions Falls risk management requires facilitating change. MI is an alternative to giving advice that respects people’s autonomy. This is critical in the community where the individual is the king of their castle and where historically there is reluctance to change. Poster Defense: Non‐specific to Client Group, Education Scoping studies: Applying the methodology in occupational therapy research Heidi Cramm (, ) Catherine White [email protected] Introduction: Increasingly utilized to synthesize health research, scoping studies are particularly relevant when a range of methods have been used, as is often the case in occupational therapy. Two occupational therapy researchers completing doctoral research projects outline their scoping study process, offering reflections on their experiences with using the method. Objectives: i) Highlight the utility of scoping studies for occupational therapists, and ii) Present two examples of scoping studies in occupational therapy. Approach: An advanced methodology for scoping studies (Levac, Colquhoun, & O'Brien, 2010) was used by the two presenters as a means of mapping and synthesizing literature relevant to their research. This involved defining the research question and scoping purpose, determining a feasible range of literature, consulting with the doctoral supervisor to iteratively select the studies, extracting the data, analyzing the data, and writing up the results and practice implications. Considerations for how the scoping protocol informed this doctoral research are identified. Practice Implications: Scoping studies are used to map key concepts and identify main sources and types of evidence, thus providing an effective tool to support occupational therapists in evidence‐based practice. The resulting synthesis can inform policy makers, practitioners and consumers. Conclusions: Scoping studies can be an effective methodology to map out existing research and identify gaps in the knowledge base for occupational therapy researchers. Poster Defense: Child/Adolescent Psychosocial Health, Institution Sensory‐motor skills: Important for autonomy of children with Autism Mélanie Couture (Université Laval, Quebec) [email protected] Introduction: Evidence‐based interventions for occupational therapists working with individuals with autism are very scarce. There is an urgent need to document the foundation of our practice.Objectives: 1) To describe the developmental trajectory of children with autism at preschool‐age over a period of 24 months regarding 3 developmental domains: motor, sensory, and autonomy. 2) To determine the contribution of sensori‐motor skills on daily living skills (DLS).Methods: This is a longitudinal study of 37 children with autism and aged 3‐5 years at T1 and reassessed 24 months later (T2). Children were tested with the Peabody Developmental Motor Scales‐PDMS‐2, the Sensory Profile, and the Vineland Adaptive Behavior Scales‐2. Results: Sensory processing difficulties of children with autism did not diminish between T1 and T2 (p> .05). Standard scores (SS) indicate that children had stable gross motor skills development in comparison to normative data but increased their performance in fine motor and total motor skills. SS remained stable and low for Socialization and DLS (< 1‐2 Standard Deviation). Only Communication did get significantly better over time (p=.0004). Best correlates of autonomy at T1 were sensory processing and fine motor skills (Jasmin et al., 2009). At T2, the only significant correlate was total motor quotient. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Conclusions: At school entry, children with autism still present important sensory processing and gross motor difficulties that are associated to their poor adaptive functioning. Specific interventions in occupational therapy focusing on sensori‐motor skills could lead to better DLS and integration in daycare or school. Poster Defense: Adult Physical Health, Institution Spasticity, co‐contraction, and elbow function for reaching: Are they related? Kimberly Edwards (, ) Jillian McTavish, Lisa Lyons, Chetan Phadke Rationale: Stroke leads to impaired upper‐extremity function, which may be related to spasticity and antagonist muscle co‐contraction. However, the association between spasticity, co‐contraction, and reaching is not well understood.Objectives: This proposed pilot study will investigate the relationship between clinical tests of spasticity, antagonist muscle co‐contraction during forward reaching, and elbow function in adults with chronic stroke. The secondary objective is to assess the relationship between spasticity and reaching components of the Wolf Motor Function Test (WMFT – a timed test of arm function).Methods: Ten participants with chronic stroke will be recruited for this study. The following assessments will be randomized to minimize the effect of practice and fatigue: a) Tardieu scale ‐ to assess spasticity angle and level of spasticity; b) surface electromyography (EMG) ‐ to measure co‐contraction in elbow flexors and extensors during a reaching movement; c) WMFT ‐ to measure arm function; and d) repetitive elbow movements test – to assess the number of times the elbow can be actively moved in the available range of motion in a 10 second period. Data will be analysed using Spearman’s correlation coefficient. Practice Implications: If a strong association is seen between the outcome variables, then it will help identify if clinical tests of spasticity can inform the occupational therapist of anticipated movement‐related co‐
contraction and potential impact on reaching movements. Conclusions: Knowledge of the relationship between spasticity, co‐contraction, and reaching may assist occupational therapists in choosing appropriate assessments and interventions for clients with chronic stroke. Poster Defense: Adult Psychosocial Health, Institution Spirituality conversations in acute mental health: A collaborative research approach Nicola Mark (, ) Tanya Neuert, Sharon Smith, Melinda Suto Introduction: Research indicates that spirituality is a resource for mental health recovery (Baetz & Toews, 2009). The inclusion of spirituality dialogue in occupational therapy is congruent with the Canadian Model of Occupational Performance which identifies spirituality as the core of every human being (CAOT, 2007). Occupational therapists as part of a multidisciplinary team, may find the incorporation of spirituality into the acute psychiatric setting challenging (Galanter et al., 2008). These issues will be explored in this present study. Objectives: This exploratory study describes the experience of spiritual conversations for patients and mental health professionals on an inpatient psychiatric unit. Methods: Our study, informed by phenomenological principles and appreciative inquiry, will use focus groups with mental health professionals and with patients to explore the lived experience of spirituality dialogue. An advisory committee, comprised of health professionals from hospital psychiatric units, will help guide the research process. Data will be analyzed thematically using interpretive description to explore commonalities and determine possible implications for practice. Practice Implications: It is anticipated that findings will lend insight into the experiences of mental health professionals and patients talking about spirituality in an inpatient psychiatric unit. Research findings will enhance our understanding of the potential benefits and challenges of discussing spirituality in this setting and provide possible recommendations for improvement in patient care. Conclusions: Findings from this study may provide occupational therapists with a greater understanding of the spirituality experiences of mental health patients and professionals in acute psychiatric settings and identify directions for future research. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Non‐specific to Client Group, Theory Spirituality in the Canadian occupational therapy landscape: Reflecting back, visioning forward Suzette Bremault‐Phillips (Univeristy of Alberta, Edmonton) Andriy Chirovsky suzette.bremault‐
[email protected] Introduction: Spirituality? How has it been understood across the Canadian Occupational Therapy landscape? Within the contemporary Canadian context, interpretation around “spirituality” is ambiguous. Similarly, it is understood in a variety of ways within the profession of Occupational Therapy. Though situated centrally in the Canadian Model of Occupational Performance and Engagement, there is much discussion over and great diversity regarding the meaning of the term. It may be helpful to look for insights regarding spirituality from perspectives both internal and external to the profession. While any number of viewpoints might be helpful, an examination of the historical and current use of the term as found in both occupational therapy and the wisdom traditions (major religious, philosophical and spiritual traditions including Buddhism, Christianity, Hinduism, Islam, Judaism, Taoism, Confucianism as well as many Aboriginal traditions) is warranted. Objectives: To examine the use of the term “spirituality”, its origins and history, and its key elements as found in occupational therapy in Canada and the wisdom traditions; and to consider ways to integrate spirituality into practice. Methods: A literature review regarding spirituality both within occupational therapy and the wisdom traditions. Practice Implications: Findings from this project will elucidate the centrality of spirituality in the OT conceptual model, foster a vision regarding spirituality in the profession, and offer ways to integrate spirituality into practice. Conclusions: Reflecting on the history of spirituality in both the Canadian OT landscape and the wisdom traditions enables the profession to collectively vision forward in this area with greater clarity and confidence. Poster Defense: Non‐specific to Client Group, Education Student occupational therapists collaborative community approach to program evaluation Alana Hosegood (, ) Donna Collins Introduction:The Multiple Sclerosis Society of Canada, Provincial Division, provides financial assistance to individuals with multiple sclerosis and their caregivers through the Client and Caregiver Special Assistance Fund Programs. Curious about the effectiveness of these programs, this agency approached a university occupational therapy program, to collaboratively explore and develop suitable program evaluation tools incorporating consumer input. Objectives:The purpose of this project was to engage student occupational therapists in a collaborative community experience, to develop and test program evaluation tools, and to determine a usable data collection method for agency consumers. Methods:Building on the results of a literature review, two student occupational therapists worked in partnership with the agency to determine best practice in developing program evaluation tools, considering the target consumer group. Subsequently, two Web‐based questionnaires were developed and reviewed for clarity by four survey design experts. Ten selected consumers then completed the questionnaires and participated in a telephone follow‐up interview regarding usability of questionnaire and Web‐based data collection method. Web‐based questionnaire responses were checked for consistency with posed questions and interviews were analyzed descriptively.Results:Interview feedback yielded no revisions to the questionnaires, as consumers reported the tools were easy to complete, comprehensive and well sequenced. Consumers expressed support for the Web‐based data collection method and responded consistently to the questions, indicating understanding of questionnaire content.Conclusions:Student occupational therapists’ collaborative involvement with a community agency and its consumers provided an effective process for developing usable program evaluation tools, while offering students a valuable community experience. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Non‐specific to Client Group, Education Student occupational therapists’ experiences of trans‐cultural competency development Ruheena Sangrar (, ) Valerie Estioko, Ashley Furrow, Lynn Cockburn, Jill Stier, Barry Trentham Introduction: The development of a trans‐culturally effective occupational therapy educational program requires a pedagogy that builds on student understandings of culture, diversity, and inclusion. Such an environment encourages students and faculty to learn from each other by sharing their diverse lived experiences, values and meaning systems within a respectful and safe space. Objectives: Student participants will present their reflections of trans‐cultural learning experiences in classroom and fieldwork settings on an ongoing basis, aimed at developing the links between culture, diversity, and the occupational therapy process. Approach: At the beginning of their occupational therapy educational program students were guided through a process to establish trans‐cultural guidelines. Using these guidelines throughout the curriculum, students examined their own cultural lenses, social locations, assumptions, and evolving understandings of culture and diversity. During the development of the guidelines, student reflections on these experiences were further explored within discussion groups. Practice Implications: Development of trans‐cultural competencies requires that students recognize the multitude of lenses through which they view the therapeutic relationship including, gender, religion, ethnicity, sexual orientation, socioeconomic status and professional status. Students report that the guidelines are applied in uniprofessional and interprofessional classroom and fieldwork relationships and learning opportunities. Conclusions: Reflections from this student experience inform ongoing revisions to learning experiences focused on developing communicator and change agent competencies that are necessary within increasingly diverse practice contexts. Poster Defense: Older Adult Physical Health, Community Sustainability of older adult physical activities post falls prevention program Kaitlyn Lee (Student, ) Joyce Lee [email protected] Rationale: A community exercise/education based falls prevention program has been shown to improve balance and fall reduction for older adult graduates post‐program. Given the relationship between physical activity (PA) and fall risk reduction there is a need to examine if graduates PA levels increase and are sustained post‐program. Objective: To describe PAs of older adults who graduate from the falls prevention program and explore what factors influence PA sustainability. Methods: The present study will use a mixed‐methods prospective cohort design in which graduates will be recruited for telephone interviews and participation in focus groups on PA. The Phone‐
FITT, the primary outcome measure, will be used to record frequency and duration of PA levels at twelve weeks and twenty‐four weeks post‐program completion. One to two focus groups will be conducted to seek participants subjective experiences of the influence of the falls prevention program on their physical activity post‐program. SPSS will be used to conduct paired sample t‐tests on Phone‐FITT scores and ethnographic content analysis will be used for focus group transcripts. Results: Findings from this study will inform the program leaders regarding older adults ability to sustain their physical activity post‐program completion and begin to explore the factors that influence this sustainability. Conclusion: The findings will add to the falls prevention literature on barriers and facilitators of sustainability and inform further program development. Poster Defense: Child/Adolescent General, Community Tactile learning strategies for parents of children with vision loss Lara Anderson (CNIB, Calgary, AB) [email protected] Rationale: Occupational therapists (OTs) address delays children with vision loss have in reaching for, grasping, and exploring new objects with their hands. It is a challenge to substitute visual learning. It is not uncommon for children with vision loss to develop sensory avoiding or sensory seeking as well (Smith Roley & Schneck, 2001) which CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin further complicate the situation.Tactile strategies have been found to be effective in a small sample of deaf‐blind children with multiple disabilities in promoting hand use. (Chen & Downing, 2006) . These strategies have the potential to be used effectively with all children with vision loss. Objectives: This study aimed to answer the questions: Do the teaching methods used with parents translate into a change the parents’ use of specific tactile strategies with their children with vision loss? Do the strategies result in a change in behaviours of children with vision loss? Methods: Parent/child dyads who receive early intervention services for vision loss were recruited. Parents were trained as a group using a video and hands on methods. They were video recorded participating in a music therapy class with their children prior to and after the training. The parents were interviewed about the training after the groups were completed. The videos and interviews were coded and analyzed.Practice Implication: OTs will have a better understand of the effectiveness interventions we use to facilitate increased hand use with children with vision loss. Conclusions: It is imperative that OTs are aware of evidence that supports interventions to best meet the needs of children with vision loss. Poster Defense: Non‐specific to Client Group, Education Teaching client safety: A narrative approach Sylvia Langlois (University of Toronto, Toronto) [email protected] Introduction: Client safety is essential in the provision of quality health care. Although many strategies can be employed to evaluate health care delivery, clients provide an invaluable source of information about how health care systems, education, assessment processes and interventions are functioning. When students engage a client to learn from their experiences with health care encounters, both positive and negative, they have the opportunity to identify with their stories, which are often powerful, poignant and influential.Objectives: Participants will learn about the Health Mentor Program and how it provides an opportunity for students to become engaged in client narratives. Key learning regarding client safety concerns identified by students will be discussed.Methods: Over one hundred students from seven health professions met with clients living with chronic conditions and who consequently had multiple exposures to the health care system. Students followed a semi‐structure interview format to elicit information about experiences regarding client safety and transition of care. Questions addressed various aspects of home and community safety, medication use and communication. The interviews were followed by guided self‐reflection assignments and participation in facilitated asynchronous on‐line discussions. Results:A qualitative analysis of written reflections and facilitated on‐line discussions identified key themes regarding client safety. Student response to these issues and implications for their future practice will be discussed. Conclusions:Students developed an enhanced understanding of the whole person. Unique encounters with clients assist in supplementing the knowledge translation process to future practice environments. Poster Defense: Non‐specific to Client Group, Education The “ACE” to learning! Assistant continuing education program Cory Feenstra (Ottawa Hospital, Ottawa) Leanne Forman [email protected] Introduction. Occupational Therapy Assistant (OTA) is a young profession which includes professionals working with different education levels. Given the difficulty to find continuing education opportunities within the province , a group of OTA’s in a multi site organisation decided to organize regional education sessions for assistants in the rehabilitation field. Objective. To cover the stages that were required to run eleven successful continuing educations evening sessions, over 2 years, for Assistants. The overall objective was to further the knowledge base and skills sets of OTA, Rehabilitation Assistants and Physiotherapy Assistant working in various settings in an urban area. Approach. An assistant education committee was formed to create and organize these sessions. To capture the interest in the Ottawa area, surveys were used to collect data. Data will be shared about the topics, the satisfaction rate, frequency and rate of participation. Results. Eleven education sessions were offered over a time span of 2 CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin years with an increasing participation rate. A review of the evaluation forms from each session has demonstrated how successful these sessions have been, and show what topics were of the most interest to the participants. Conclusion. Other professional looking at setting up continuing education sessions for Assistants in their community could learn from the list of education session offered. These continuous learning session have facilitated the networking between the support personal and other health professionals. Poster Defense: Non‐specific to Client Group, Education The clinical reasoning worksheet: Facilitating clinical reasoning during fieldwork Lesley Cotsianis (Health Sciences Centre, Winnipeg) Danielle Harling, Natalie Macleod Schroeder [email protected] Introduction: Fieldwork experience is essential for the development of clinical reasoning. Educators foster clinical reasoning experiences and must evaluate a student’s development of clinical reasoning skills. However, there is a limited selection of formal tools available for facilitating and evaluating development of clinical reasoning in a fieldwork setting. Objectives: To illustrate the purpose and use of a teaching tool used to facilitate development of clinical reasoning in occupational therapy students during fieldwork. Approach: Designed to reflect the occupational therapy process, the Clinical Reasoning Worksheet is a guide to critical thinking that can be used for evaluative discussions between educator and student. Following a literature review and discussion with colleagues, the tool was developed during an intermediate level fieldwork placement to meet the learning needs of a student who was expressing difficulties with clinical reasoning. It has subsequently been used by other students in varied practice settings. Feedback regarding its usefulness was gathered from educators, students and fieldwork advisors. Practice Implications: The Clinical Reasoning Worksheet has high clinical utility and can be utilized by fieldwork educators in conjunction with other methods of developing and eliciting clinical reasoning. Students can use it as a structured method of expressing their rationale and critical thinking in a variety of clinical situations. Conclusions: Clinical reasoning is a complex process that educators and students engage in, and an essential competence developed and evaluated in a fieldwork setting. The Clinical Reasoning Worksheet is applicable to basic placements when reasoning skills are emerging, as well as during more advanced placements when students struggle with this competence. Poster Defense: Non‐specific to Client Group, Education The continuing education needs of occupational therapists Elizabeth Steggles (Canadian Association of Occupational Therapists, Hamilton) [email protected] Introduction: Curriculum and resources have been developed by a program that assists internationally educated occupational therapists transition into Canadian practice. The program currently receives government funding and is available free of charge. In order to be self‐sustaining, the program will need to charge tuition and attract a broader audience that may include domestically trained occupational therapists. Objective: To determine the continuing education needs of domestically trained occupational therapists and the relevance of the existing resources. Methods: CAOT members who graduated fifteen or more years ago were invited to attend one of several informal focus groups that were held across the country. Participants were asked about their continuing education activities and the perceived utility of the existing program. An experienced occupational therapist facilitated the groups and made notes that were distributed to participants for verification. Those unable to attend a group in person were invited to complete a questionnaire. Results: Conferences and workshops were cited most often as current activities but reduced funding and time are significant barriers to attendance. Participants were open to online learning as a cheaper option but some were apprehensive about the use of technology. Of the existing resources, participants were most interested in current theory, evidence based practice and mentorship. Most wanted learning opportunities relevant to clinical practice, during lunchtime and spread over a long period. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Conclusions: The current online format and some of its content have merit. Modifications and beta trials are planned. Poster Defense: Adult General, Institution The effectiveness of occupational therapy within an oncology rehabilitation program Christina Risteski (, ) Ariella Rabinovitch, Haidee Law, Margaret Liu, Young‐Eun Russell , Jennifer Soong, Debbie Hebert Rationale. Individuals with cancer are living longer due to medical advances in detection and treatment. Despite adding years to patients’ lives, cancer treatments are associated with adverse health effects. Occupational therapy (OT) can play a key role in rehabilitating cancer survivors, however there is limited research evaluating the effectiveness of OT within oncology rehabilitation to ensure patients receive the most effective rehabilitation. Objective. The objective of this pre‐post mixed methods study is to examine whether OT, as part of an in‐patient oncology rehabilitation program, will improve the performance of chosen daily activities for adults living with cancer. Methods. A pre‐posttest mixed methods design will be used. A convenience sample will be recruited from the in‐patient oncology program being evaluated. Participants will complete the Life‐H 3.1, KPSS and GAS measures before and after participating in the OT oncology rehabilitation program. One month post‐discharge, participants will complete the LIFE‐H 3.1 and a qualitative semi‐structured interview aimed at understanding their experiences and perceptions of the program. Assessment data will be analyzed using a t‐test for paired comparison and interviews will be analyzed through directed content analysis. Practice Implications. The evaluation of the OT oncology rehabilitation program will provide rationale for the inclusion of OT within oncology rehabilitation teams and the results may also contribute to future evidence‐based program development within oncology rehabilitation. Conclusion. This study will provide further exploration of the effectiveness of OT and its impact on patient care and satisfaction within an oncology rehabilitation program. Poster Defense: Child/Adolescent Physical Health, Institution The environmental impact on disabled youths’ experiences in recreation programs Janell Mason (University of Toronto, ) Ashton Scott, Patty Rigby, Gillian King, Beata Batorow [email protected] Rationale: Participation in activity is crucial to development. However, youth with physical disabilities experience decreased rates of involvement in leisure and recreation programs due to a variety of environmental factors [1]. The specific factors that promote rewarding participation experiences have been underrepresented in the literature to date. This knowledge is imperative to removing barriers impacting involvement and thus encouraging greater participation. Understanding the environmental features which increase participation and enjoyment of leisure and recreation activities can help enhance quality of life and transform how programs for this population are planned and put into practice. Objective: The objective of this quantitative study is to examine the relationship between the environmental qualities of leisure and recreation activity settings and youths’ experiences participating in these activities. Methods: Approximately 40 participants, youth with physical disabilities attending recreation and leisure programs at a children’s rehabilitation facility, will be recruited to partake in this study. Correlational analysis (i.e., Pearson’s correlation coefficient) of ratings measured on the Measure of Environmental Qualities of Activity Settings (MEQAS) and the Subjective Experiences of Activity Settings (SEAS) will inform the specific relationships between variables. Practice Implications: Findings from this study will help to guide the development of activity profiles in rehabilitation settings. Enhancing the knowledge base of occupational therapists regarding the environmental factors that impact participation can help to advance treatment planning and program development. Conclusions: This project will identify specific variables that influence the fit between youth, activities, and specific contexts, helping to promote optimal participation for this population. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Child/Adolescent General, Institution The expectations for a kindergarten child with a developmental disability Amanda Doble (, ) Laura Anne Sheehan, Michelle Villeneuve, Angela Pyle Introduction: School‐based occupational therapists have an important role to play in supporting educational inclusion of students with developmental disabilities. However, understanding the expectations that teachers and families have for students with developmental delays and disabilities in educational contexts is critical for occupational therapists to contribute effectively to alternative education programming and outcomes for students with developmental disabilities. Objective: This qualitative case study examined multiple perspectives concerning the expectations of the classroom teacher, parent, and occupational therapist when providing educational programming, supports and services for one student with Down syndrome in the context of her Junior Kindergarten program. Methods: Data were collected over a 12 month period during the focal participant’s transition from preschool to Junior Kindergarten. Qualitative data included formal and informal interviews, observations, and document analysis. The participants included the focal participant, her mother, teacher, and occupational therapist. Results: Three themes concerning expectations emerged including, a) Individual Skills & Abilities; abilities, attributes, and roles required in order to meet expectations, b) Tasks and Activities; expectations for the occupations that are required for a Kindergarten student , and c) Environmental Services and Supports; the expectations for environmental characteristics needed in order to foster learning and growth. Conclusion: Understanding the multi‐dimensional nature of expectations within an ecological systems framework allows a more comprehensive understanding of the expectations associated with a child diagnosed with Down syndrome entering Kindergarten. Poster Defense: Non‐specific to Client Group, Education The experiences of internationally‐educated occupational therapists transitioning to Canadian practice Shaminder Dhillon (McMaster University, Hamilton) Leah Dix, Colleen McGrath, Pat McMahon Introduction: The profession of occupational therapy has evolved internationally in different ways, giving rise to considerable variation in how the profession is practiced. When internationally‐educated occupational therapists (IEOTs) attempt to transition to Canadian practice, their experiences are diverse. To provide relevant support to IEOTs in their transition, their experiences need to be understood and appreciated. Objective: To understand the diverse experiences of IEOTs who are transitioning to Canadian practice. Methods: A team providing support and resources to IEOTs in their transition to Canadian practice conducted a phenomenological study to understand the experiences of the IEOTs who had been assisted over the past year. A research assistant and transcriptionist who were not members of the team were hired. The research assistant conducted and recorded telephone interviews with the IEOTs, while the transcriptionist transcribed and anonymized the recordings. Four team members analyzed the transcripts using immersion/crystallization. Results: Twenty‐eight IEOTs participated in the interviews. From this data, three themes emerged including: IEOTs citing personal factors that contributed to a manageable transition; IEOTs citing personal factors that contributed to a challenging transition; and finally IEOTs citing environmental factors that contributed to a challenging transition. Each theme includes strengths, resources, limitations and barriers that explain the IEOTs’ experiences. Conclusion: IEOTs experience their transition to Canadian practice as manageable or difficult for varied reasons. This has led to specific recommendations for other IEOTs, government agencies and programs that support IEOTs in their transition to practice. Poster Defense: Non‐specific to Client Group, Community The impact of community gardening on perceived health and well‐being Sonja Feddes (UBC MOT Student, Vancouver) Elizabeth MacDonald, Melinda Suto [email protected] CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Rationale: Community gardening has become a popular activity in urban settings. It has been suggested that interactions with nature have a positive impact on personal well‐being (Hasen‐Ketchum & Halpenny, 2010). The occupation of gardening has been linked to positive health outcomes, including relaxation and stress relief (Kingsley, Townsend, & Henderson‐Wilson, 2009; Van Den Berg & Custers, 2011). However, little is currently known about how participation in community gardening impacts well‐being. Objectives: The aim of this study is to provide insight into the experiences of community gardeners and to describe how participation in a community garden impacts the perceived health and well‐being of garden members. Approach: Using semi‐structured interviews, this exploratory qualitative study will describe the lived experience of a sample of 5‐10 community gardeners who use urban community gardens. Data analysis will be inductive and aimed at identifying predominant themes. Practice Implications: The results will contribute to occupational therapists’ understanding of the relationship between community gardening and perceived health and well‐being. The knowledge gained from this study will provide insight into the potential value of community gardening as a tool for health promotion. The findings will also provide preliminary information regarding the potential benefits of using community gardening as a therapeutic tool for enhancing the health and well‐being of clients with chronic health conditions or disabilities. Conclusions: Occupational therapists may benefit from an enhanced understanding of community gardening as a personally meaningful and engaging occupation. Furthermore, the findings from this small‐scale study may provide useful insights for therapists interested in health promotion. Poster Defense: Non‐specific to Client Group, Theory The Kawa Model as a conceptual framework for examining occupational therapy Natalie MacLeod Schroeder (, Winnipeg) Charlotte Enns, Juliette Cooper, Marlene Atleo [email protected] Introduction: Occupational therapy is a culture. Therapists share a specialized language, common values, beliefs and practices as well as a shared body of knowledge. Therefore, the growth and development of occupational therapy can be examined and analyzed as with any other cultural group. While the Kawa model (Iwama, 2006) was developed for occupational therapists to use with their clients to examine personal, situational and environmental influences on occupational performance, it also has potential for use as a framework to understand the profession of occupational therapy. Objective: This poster will demonstrate the use of the Kawa model to explore the profession of occupational therapy in Canada. Approach: The Kawa model was used as a means of understanding how occupational therapy has changed over time in response to internal and external influences, and to examine the profession within the current Canadian context. Practice Implications: Understanding the influences on the growth and development of a profession is necessary in order to plan for the future. Development of a profession is influenced by internal factors such as the skills and practices of its members and by external factors such as other professions, political agendas and financial resources. The Kawa model provides a method grounded in occupational therapy theory to explore strengths and weaknesses of the profession as well as opportunities and threats. Conclusion: The Kawa model provides a useful tool for reflection upon the profession of occupational therapy, allowing for examination of its strengths and limitations as well as the broader context of practice. Poster Defense: Non‐specific to Client Group, Theory The Kawa Model as a reflective tool for occupational therapists Natalie MacLeod Schroeder (University of Manitoba, Winnipeg) [email protected] Introduction: Reflection on practice is considered an essential competency for occupational therapists. Therapists must be able to examine their practice and experience critically in order to grow and develop within the profession. While reflection is necessary for development and growth, it is a difficult skill to learn and apply. The Kawa (river) CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin model (Iwama, 2006) provides a method of examining practice considering interconnectedness to environment, personal attributes and life circumstances. Objective: To describe use of the Kawa model as a tool for reflection in occupational therapy. Approach: The author’s personal stories of critical moments of occupational therapy practice were analyzed using the Kawa model in an effort to understand how personal characteristics, environmental facilitators and barriers and discrete circumstances influenced feelings of success and discomfort in practice.Practice Implications: Each occupational therapist comes to the profession with their own river, their own life history, influenced by their personal context, attributes and circumstances. The river winds and changes throughout the course of a career, affected by practice environments, experience and personal characteristics. Use of the Kawa model as a reflective tool facilitates examination of the multiple interconnected elements of any practice situation using a method familiar to occupational therapy. Conclusion: As the Kawa model is recognizable to many occupational therapists as a clinical tool, it provides a practical framework that has potential for use during fieldwork education and by both novice and more experienced therapists. The Kawa model’s power as a reflective tool enables therapists to better apply the essential competency of reflection. Poster Defense: Adult Psychosocial Health, Institution The McGill Occupational Therapy Behavioural Observation Scale (MOTBOS) Linda Berthiaume (, ) Ferdinand Hehewerth, Angel McGee, Julianne Noseworthy, Anne Richard, Aileen Castro, Suzanne Rouleau , Heather Lambert Introduction: A day hospital program (DHP) in psychiatry is an intensive time‐limited treatment program for acutely to sub‐acutely ill clients, using activities to assess and treat the impact of mental illness on function in everyday occupations. Currently, no reliable and valid tool exists for documenting client behaviours in a DHP context. Objective: The main goal of the project was to identify or create a behavioural observation scale to supplement charting. The Canadian Model of Occupational Performance and Engagement (CMOP‐E) was selected as it provides a framework for understanding behaviors that is current and relevant to today’s occupational therapy practice. Methods: A qualitative review of occupational therapy charts for clients of the DHP was performed to identify relevant behaviors. Saturation was reached after 24 charts; 29 were reviewed in total. Data was analyzed using the constant comparative method and through axial coding was categorized according to the CMOP‐E. Using current literature, operational definitions were developed for the behaviours identified and a scoring scale was developed. Results: The McGill Occupational Therapy Behavioural Observation Scale (MOTBOS) was designed, comprising 29 observable behaviours manifested in activity groups, to be scored on a 6‐point scale for frequency of observation, ranging from ‘never’ to ‘always’. Conclusion: While the MOTBOS will require validation before clinical use, it promises to be a time‐efficient means of charting in the DHP setting, facilitating communication between professionals, and providing an objective record of client progress using the CMOP‐E. Poster Defense: Adult General, Education The occupational therapy students moving and handling residency Andrea Duncan (University of Toronto, Toronto) Nikta Aghaipour, Alina Gonin [email protected] Rationale: Traditional moving and handling (MH) techniques place health care professionals and caregivers at risk for musculoskeletal injuries. It is essential for occupational therapists (OT) to have skills and knowledge in evidence‐
based safe client handling practices, to be confident in training caregivers, and to recommend appropriate equipment. However, OT programs in North America devote minimal attention to MH techniques, impacting the confidence of new graduates in teaching MH techniques, and recommending appropriate equipment. Objective: To understand the experiences of Canadian Masters of Science in Occupational Therapy (MScOT) students, undergoing an evidence‐based patient MH practicum; and to identify the program’s influence on knowledge and skills development, and the long‐term impact on practice. Method: Mixed methods study utilizing qualitative CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin questionnaires, and a written knowledge based test. A sample of 14 second year MScOT students from two Canadian Universities participated in a MH residency during their last fieldwork placement. Students received classroom training and were given the opportunity to apply their knowledge. A similar sized control group of practicing OTs will be recruited to assist in understanding the program’s long term impact on practice. A thematic analysis of the qualitative data will be used to explore students’ experiences. Practice Implications: This research will be used to raise awareness about the need to improve MH curriculum in OT programs across North America, ultimately improving client outcomes. Conclusion: Findings will support the implementation of MH training to facilitate OTs competence in the use and recommendation of lifting and transferring equipment. Poster Defense: Non‐specific to Client Group, Education The post‐professional education needs of occupational therapist/physiotherapist assistants in Ontario Trudy Langendoen (University Health Network, Toronto Western Hospital, Toronto) Candy Pleasance, Andrea Dyrkacz, Carol Heck [email protected] Introduction: There are few post‐professional educational opportunities specifically‐designed for occupational therapist assistants and physiotherapist assistants (OTA/PTA) in Ontario. Therefore, a study was conducted to determine the ongoing learning needs of OTA/PTA. Objectives: 1) To determine how OTA/PTA identify and prioritize their post‐professional education needs in terms of preferences, areas of interest, and factors that influence their decision to attend courses, 2) the impact of demographics factors on these choices. Methods: An online questionnaire was sent in October 2010 to OTA/PTA in Ontario with accessible email addresses. Descriptive statistics or means were used to describe demographic characteristics and for ranking factors. T‐tests were performed to determine differences between more and less experienced respondents. Results: Demographically, respondents were primarily female, with an average age 35.2 ± 9.8 years, working full time for 8.1 ± 5.2 years in larger urban general hospitals, rehabilitation settings or outpatient clinics, providing care to orthopaedic, stroke, geriatric or general medicine patients. Experienced OTA/PTA were more likely (p=0.04) to work in rehabilitation settings, while less experienced respondents tended to work in acute care or outpatient settings. The preferred education delivery methods were hands‐on skills workshops and courses. The primary rationale for pursuing post‐
professional education was to upgrade or develop clinical skills, participate in inter‐professional collaboration or network with colleagues. Conclusion: The results of this study will be used for future planning and implementation of post‐professional educational opportunities better aligned with the priorities and learning needs of OTA/PTA in Ontario. Poster Defense: Adult General, Community The role of assistive technology in self‐perceived participation Jacquie Ripat (University of Manitoba, Winnipeg) Roberta Woodgate [email protected] Introduction: Occupational therapists frequently recommend assistive technology (AT) to enable client’s occupations. However, existing AT definitions that focus on using technology to remediate impairments or improve function do not integrate the current emphasis on ensuring congruence between the environment and technology or the social aspects of participation realized through AT use. Objective: The aim of this study was to develop an understanding of how AT contributes to self‐perceived participation for individuals with spinal cord injuries, and to propose a revised definition of AT in light of the findings. Methods: A grounded theory study of 19 adults with spinal cord injuries was conducted. Participants engaged in individual in‐depth interviews, and took photographs of the role of AT in their own environments. Analysis consisted of an inductive process of constant comparison. Participants attended a follow‐up focus group intended to verify and contribute to the credibility of findings. Results: The primary theme identified was Assistive Technology as a Means to Participation. Three categories served to identify the decision‐making processes individuals underwent to select AT that would promote positive CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin participation experiences: Inclusion versus Autonomy and Accomplishment, Availability and Cost, and Contexts of Use. A new definition of AT was proposed; this definition identifies AT as a means to enable occupation, emphasizes the relevance of the environment, and highlights the importance placed on self‐perceived participation. Conclusion: Occupational therapy recommendations must be based on a thorough understanding of the role that AT plays in the lives of clients. Future research will further develop and validate the definition proposed in this study. Poster Defense: Adult Psychosocial Health, Institution The role of occupational therapy at a hospital‐based addictions program Niki Kiepek (, ) [email protected] Introduction.Occupational therapists often work with clients who have problems associated with their use of alcohol and drugs. There is also an opportunity for occupational therapists to be employed in roles that primarily involve addictions counselling. As these positions develop it is important to share information about current practice settings and roles.Objectives.This presentation describes the role of an occupational therapist working in a multidisciplinary hospital‐based withdrawal management program. This role includes providing addiction counselling to i) a withdrawal management program (detox), ii) acute inpatients, iii) pregnant women and their spouses attending a prenatal clinic, and iv) out‐patients temporarily residing at a hostel.Approach.This is a practice‐
based description of a unique program that includes an occupational therapist in addiction counselling services. The intention is to describe the specific services provided, to explicate the unique contributions of the occupational therapist on the team, and to discuss the negotiation of roles in a multi‐disciplinary context. Practice Implications.This presentation is intended to contribute to discussions about occupational therapy scope of practice and provide information about the role of an occupational therapist in addictions counselling. The integration of addictions counselling into hospital‐based services is fairly unique, and occupational therapists may find a novel role for advocacy and/or practice. Conclusions.Occupational therapists can play a unique and important role in program development related to addictions counselling. They also bring complementary strengths to contribute to a multi‐disciplinary addictions counselling team. Poster Defense: Non‐specific to Client Group, Institution The role of occupational therapy in acute care across Canada Alison Lake (, ) Katy Keyes, Natasha Nzeakor, Emily Cheung, Heidi Chan, Alison Lake, Jennifer Joachimides, Carol Heck Rationale: Acute care environments present a variety of challenges for occupational therapists (OTs) practicing in a holistic manner. Economic pressures and decreased lengths of stay have placed greater constraints on the healthcare system including OT services in the acute care setting (Griffin & McConnell, 2001; Craig, Robertson, & Milligan, 2004). Despite these pressures, the role of OT in acute care is considered an essential health service with significant evidence supporting the importance of OTs as vital members of the healthcare team (Kendall, 1994; Craig et al., 2004). Objectives: The study examined the role of OT and explored factors that impact OT practice in Canadian acute care environments. Methods: A cross‐sectional mixed methods design was used. A self‐
administered questionnaire was sent to OTs working in larger (> 100 beds) urban in‐patient acute care adult settings within Canada. Descriptive and inferential statistics were used to analyze quantitative data while thematic analysis was used to explore meanings of identified themes from qualitative data. Results: Canadian OTs in acute care settings identified the role of OT as primarily to assess and plan for discharge. Major challenges for OT practice in acute care reflect time and budgetary constraints and included meeting high demands for services with low staffing levels, providing effective treatment, decreased availability and accessibility of team members, and a lack of opportunity and support for OT‐specific education. Conclusions: The results of this study may be used to CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin generate foundational knowledge for OT practice and guide future research while promoting the OT profession in acute care. Poster Defense: Adult Physical Health, Institution The use and rationale of upper extremity orthoses for spasticity Reema Farhat (, ) Erica Woo, Debbie Hebert, Pat McKee [email protected] Introduction: Spasticity, a common sequela of acquired brain injury (ABI), negatively affects occupational performance (Lannin & Herbert, 2003). Although upper extremity orthoses are commonly used to manage spasticity in adults with ABI, the decision‐making process about their application and optimal orthotic designs remains controversial (Lannin & Ada, 2011). Objective: This study will identify the types, regimens and rationale of orthotic interventions for the wrist and hand, prescribed by occupational therapists, in rehabilitation of adults with post‐ABI spasticity. Methods: This study uses a non‐experimental descriptive research method. Approximately 40 occupational therapists from acute and rehabilitation settings, with experience in providing orthoses for neurorehabilitation, will be invited to participate. An online survey containing closed and open‐ended questions will inquire regarding 1) therapists’ prescription of orthoses, and 2) rationales and therapists’ opinions. Data will be analyzed with descriptive statistics and content analysis (Creswell, 2003). Practice Implications: Current practice characteristics about orthotic interventions identified in the study will help understand factors influencing use of orthoses to manage post‐ABI spasticity by occupational therapists amidst existing controversies and clinical uncertainties. This study will be the first step in developing a framework that would help develop a consistent decision‐making process and practice guidelines. Future studies can compare the effectiveness of different types of orthoses and regimens identified through this study. Conclusions: Orthotic interventions used to manage post‐ABI spasticity in adults are inconsistent and the decision‐making process is unclear. Identifying therapists’ use of orthoses, rationale and opinions will provide needed insight into factors influencing these interventions. Poster Defense: Child/Adolescent General, Institution Towards complementarity of services ‐ What needs to be done Sylvie Tétreault (Université Laval, Québec) Andrew Freeman, Pauline Beaupré, Pascale Marier Deschênes, Hubert Gascon, Monique Carrière [email protected] Introduction: Collaboration between stakeholders from different organizations is a major challenge which needs to be addressed in order to offer concerted and continuous interventions to Quebec’s youths with disabilities. Objectives: From 2007 to 2010, a research team was mandated to evaluate the implementation and impacts of a partnership for complementarity of services established, in 2003, between the health and social services network and the education network. This agreement was assessed particularly for children with special needs and their families. Methodology: The analysis of perspectives for an effective framework of collaboration was based on data collected during interviews with 181 stakeholders (health professionals, program directors or managers, school principals, teachers, etc.) from both networks. Results: Among other themes, perceptions regarding intersectoral collaboration, difficulties encountered and suggested solutions were discussed. Stakeholders from both networks agreed on their wishes for better collaboration. The first concern highlighted by participants was the need of an agreement for the confidential information sharing. Also, school principals and teachers perceived it would be helpful if health professionals visited schools, offered their services on a preventive basis and adjusted their recommendations to a classroom context. The need for a common planning and meeting place has been enunciated on many occasions. For participants from the health and social services network, this means taking in consideration the particular schedule of the educational system. Conclusion: To ensure stakeholders are able to provide greater concertation and better complementarity of services, certain means need to be implemented and carefully monitored by representatives from both networks. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Non‐specific to Client Group, Community Training a pug with ataxia as an occupational therapy assistance animal Heather Lambert (, Montreal) Lise Hargrave [email protected] Introduction: The effectiveness of animals as adjuncts to therapy has been amply demonstrated. Trained therapy animals from associations such as MIRA are generally large‐breed dogs that receive extensive specialized training. However, some clients may not require this level of training, and may be intimidated by a large animal. Also, obtaining and keeping such an animal may not be practical for a sole therapist or small practice. Objectives: The training of a rescue dog with a significant neurological impairment and of a small, people‐oriented breed, to assume the role of a therapy assistance animal will be discussed. Approach: A 16 month‐old Pug with cerebellar ataxia and a history of neglect was adopted from a breed‐specific rescue organization. A program of rehabilitation was developed by the owner, who is an OT, in conjunction with a professional trainer. The goal of the dog’s training was to 1) improve physical coordination; 2) to improve attention and concentration; 3) to learn specific signals and verbal commands; 4) to gain the social skills necessary to work with a variety of clients. Practice Implications: The physical and cognitive improvements seen in this Pug, and his start in Fall 2011 as a therapy assistance animal will be discussed. Practical considerations for the training and certification of a dog as a therapy assistant will also be discussed. Conclusions: Rescue animals from non‐traditional breeds, including those with significant neurological impairments, are excellent candidates for assuming the role of therapy assistance animals provided they receive adequate training. Poster Defense: Older Adult General, Institution Transition into long‐term care: Narratives of Chinese‐Canadian families Nai‐Yuen Ho (, ) Richard Chui Rationale: The transition of older adults to long‐term care homes (LTCHs) is often a difficult process, especially for members of minority ethnic communities. In Canada, a multicultural country, it is important to note that these populations may face unique challenges due to cultural and linguistic differences. The Chinese‐Canadian community is the second largest ethnic minority group in Canada. However, there is no literature regarding the unique storied experiences of older Chinese individuals transitioning to LTCHs. Objective: The objective of this qualitative study was to explore the narratives of Chinese older adults who transitioned to a LTCH and their family members. Methods: Up to five Chinese older adults who had transitioned to a LTCH within the past 3‐6 months and their family members were invited to participate in narrative interviews. Interviews were transcribed and analyzed using Polkinghorne’s (1995) approach to narrative analysis. Practice implications: This pilot study informs occupational therapists about transitioning to LTCHs for Chinese older adults and their families. A greater understanding of the contextual interplay between Chinese culture and the transition will enable occupational therapists to better support this population. Conclusion: This study reveals the significance of the cultural interplay in transitioning into LTCHs and indicates a need for a more in‐depth understanding. Poster Defense: Non‐specific to Client Group, Theory Understanding gender in occupational therapy and occupational science literature Alyssa Bierbrier (, ) Jennifer Jimmo, Barry Trentham [email protected] Rationale: While numerous academic and professional disciplines, particularly feminist studies, have examined the gendered nature of occupation and occupational choices, preliminary reviews suggest that the occupational science (OS) and occupational therapy (OT) literature is relatively silent about this phenomenon. This is surprising given the centrality of occupation to practice and theory development within both OT and OS. Objective: This study critically analyzes OT and OS literature on gender over the past 10 years to identify patterns of implied meanings of gender CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin and its relation to practice and theory development. Approach: Informed by a critical feminist analytical lens, this study uses a qualitative summative content analysis framework to examine how gender is represented and discussed. Embedded themes are then discussed within current understandings of gender within the broader field of gender and feminist studies. Practice Implications: Identified gaps, assumptions and potential limitations within current OS and OT gender discourse offers academics, clinicians and students an opportunity to reflect on the professions’ scholarship on gender as applied to occupation and the occupational enablement process. Conclusions: This research sets the stage for future research aimed at examining how OS and OT gender discourses impact on therapeutic processes. Poster Defense: Non‐specific to Client Group, Theory Understanding ruling relations: Institutional ethnography’s contribution to occupational therapy practice Annie Carrier (Université de Sherbrooke, Sherbrooke) Birgit Prodinger [email protected] Introduction: The Canadian Practice Process Framework (CPPF) integrates the core values of occupational therapy (OT), for example its client‐centered approach, and recognizes the importance of the practice and societal contexts. The context in which OT practice processes take place is governed within ruling relations, i.e. the invisible coordination of professionals’ and clients’ activities in different sites within organizations of power. These ruling relations may impact upon OT practice processes. Objective: To illustrate the usefulness of institutional ethnography (IE) to understand the ruling relations that affect OT practice processes. Methods: A scoping study was conducted. Six databases, including Medline, OTDBASE and CINAHL were searched and relevant scientific literature on IE from 1980 to August 2011 was identified. Data were collected and analyzed using a thematic chart and content analysis. Themes were then linked to the CPPF. Findings: From the 90 studies located, 38 were analyzed. Previous IE research explored how ruling relations coordinate activities of professionals and clients in practice contexts, including health care and social service provision. Coordination of activities such as assessments and evaluations of outcomes and organization of power is mediated by documents (e.g., assessment forms, health policies). These documents, originating from the societal context, render professionals’ activities accountable to professional associations, institutional regulations, and funding agencies. Because IE makes visible ruling relations and organization of power, it can strengthen OT practice. Conclusion: Powerful in making ruling relations visible, IE can enhance occupational therapists’ understanding regarding how context affects OT practice processes throughout all pathways of the CPPF. Poster Defense: Adult Psychosocial Health, Community Understanding the occupational lives of homeless adults with mental illness Sarah Illman (, ) Sandy Spence, Bonnie Kirsh Introduction: The homeless population is comprised of a large number of people living with a mental illness (MI). The nature of engagement in meaningful activity or occupations by homeless adults living with a mental illness is not well documented or understood. Objective: The objective of this study was to understand how people with MI who are homeless spend their time, their reasons for doing so, as well as barriers and enablers to engaging in occupations of their choice. The central research question is “What is the nature and meaning of occupational engagement by homeless adults living with a mental illness?” Methods: A secondary analysis of 60 interview transcripts, gathered from homeless adults, was conducted using a qualitative, grounded theory methodology. The interview data were thematically coded by two independent researchers and the preliminary themes were discussed until a consensus was formed and saturation of themes was achieved. These themes were analyzed to elicit implications of the research. Practice Implications: This research enables an understanding of the occupational lives of individuals who are homeless living with MI. The findings provide insight into the needs of this population and inform occupational therapy practice and intervention strategies. Conclusions: This study’s findings will help to CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin optimize engagement in occupation by this population, improving the health and well being of homeless adults living with a mental illness. Poster Defense: Older Adult General, Institution Unique challenges for occupational therapy in an emergency department Francine Bisson (St. Boniface Hospital, Winnipeg) Sandy Lopes Introduction: The role of Occupational Therapy (O.T.) in the Emergency department (ER) of a tertiary care facility has evolved from a consultative role to an active member of the team 7 days/week. Changes in the practice have developed from the need created by an ageing population, an increase in chronic diseases and a push to manage clients in the community rather than inpatient settings.Objectives: Participants will understand:1. The challenges faced by O.T. in the ER. 2. Methods used to overcome these challenges.3. How O.T. integrated itself as an active team member.4. Which assessments have been used to better evaluate a client’s occupational performance, potential for rehab and readiness for dischargeMethods: This presentation will provide: an overview of the ER population, the referral process, communication methods, the assessment tools and treatments utilized. A case study will be reviewed as a practical example. Practice Implications: A unique challenge of the ER is its fast‐
paced nature. Assessments and planning are expected to be completed within a few hours of arrival. At this time, the clients and their families are potentially in crisis and diagnoses are not yet clear. Conclusion: The role of O.T. in ER is exciting, challenging, and evolving. The therapist has to be willing to ask questions, maximize effectiveness within the current healthcare restraints and, most importantly, advocate for clients. Poster Defense: Older Adult General, Community Using a knowledge translation model to change practice: Lessons learned Robin Stadnyk (Dalhousie University, Halifax) Grace Warner [email protected] Introduction. The Promoting Action on Research Implementation in Health Services model (PARiHS) is a theory‐
based approach to guide action‐oriented efforts to enhance capacity for research use by practitioners (Kitson, Harvey, & McCormack, 1998; Kitson et al., 2008). This paper reports on lessons learned from a research project using the PARiHS model to identify a facilitation strategy for community‐based occupational therapists to work more effectively with family members of their clients. Objectives: This paper1) briefly describes the PARiHS framework, 2) demonstrates application of the framework in the practice setting and 3) identifies key lessons learned from implementing the framework and 4) provides implications for practice. Methods: Kitson et al.’s framework was used to identify 1) evidence relevant to therapists working effectively with family members; 2) key contextual factors in deciding how best to use the evidence in practice and 3) facilitation strategies for changing attitudes and skills that were judged to be most relevant to community therapists. Throughout the research, the context of participating therapists and their managers was key to understanding what kinds of evidence were trusted and what facilitation approaches were possible. Practice implications: Successful efforts to enhance capacity for research use require attention to contextual issues. The PARiHS model is a useful framework for helping raise awareness of important contextual issues in the knowledge translation process. Conclusions: The PARiHS model is useful for practitioners when due attention is paid to the knowledge translation process, and in particular to contextual factors. Poster Defense: Child/Adolescent General, Institution Using the participation model to promote sustained use of access technology Katherine Chow (, ) Tania Desai, Leslie Mumford, Tom Chau Introduction: Access Technology (AT) is utilized to support the development and learning of children with disabilities in the school environment. Despite advancements in the field of AT, the rates of abandonment remain extremely CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin high. This project will draw from the Participation Model and address two barriers that influence a student’s use of AT: 1) the fit between the student and technology, and 2) opportunities for AT use in the classroom (Buekelman & Mirenda, 2005).ObjectivesThe purpose of this research is to develop a comprehensive approach to providing AT in school settings that includes individualized AT development, in addition to sufficient student and teacher training on AT use.Methods and ApproachObservations, formal assessments, and interviews with parents and teachers on current opportunities and access to communication will inform the development of customized AT for 11 students. A multidisciplinary team will then use evidence‐based AT training to ensure that students are using the technology reliably and efficiently. Concurrently, education for teachers will be provided on methods to incorporate AT into the curriculum. Outcome measures include: School function Assessment, Family Impact of Assistive Technology Scale and Quebec User Evaluation of Satisfaction with Assistive Technology. Goal Attainment Scaling will be utilized in parallel with Individual Education Plan (IEP) goals to evaluate the students’ educational progress.Results and ConclusionsWe anticipate that this approach will result in the provision of individualized AT and lead to increased meaningful engagement in classroom activities, support the students’ IEP goals and decrease the likelihood of AT abandonment. Poster Defense: Child/Adolescent General, Community Validating the client grouping model: A Delphi process Tanya Glencross‐Eimantas (ErinoakKids, Burlington) Heather Marrin, Mary Stergiou‐Kita [email protected] Introduction/Rationale: Functional classification systems have been used for over 30 years in a number of jurisdictions to describe client populations and rationalize resources. Recognizing a need to promote service coordination and consistency, staff at a children’s treatment centre in Ontario developed the Client Grouping Model in order to functionally describe the clients receiving service. This poster presentation will describe the validation process undertaken which includes a scoping review and a Delphi process. Objectives1. To review the scoping review results2. To review the Delphi process results. Methods/Approach: Using a scoping review and Delphi consensus process, validation for the Client Grouping Model was undertaken. Delphi participants included international experts in classification systems. Based on a critical appraisal framework for classification systems, appropriateness, feasibility, face and content validity were evaluated using both qualitative (open ended questions) and quantitative (Likert scaling) approaches. Results/Practice Implications: Because evidence based practice necessitates ensuring that the development of practice tools involves rigorous processes, both a scoping review and a Delphi process were utilized. The process of validating the Client Group Model, a descriptive classification tool, that is being used as a multidisciplinary communication tool, a management tool for resource allocation and caseload management, a tool to develop clinical pathways and an education tool was examined. Conclusions: This tool underwent a rigorous validation process that examined the classification system literature with the intention of informing the tool constructs. Subsequently a Delphi process was employed to examine appropriateness, feasibility face and content validity. Poster Defense: Older Adult Physical Health, Institution Validating the wheelchair outcome measure for residents in long‐term care Shahriar Parvaneh (UBC, University of Social Welfare and Rehabilitation Sciences, Vancouver, Iran) Ben Mortenson, William Miller [email protected] Introduction: The Wheelchair Outcome Measure (WhOM) is a client‐centred measure, which was developed to facilitate the identification of wheelchair‐related occupational outcomes. The measure demonstrates good psychometric properties among individuals with spinal cord injury and community dwelling power mobility users; however, its validity among those living in residential care is unknown. Objectives:To determine test‐retest reliability and construct validity of the self‐report and the proxy versions of the WhOM among residents in long‐
CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin term care. Methods: The WhOM was administered to 55 wheelchair users living in residential care: self‐
respondents (n=38) and proxy‐respondents (n=17). Retest data were collected to estimate reliability using Intraclass Correlation Coefficients (ICC) for each of the tool scores (Importance, Satisfaction and Importance×Satisfaction). For construct validity testing, spearman’s correlation coefficients were used to assess whether WhOM scores were correlated with scores from the Late Life Function and Disability Instrument (LLDI) and Geriatric Depression Scale (GDS).Results:The ICCs for the WhOM scores were between 0.68 and 0.84. Validity testing for both the self‐respondents and proxy‐respondents groups showed moderate correlations with Importance×Satisfaction and LLDI (rs=0.46‐0.50). No significant correlation was found in support of our a priori hypothesis about association between Satisfaction and LLDI and GDS scores, and also between Importance×Satisfaction scores and GDS scores. Conclusion: This study provides preliminary support for the validity and test‐retest reliability of the WhOM in a sample of adults in residential care, but further testing is warranted to ensure it can facilitate prescription of the right device at the right time for residents in these settings. Poster Defense: Older Adult Physical Health, Institution Veterans' experience of ageing with chronic obstructive pulmonary disease (COPD) Viviana McAllister (McGill University, Montreal) Roshani Gandhi, Teresa de Vries, Phuong Hao Nguyen, Jennifer Ranallo, Patricia McKinley [email protected] Introduction: COPD negatively impacts physical activity and participation in activities of daily living (ADLs), but little research exists for individuals over 70 years, especially for veterans.Objective: To increase the relevance of a pulmonary rehabilitation program for veterans with COPD. Facilitators and barriers for participation are identified, and recommendations proposed that address the lived experiences of these veterans. Methods: Cross‐sectional design, mixed‐model exploratory study; n=11, average age 89.91 (6 in‐patients, 5 out‐patients); at Ste. Anne's Veterans Hospital in Montreal, Quebec; measurements were an interview, Mini‐Mental Status Exam (MMSE), pulmonary functions tests (GOLD staging for COPD severity), Activities Balance Confidence Scale (ABC), and Six Minute Walk Test (6MWT). Results: For the 6MWT & ABC, there was a strong correlation for out‐patients and a moderate relationship for in‐patients, with out‐patients having significantly greater scores on these measures than in‐patients (p<0.05). The merging of the two concept maps presented an overarching theme of quality of life (QoL) (Map theme count—inpatient= 27; outpatient=18). Both groups perceived health similarly; COPD was not considered their major limitation at moderate levels of severity; by contrast, sensory deficits were perceived as much more limiting. Both groups highly valued camaraderie for their QoL. Differences include in‐patients discuss death and aging processes more, while out‐patients discuss self‐management more. Conclusions: The performance on the 6MWT and ABC were directly related to patient’s perspectives. Recommendations include just‐right challenges, screening of ADLs, patient education, further research regarding accessibility, and the need to investigate rehabilitation practices for patients in isolation to avoid deconditioning. Poster Defense: Non‐specific to Client Group, Education Visual consent framework: Doing research with people who communicate differently Gail Teachman (Holland Bloorview Children's Rehabilitation Hospital, Toronto) Margot McMain‐Klein [email protected] Introduction: People with communication difficulties are often excluded from participation in research studies because of concerns about their ability to provide informed consent. As a result, their perspectives are missing and unaccounted for in literature guiding best practice in occupational therapy. Drawing on a study that explored optimal activity environments for disabled young people who are non‐speaking, we share an innovative ‘Visual Consent Framework’ that we developed and implemented to augment existing traditional research consent procedures. Objectives: This poster will describe and illustrate the visual consent framework that we used to share CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin information about our study and to actively engage young people with communication disabilities in the research consent process. Approach: Augmentative and alternative communication strategies were adapted to create visual tools and a structured consent process. We report our rationale, objectives, benefits and challenges related to using the framework in the context of a large mixed‐methods multi‐centre research study. Practice Implications: Research evidence aimed to guide practice will be strengthened by including, rather than excluding, people who encounter communication challenges secondary to conditions such as cerebral palsy, stroke, brain injury or neurological disease. This framework might also improve processes related to consent for treatment for these individuals. Conclusions: Our use of a ‘Visual Consent Framework’ successfully addressed ethical concerns about participants’ ability to provide informed consent for their participation in research. Poster Defense: Adult General, Institution Visual‐Perceptual deficits: an evidence based review Meeta Gugnani (Rouge Valley Health Systems, Ajax, ON) Barbara Stygles [email protected] Introduction: Vision plays a major role in our ability to adapt to the environment. A large portion of our daily life requires effective visual processing and visuo‐motor performance. It is important prerequisite to perception and cognition and influences motor planning and postural control. Evaluation that focuses on deficits of components of function thought to be prerequisites of occupational performance have been termed the bottom‐up assessments. Examining role competence, the tasks which define these roles and what the patients can and cannot do, are top‐
down assessment. A combination of bottom‐up and top‐down assessments facilitate in understanding the functional deficits completely in our patients. Objectives‐ To provide evidence‐based information on evaluation and treatment of visual ‐perceptual deficits.Approach‐ The presentation will include functionally based assessments for visual‐perceptual deficits that have been validated in literature and also ideas on remediating the deficits using functional tasks.Practice Implications – Understanding the assessments that are evidence‐based and have sound validity and reliability in measuring the components of visual‐perceptual domains is important. None of the test measures discreet functions. Other deficits may be inherent part of the test and may be hard to rule out. Hence using the tests that are the best measure of a specific deficit is important. The administration and scoring criteria for the tests used will also be discussed in the presentation Conclusions‐ The session will facilitate understanding of visual‐perceptual challenges that occur as a result of a brain insult and functional means of remediating these deficits. Poster Defense: Adult Physical Health, Community Web‐based toolkit promoting best practices for cognitive impairment post‐stroke Marlene Stern (, ) Louise Nichol, Vikas Sethi, Emily Ewert [email protected] Introduction: Given the prevalence and negative outcomes of vascular cognitive impairment (VCI), Canadian Best Practice Recommendations for Stroke Care [CBPRSC] (2010) suggests persons at high risk for cognitive and perceptual impairments related to vascular disease should be screened using validated screening tools, recommendation 7.4 (Canadian Stroke Strategy [CSS], 2010). Post‐stroke patients demonstrating signs of cognitive impairments in the screening process must receive additional assessment from professionals with expertise in this area (CSS, 2010). To support occupational therapists (OT) consistent application of best practices in the management of cognitive impairment for post–stroke patients, and, educate their interprofessional colleagues about OT expertise in this area, an OT workgroup (administrators and expert clinicians) developed an intranet knowledge translation toolkit. Objectives: The poster will provide an overview of the toolkit content including: the Frequently Asked Question (FAQ) forum for OTs; Understanding Occupational Therapy Competencies in Cognition document for OTs and interprofessional colleagues; and, the FAQ usage and clinical utility findings. Methods: FAQ and competency document content and structure were informed by evidence‐based literature, expert opinion, and CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin existing frameworks. The clinical utility of the FAQ forum is being gathered via online feedback. Results: Clinical utility data on FAQ usage and lessons learned on FAQ development and promotion will be shared. Conclusion: The evaluation will inform whether the web toolkit is an effective knowledge translation tool to facilitate application of best practices, warrants posting on the internet, and whether the toolkit has potential application for other areas of OT practice. Poster Defense: Non‐specific to Client Group, Education What we teach and what remains, a proposal. Julien Voisin (U Laval, Québec) Claire Gane [email protected] Introduction: Students newly admitted to occupational therapy program (OTP) often have a vague idea of their future clinical practice. As a consequence they usually find it difficult to link the content of the basic sciences with its usefulness later in their career. It is then questionable to what extent their learning strategies target their long term needs. Objectives: To determinate the amount of retention of basic material from one year to the next. Approach: The proposed method consists in online surveys provided by Google within Gmail accounts. Students engaged in basic science courses during their first year in the OTP are asked to fill a survey the following year, without relying on textbooks or course notes. The survey is composed of the same questions used to examine them during the previous year. Practice Implications: Occupational therapy educators need to evaluate the efficacy of their teaching strategies. Using the proposed method, data can be collected year after year so as to thourougly monitor the impact on long term retention of new learning strategies educators may want to implement. Two limits of the method are that it relies on good will from students to fill the questionnaires, and that it requires the designing a new set of questions each time the previous set has become available online. Conclusions: The proposed method can help to monitor the impact of modification in teaching strategies on long term retention of basic science material, at the expense of some extra work for both students and professor. Poster Defense: Adult Physical Health, Institution Wheelchair Floor‐Board for Wii: An innovative balance rehabilitation tool Cassandra Crosby (, ) Danielle Rae, Jill Harburn, Tal Jarus Introduction: Dynamic and static sitting balance are important for functional activities, and are often a focus of rehabilitation post spinal cord injury [1]. The Nintendo Wii Balance Board is a novel and potentially motivating balance therapy modality, however it is not accessible to wheelchair users. The Vivify Floor‐Board, an innovative platform developed by a consumer, enables Wii Balance Board use with a wheelchair. While studies have examined Wii‐habilitation of balance and balance confidence, the efficacy of the Floor‐Board in these areas has yet to be explored. Objective: To determine the effectiveness of the Floor‐Board adaptation for Wii in improving static and dynamic sitting balance, balance confidence, daily function and satisfaction with intervention for people with spinal cord injury. Methods: In this multiple‐baseline, single subject study, 5 adult participants from a provincial inpatient spinal cord injury program will play Wii Fit Plus balance games using the Floor‐Board four times per week for 3‐7 weeks, dependent on baseline phase length. Balance, balance confidence, daily function, and satisfaction with intervention data will be compared with baseline data to determine effectiveness of the intervention. Practice Implications: The proposed study is expected to show clinically significant effectiveness of the Floor‐Board in improving balance, balance confidence, daily function and satisfaction with intervention, proving its utility as a rehabilitation modality. Conclusions: Results may help occupational therapists understand the benefits of the Floor‐
Board so that it can be confidently implemented in practice. The Floor‐Board may also be a useful tool for motivational and easily accessible balance rehabilitation at home. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Child/Adolescent Physical Health, Institution Wii or Kinect? Balance rehabilitation in children with brain injury Melissa Maron (, ) Jessica Cheung, Melissa Maron, Sandy Tatla, Tal Jarus Background: Children with acquired brain injury (ABI) often display balance deficits that impact participation in daily living. Nintendo‐Wii and X‐box Kinect are popular gaming systems that may assist occupational therapists in providing meaningful therapy. While the Kinect receives sensory input from full body movement, the Wii receives input from a handheld remote or balance‐board. There is no evidence of a difference between these two consoles in improving balance.Purpose: To determine the effectiveness of Wii versus Kinect in improving balance, motivation, and functional abilities in children with ABI.Methods: In a multiple‐baseline single subject design, three participants played Wii balance games daily for 30 minutes during the intervention phase for one, two or three weeks, depending on their baseline length. Balance and motivation were measured daily, and functional ability weekly. Data was analyzed using the Two Standard Deviation Band Method. The study will be replicated with Kinect games and results from each console will be compared. Results: Preliminary data from the Wii showed significant improvement in dynamic balance over the intervention phase. Results for static balance and center of pressure were inconclusive. Although motivation did not improve significantly, participants verbally expressed enthusiasm. Functional ability showed a trend towards improvement. Data collection is ongoing for the Kinect and it is hypothesized that results will support initial findings and possibly supersede the Wii.Conclusions: The Wii and the Kinect are motivating therapy tools that can improve balance in children with ABI. Results can guide therapists’ decisions on which console to use as part of the rehabilitation process. Poster Defense: Adult Psychosocial Health, Institution Window to the soul: Art and transformation Moira Toomey (The Ottawa General Hospital, ) [email protected] Introduction: Visual art in hospital environments improves individual’s sense of well‐being, provides hope and aids communication. Personalized visual art was painted in patients’ hospital rooms with the glass windows acting as the painters’ canvas. High school fine art students executed the painting while the patient directed and informed the art with the occupational therapist facilitating and guiding the process. Feedback was collected from the patients, their families and the staff by questionnaire and informal interviews. Objectives: The objectives of this presentation are to challenge participants to: Expand their perceptions of current occupational therapy practice: Reflect on creativity and occupations; (doing, being, becoming and belonging): Integrate and balance these concepts in professional practice. Approach: Using video, power point media and group discussion the participants will have the opportunity to reflect, share and enlarge their vision and scope of practice. Ideas involving occupation (e.g. doing vs. being), creativity, spirituality and client/therapist relationship, will be presented for in‐depth discussion. Practice Implications: Traditionally occupational therapists used crafts to assist patients’ return to independent function. This project challenges OT practice within the medical model of practice in acute care and expands the concept of “doing” in respect to visual art. Conclusions:Individualised art in this form is a significant adjunct to healing and is a powerful tool in the relief of psychosocial and spiritual suffering. For several patients their paintings assisted in their transition from active cancer treatment to end of life care. Occupational therapy is ideally situated to facilitate this creative modality and enable client transformation and transcendence. Poster Defense: Adult General, Community Workplace practice: reflecting on the past to influence the future Gail Archer‐Heese (, Winnipeg) Leslie Johnson [email protected] CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction: While occupational therapy (OT) has sound roots in work‐related practice, over time the role has changed significantly. Recognizing dynamic workplace opportunities influenced by changing worker and employer expectations, health and safety philosophies, and legislation, a small provincial OT interest group recognizes the benefit of re‐focusing practice in the workplace. Objective: This poster will highlight the strategies used by the interest group to promote expanded OT roles in the workplace, framed by a timeline of involvement in various settings across the province. Approach: Examples of initiatives used by the interest group to promote the expanding role of OT in the workplace will be offered. These include providing “lunch and learn” sessions with human resources agencies, hosting booths and presenting workshops at health and safety conferences, creating and promoting insurance lobby information, developing and distributing promotional materials related to OT services in the workplace, and creating an engaging “OT in the Workplace” link on the provincial OT society website. We will identify our challenges and celebrate our progress in raising the profile of occupational therapy in the workplace in this region. Practice Implications: As the practice and location of OT service delivery continues to expand, we need to be aware of our stakeholders, and respond to their dynamic needs and obligations. Sharing our experiences may inform and challenge others. Summary: A reflection of practice over time is an integral process for OTs to focus and direct our future of providing ‘added value” services and meeting the evolving workplace demands. Poster Defense: Child/Adolescent Psychosocial Health, Community Youth’s self‐reported experiences of leisure activity settings Beata Batorowicz (McMaster University, Hamilton) Gillian King, Patty Rigby, Margot McMain‐Klein, Laura Thompson, Terry Petrenchik [email protected] Introduction: With increasing interest in the measurement of participation, there is a need for reliable and valid measures of youth experiences of recreational and leisure activity settings at home and in the community. The Self‐
Reported Experiences of Activity Settings (SEAS) was developed to measure key aspects of the experiences of youth with or without physical disabilities in recreational and leisure activity settings. Objectives: To describe the SEAS and its development. Methods: The development process involved a construct approach to instrument construction, including (a) examination of interdisciplinary literature to develop initial items, (b) consultations with experts, including youth with and without disabilities, parents and scholars, (c) pretesting and piloting with youth, and (d) subsequent revisions (Streiner & Norman, 2008; Wiggins, 1973). Currently, the psychometric testing is underway to examine construct validity, intra‐rater reliability, test‐retest reliability and equivalent form reliability. Results: The SEAS contains scales of processes of psychological engagement, personal, interpersonal and transpersonal (spiritual) experiences and has multiple formats, including text, graphic symbols, paper, and electronic. It is completed by youth, asking them to rate their experiences of a particular leisure activity setting. The presentation will include analysis of measurement properties of SEAS from a dataset of 30 youth with and without disabilities, many of whom completed the SEAS in both formal and informal activity settings. Conclusions: The SEAS will allow to examine the experiences of youth with disabilities who participate in leisure activity settings. It could be used for research and program evaluation. Poster Defense: Pas de clientèle spécifique, Éducation Approche pédagogique novatrice durant un stage : Groupe de codéveloppement professionnel Marie‐Josée St‐Pierre (Université du Québec à Trois‐Rivières, Trois‐Rivières) [email protected] Introduction : À l’instar des travaux de Schön (1994) qui perçoit la pratique réflexive comme une voie essentielle au développement professionnel, Daniels (2010) décrit les bénéfices de la collaboration par les pairs durant la formation clinique pour développer les habiletés de réflexion des étudiants. Pour soutenir les étudiants en ergothérapie durant un de leurs stages, une approche pédagogique novatrice adaptée du groupe de CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin codéveloppement professionnel de Champagne et Payette (1997) a été mise sur pied. Cette démarche de résolution de problème entre étudiants et encadrée par le milieu universitaire permet de porter un regard différent sur une problématique vécue en stage et se veut un ajout aux heures dans le milieu clinique. Objectifs : Illustrer le modèle conceptuel du groupe de codéveloppement adapté pour des étudiants en apprentissage et discuter des résultats de son implantation. Méthode/approche : L’affiche détaille les étapes et le mode de fonctionnement d’un groupe de codéveloppement et présente des exemples concrets vécus par deux cohortes d’étudiants. Un questionnaire d’évaluation d’une activité de formation est remis à la fin du processus à tous ces étudiants. Résultats : Les commentaires positifs des étudiants quant au soutien de leurs pairs et à la résolution de certaines problématiques vécues en stage et ce, malgré l’exigence de temps que demande cette démarche se dégagent dans l’évaluation de l’activité. Conclusion : Les résultats appuient la pertinence de ce groupe pour soutenir les étudiants dans leurs apprentissages et démontrent l’importance de créer des outils pédagogiques structurés visant le développement d’une pratique réflexive. Poster Defense: Personnes âgées Général, Communauté Autonomie fonctionnelle et capacités motrices chez les ainés en santé Emilie Breton (Étudiante à la maîtrise à l'université de Sherbrooke, Granby) Francisca Beloin, Cindy Fortin, Audrey Martin, Marie‐Ève Ouellet , Mélanie Levasseur [email protected] Introduction: Le vieillissement peut être accompagné d’une réduction des capacités motrices et d’une perte d’autonomie fonctionnelle. Certaines études réalisées auprès de clientèles vivant avec des incapacités ont démontré un lien entre autonomie et capacités motrices, mais à notre connaissance, aucune n’a visé à comparer ce lien entre les femmes et hommes. Objectif : Examiner et comparer les relations entre l’autonomie fonctionnelle et les capacités motrices de femmes et d’hommes âgés. Méthode: Cette recherche s’imbrique dans l’étude NuAge, étude longitudinale multicentrique à quatre temps de mesure annuelle, réalisée auprès d’aînés autonomes et en santé au 1er temps de mesure, recrutés selon un échantillonnage aléatoire stratifié par âge et sexe. Les données du Système de mesure de l’autonomie fonctionnelle (SMAF) et de mesures de capacités motrices (force, équilibre, vitesse de marche, levé de chaise) collectées au 3e temps de mesure auprès de 1 278 participants, dont 662 femmes, furent utilisées. Résultats: Les corrélations entre l’autonomie fonctionnelle et les capacités motrices varient de faibles à modérées, selon la variable motrice, et sont généralement plus élevées chez les femmes. Tel qu’anticipé, les capacités motrices des hommes sont faiblement associées à leur autonomie dans les activités domestiques. Conclusion: Les différences d’habitudes de vie pourraient expliquer les différences des corrélations obtenues entre les hommes et les femmes. Lorsqu’évaluées individuellement, les capacités motrices sont modérément associées à l’autonomie fonctionnelle chez ces aînés, en partie dû à leur faible variabilité au SMAF. Il serait intéressant d’examiner quel ensemble de capacités motrices permettraient de mieux prédire l’autonomie fonctionnelle. Poster Defense: Pas de clientèle spécifique, Administration Politique de santé Création d'un portfolio électronique destiné aux ergothérapeutes Diane Méthot (Ordre des ergothérapeutes du Québec, Montréal) Jacques Gauthier [email protected] Introduction : L’évolution du contexte réglementaire encadrant la formation continue des professionnels et le développement des données scientifiques sur le transfert des connaissances ont mené un ordre professionnel en ergothérapie à réviser ses orientations visant à soutenir la pratique de ses membres et leur développement professionnel. Objectifs : Présenter les principes ayant mené à la création d’un portfolio électronique (e‐portfolio) pour les ergothérapeutes en exercice. Offrir une démonstration du fonctionnement de l’outil. Méthodes : Recension des écrits sur le transfert des connaissances, analyse de l’utilisation des technologies de l’information comme méthode de soutien au développement professionnel, analyse des pratiques des ordres professionnels sur l’utilisation du portfolio, analyse des pratiques et des expériences de l’ordre professionnel concerné, sondage CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin auprès de ses membres, création d’un comité d’experts. Résultats : L’ensemble des données analysées souligne que la pratique réflexive et l’apprentissage réflexif sont les approches à privilégier pour assurer le maintien et le développement des compétences professionnelles. L’outil à privilégier pour soutenir cette approche est le portfolio professionnel. L’usage d’un e‐portfolio facilite la gestion du développement professionnel. Conclusion : L’utilisation du portfolio électronique devrait permettre une autogestion plus efficace et accessible du plan de développement professionnel des ergothérapeutes et de leur participation aux activités de formation continue. Il permet également à l’ordre professionnel de remplir son mandat de protection du public en facilitant la mise à jour et l’évolution des compétences de ses membres sans accroître les mesures de contrôle de l’exercice de la profession. Poster Defense: Adultes Psych./Soc., Établissement Déficience intellectuelle : Technologie d’assistance mobile améliorant le rendement occupationnel Émilie Boisvert (UQTR (étudiante), Terrebonne) Claire Dumont [email protected] Introduction: Être capable de performer dans les activités de tous les jours est un domaine d’intérêt, en ergothérapie, qui n’échappe pas à la clientèle ayant une déficience intellectuelle (DI) (Hällgren et Kottorp, 2005). Pour faciliter les occupations, des moyens compensatoires sont souvent préconisés. Ainsi, les technologies d’assistance (TA) mobiles sont, de plus en plus, vues comme des facilitateurs dans le quotidien des personnes ayant des déficits cognitifs (Joode, Heugten, Verher & Boxtel, 2010). Objectif: L’étude vise à vérifier l’impact d’une TA à l’horaire, de type tablette électronique, sur le rendement occupationnel d’une personne présentant une DI. Méthodes : Il s’agit d’une étude de cas mixte et exploratoire. Une personne ayant une DI doit expérimenter la TA pendant six semaines. Des mesures sont prises avant et après l’expérimentation et des observations sont notées au cours de l’expérimentation. L’instrument utilisé est la Mesure canadienne du rendement occupationnel (MCRO). Une analyse de contenu et la comparaison entre les moyennes de rendement et de satisfaction du MCRO seront effectuées. Résultat : Les résultats permettront de constater si oui ou non la TA augmente le rendement occupationnel, la satisfaction de la personne et si elle répond adéquatement aux désirs en matière de besoins occupationnels de la personne. Conclusion : Cette étude contribue à l'augmentation de nos connaissances sur des moyens prometteurs d’habiliter les occupations significatives des personnes ayant une DI. Poster Defense: Adultes santé phys., Établissement Définir des critères de référence en ergothérapie en maladies neuromusculaires Katheri Raymond (, ) Marie‐France Cormier, Christine Vachon, Louis‐Pierre Auger, Sabrina St‐Onge, Jean Mathieu, Cynthia Gagnon [email protected] Introduction : La dystrophie myotonique de type 1 (DM1) est la forme la plus fréquente de maladies neuromusculaires chez l’adulte. La DM1 est caractérisée par une diminution de la force progressive selon un patron de distal à proximal entrainant des incapacités notamment aux membres supérieurs. Malheureusement, ces incapacités sont peu documentées en lien avec la participation sociale. De plus, les personnes atteintes sont souvent peu référées en ergothérapie malgré une faible participation sociale à plusieurs niveaux. Objectifs :1) Déterminer et comparer les aptitudes aux membres supérieurs chez les personnes atteintes de DM1 selon le phénotype. 2) Explorer des critères de référence pour les services d’ergothérapie. Méthodes : Une étude transversale auprès de 200 personnes atteintes de DM1 avec une sélection aléatoire parmi un registre de 454 personnes. Les aptitudes suivantes aux membres supérieurs ont été évaluées : la dextérité fine (Purdue Pegboard), la dextérité grossière (Box and Block Test), la force de préhension (Dynamomètre Jamar), la force des pinces. La participation sociale a été évaluée avec la Mesure des Habitudes de Vie (sections nécessitant des aptitudes motrices aux membres supérieurs). Résultats : La comparaison entre les phénotypes sera effectuée à l’aide d’un Test‐t de Student. Les critères de références seront définis pour chacune des catégories d’habitudes de vie à l’aide de la technique du Receiver Operating Characteristic selon les résultats obtenus pour chacune des instruments de CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin mesure (analyse corrélationnelle). Conclusions. Cette étude permettra de mieux dépister les problèmes reliés aux activités courantes et aux rôles sociaux chez cette clientèle et orienter le suivi en ergothérapie. Poster Defense: Personnes âgées santé phys., Communauté Définition d'un 'cas simple' de choix d'équipement pour l'hygiène corporelle Manon Guay (Université de Sherbrooke et Centre de recherche sur le vieillissement, Sherbrooke) Marie‐France Dubois, Johanne Desrosiers, Judith Robitaille [email protected] Introduction: L'ergothérapeute est l’expert pour évaluer les personnes vivant à domicile et au besoin, choisir l'équipement pour l’hygiène corporelle. Cependant, afin de promouvoir l’accès aux services, plusieurs ergothérapeutes sollicitent la collaboration du personnel non‐ergothéapeute pour évaluer les ‘cas simples’. Actuellement, aucune définition n’est disponible pour décrire cette clientèle, ce qui ouvre la porte à des situations qui pourraient être préjudiciables à la population ou engendrer des infractions à la déontologie. Objectif: Caractériser les ‘cas simples’ de choix d’équipement pour l’hygiène en ergothérapie communautaire. Méthode: Consultation d’experts via la méthode RAND/UCLA qui comprend une recension des écrits, trois vagues de questionnaires et un groupe de discussion focalisée avec dix ergothérapeutes qui ont une pratique régulière dans le domaine. RÉSULTATS: Huit caractéristiques ont été retenues pour décrire les ‘cas simples’ de choix d’équipement pour l’hygiène. Ces indicateurs couvrent les trois domaines du MCRO‐P: l’occupation (se déplacer seul jusqu’à sa baignoire ou à sa cabine de douche, ne pas nécessiter ou souhaiter tremper dans l’eau), la personne (n’avoir aucune contre‐indication médicale, avoir une morphologie dans les limites de la norme, une condition médicale stable, la capacité de se lever et de suivre des consignes) et l’environnement (avoir une baignoire ou une cabine de douche standards). Conclusions: La recension des écrits et la consultation d’experts ont permis d’adopter un langage commun pour décrire les ‘cas simples’. Ces résultats permettront de soutenir les ergothérapeutes lorsqu’ils décident, ou non, de solliciter la collaboration du personnel non‐ergothérapeute pour répondre aux besoins de cette clientèle. Poster Defense: Enfants/ Adolescents Général, Communauté Démarrage d'une clinique universitaire en ergothérapie: défis et éléments facilitant Marie Grandisson (Université du Québec à Trois‐Rivières, Trois‐Rivières) Nancy Baril, Noémi Cantin, Martine Brousseau, Patrick Major, Huguette Picard [email protected] Introduction : Il existe très peu de cliniques universitaires en ergothérapie au Canada. Celles‐ci sont pourtant considérées prometteuses pour améliorer les pratiques cliniques (Warner, Delinek, & Davidson, 2010) et représentent une occasion unique de formation clinique alors que recherche, enseignement et clinique ont une chance exceptionnelle d’interagir. Objectifs : Présenter les principaux défis et éléments facilitant survenus lors du démarrage d’une clinique universitaire en ergothérapie auprès de la clientèle enfant (2011‐2012). Méthodes : Effectuer une évaluation de l’implantation (Brousselle et al., 2009) de la clinique à partir d’analyses qualitatives. Les ergothérapeutes impliquées complèteront un journal de bord sur les défis et éléments facilitant rencontrés après chaque période de stage de 3 à 8 semaines à la clinique. Les informations rapportées par les stagiaires dans l’évaluation du milieu complétée seront aussi analysées. Enfin, une entrevue semi‐structurée sera effectuée au téléphone par une tierce personne auprès des principaux partenaires de la clinique (i.e. centres de la petite enfance, centres de pédiatrie sociale, et milieux scolaires), et ce, afin de recueillir leur perception des éléments qui ont facilité ou nuit au partenariat. Les données seront analysées globalement pour proposer des recommandations pour le démarrage ou la poursuite des services dans une clinique universitaire. Conséquences pour la pratique et conclusions : Les principaux défis et éléments facilitant seront présentés. Le regard critique porté sur l’expérience de démarrage peut être utile aux milieux de formations et aux ergothérapeutes songeant à implanter une clinique ou contribuer à l’amélioration des pratiques en ergothérapie. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Pas de clientèle spécifique, Établissement Engagement dans le travail d’équipe: La nécessaire confiance Tania Arieira (, Montreal) Pierre‐Yves Therriault [email protected] Introduction: Pour offrir des services, le système de santé et des services sociaux (SSSS) préconise le travail en équipe interdisciplinaire. Ce changement implique une plus grande collaboration et une exposition des professionnels aux règles du travail collectif. Objectif : Cette étude vise à comprendre, par le cadre conceptuel de la psychodynamique du travail (PDT) (Dejours, 2009), l’influence de la confiance sur le fonctionnement des équipes interdisciplinaires et dans l’établissement d’un milieu de travail favorisant une bonne santé mentale. Méthodes: Un devis qualitatif a été développé pour répondre à cet objectif. Il concerne trois équipes de projet composées de professionnels de différentes disciplines du SSSS (n=8) ayant accepté volontairement de participer à une entrevue semi‐structurée. Les verbatim des entrevues ont été dressés et leur analyse s’est effectuée à l’aide logiciel NVivo. Résultats : Les données démontrent l’importance de la confiance pour supporter la coopération. La confiance est fondamentale au fonctionnement des équipes et au maintien d’une bonne santé mentale chez les professionnels. D’autres variables telles que le respect, la fidélité aux règles de travail et le vivre ensemble sont aussi essentielles à la confiance et influencent l’engagement singulier dans l’équipe. Conclusions: Des études ultérieures seront requises pour mieux cerner les mécanismes inhérents au déploiement de la confiance dans le travail d’équipe. La PDT constitue un cadre conceptuel innovateur permettant de cibler les enjeux de la collaboration et de maximiser le travail d’équipe dans le SSSS. Poster Defense: Adultes santé phys., Éducation Ergothérapie participative dans une pharmacie communautaire : Premiers résultats Sophie Guimont (Services d'ergothérapie de Joliette, Joliette) Therriault Pierre‐Yves [email protected] Introduction L’utilisation des approches participatives est prônée pour la prévention des troubles musculosquelettiques (TMS) associés au travail. Développée en 2008, une approche, l’ergothérapie participative, a démontré son efficacité et utilité pour différentes interventions menées avec des travailleurs d’usine et de bureaux. Des entreprises de services, elles aussi, au prise avec le phénomène des TMS, s’intéresse à ce type d’approche. Objectif Cette communication décrit l’implantation et l’évaluation d’un programme d’ergothérapie participative élaboré pour prévenir les TMS chez les travailleurs d’une pharmacie communautaire. Méthodes Pour réaliser cette étude, un devis quasi expérimental pré‐ et post‐intervention avec groupe témoin a été développé. Différentes mesures ont été prises avant et après l’intervention (perception des capacités de travail, détermination des exigences du poste de travail, intensité et localisation de la douleur, comparaison des capacités du travailleur et des exigences du poste de travail). Suite aux premières mesures, l'intervention, de type éducatif, comprend trois rencontres basées sur l’ergonomie et les facteurs de risque d’apparition des TMS. L’analyse des données concerne les deux groupes, expérimental et témoin. Résultats Il est prévu, chez les participants du groupe expérimental, une amélioration de la santé par la diminution de la douleur en lien avec l’augmentation des connaissances sur les TMS ainsi qu’une généralisation de ces dernières pour bonifier les conditions d’exécution des occupations pratiquées hors travail. Conclusions Inscrite dans la perspective de l’habilitation et l’autonomisation, l’intervention en ergothérapie participative, malgré ses limites, outillera les travailleurs face au développement des TMS. Poster Defense: Personnes âgées santé phys., Communauté Évolution de la perception visuelle après un accident vasculaire cérébral Audrée Jeanne Beaudoin (Université de Sherbrooke, Sherbrooke) Bénédicte Fournier, Léonie Julien‐Caron, Lucie Moleski, Joanie Simard, Louisette Mercier, Johanne Desrosiers [email protected] CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction : Les troubles visuoperceptifs sont fréquents après un accident vasculaire cérébral (AVC) et conduisent souvent à une réduction de l’autonomie fonctionnelle. Mieux comprendre l’évolution de ces troubles devrait permettre de cerner les besoins d’interventions ergothérapiques. Objectif : Documenter l’évolution des atteintes visuoperceptives suivant un AVC chez les ainés de 65 ans et plus. Méthodes : Cette étude a été réalisée auprès de 195 participants recrutés dans un de ces milieux de soins : 1) hôpital de courte durée (groupe HCD), 2) unité de réadaptation fonctionnelle ou hôpital de jour (groupe RÉA). La perception visuelle a été mesurée avec le Motor free Visual Perceptual Test‐ version verticale (MVPT‐V). Tous les participants ont été évalués au début de l’étude (T1). Seuls ceux présentant des déficits étaient évalués trois mois (T2 ; n = 99) ou six mois (T3 ; n = 67) plus tard. Résultats : Les scores moyens au MVPT‐V sont similaires pour les deux groupes. Malgré une amélioration des scores dans le temps (p < 0,05), les profils d’évolution sont très variés entre les participants. En effet, environ 50 % des participants des deux groupes se sont améliorés alors que 42 % du groupe HCD et 23 % du groupe RÉA se sont détériorés. Conclusion : Les données supportent que les troubles visuoperceptifs évoluent différemment suivant l’AVC. Malgré des troubles comparables dans les deux groupes, les participants du groupe HCD n’ont pas été dirigés vers des services de réadaptation alors qu’un plus grand pourcentage d’entre eux s’est détérioré. Poster Defense: Personnes âgées Général, Communauté Évolution dynamique de la qualité de vie des proches aidants Isabelle Daneau (CLSC René‐Cassin (CSSS Cavendish), Montréal) Michèle Hébert [email protected] Introduction : La prévalence de la maladie d’Alzheimer augmente constamment. Le déclin associé à la maladie demande une implication importante des proches aidants pour soutenir la personne au quotidien. Quel est l’impact du déclin et de l’augmentation associée des responsabilités des proches aidants sur leur qualité de vie? Il n’existe pas de réponse consensuelle à cette question, étudiée antérieurement de façon quantitative et ponctuelle. Objectif : Proposer une théorie substantive sur l’évolution de la qualité de vie des proches aidants de personnes atteintes de démence, selon le déclin associé à la maladie. Méthode : Un processus de théorisation enraciné a été retenu dans les perspectives du Modèle canadien du rendement occupationnel et des stades de déclin de la maladie d’Alzheimer de Reisberg. Quatre proches aidants ont participé à deux entrevues semi‐structurées pour documenter leur perspective de la maladie de leur proche, leurs responsabilités et leur qualité de vie. Résultats : Les perspectives des proches soulèvent huit facteurs reliés à leur qualité de vie : les signes et symptômes du proche, le diagnostic, les impacts affectifs, cognitifs et occupationnels associés au rôle d’aidant, la relation interpersonnelle, la spiritualité et l’environnement social. Conclusions : Une théorie substantive est proposée, expliquant l’évolution dynamique et fluctuante de la qualité de vie selon l’apparition de la maladie, l’étape du diagnostic, la progression des symptômes et les décisions prises par l’aidant. Cette nouvelle perspective peut aider les intervenants à soutenir les proches aidants dans leur quête d’une qualité de vie acceptable. Poster Defense: Pas de clientèle spécifique, Théorie Facteurs influençant la relation thérapeutique selon l'expérience vécue de l'ergothérapeute Marie‐Pier Chiasson (Hôpital Montfort, Ottawa) Virginie Lubino, Mélissa Mongrain, Paulette Guitard, Tricia Morrison [email protected] Introduction. La relation thérapeutique est la pierre angulaire de l’intervention en ergothérapie. Elle demeure cependant un sujet encore très peu exploré à ce jour au sein de cette profession. Afin qu’ils parviennent à exercer leurs soins en fonction d’une pratique centrée sur le client, il est nécessaire que les ergothérapeutes soient conscients de l'existence de facteurs influençant la relation thérapeutique qu’ils entretiennent avec leurs clients. Objectifs. Cette étude a donc pour objectif d’explorer, de décrire et de comprendre l’expérience vécue de l’ergothérapeute face aux divers facteurs influençant la relation thérapeutique. L’étude vise d’une part à identifier CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin les facteurs favorisant ou nuisant à la relation thérapeutique et d’autre part, à décrire la manière dont l’ergothérapeute y fait face. Méthodes. Cette recherche qualitative inspirée de l’approche de la théorisation ancrée comprend une analyse des données des entrevues semi‐structurées menées auprès de quatre ergothérapeutes ayant au moins trois ans d’expérience. Résultats. Les résultats de cette recherche démontrent trois différentes sources d’influences à la relation thérapeutique soit le thérapeute, le client et le système de santé. Conclusion. Les facteurs ressortis de cette étude peuvent être perçus comme étant des influences positives ou négatives dépendamment du contexte dans lequel ils se retrouvent. Les résultats sensibiliseront les ergothérapeutes à ce qu’ils soient plus attentifs et conscients de l'existence de ces sources d’influences afin de maximiser la qualité de la relation qu’ils entretiennent avec leurs clients. Poster Defense: Pas de clientèle spécifique, Éducation Former des ergothérapeutes influents en développant leurs compétences clinico‐administratives Audette Bédard (Université Laval, Québec) Monique Carrière, Marie‐Ève Lamontagne [email protected] Raison d’être : Les ergothérapeutes sont des professionnels appelés à agir dans et sur le système pour donner des services de qualité aux différentes clientèles. Pour ce faire, il convient de les placer en situation d’apprentissage progressif tout au long du continuum de formation, pour relever le double défi du développement des compétences cliniques et des compétences clinico‐administratives. Objectifs : L’enchaînement des thèmes abordés et des habiletés développées en alternant cours et stages est présenté. L’importance d’acquérir des connaissances, de développer des savoir‐faire et de revenir sur l’action et ses résultats par l’activité réflexive est démontrée. Approche : Conscients de ce défi et fidèles à l’approche socio‐constructiviste, les enseignants ont jugé nécessaire de créer quatre blocs d’activités qui se tiennent avant, pendant et après les stages du baccalauréat. Ce cours s’intitule Environnement organisationnel et est suivi du cours Gestion de programme à la maîtrise. Cette formule pédagogique permet d’ancrer les apprentissages dans la réalité et d’intégrer progressivement théorie, action et réflexion. Résultats : Les constats qui font suite à l’expérience avec une première cohorte montrent l’importance d’expliquer les objectifs poursuivis, de préciser les attentes au regard des activités d’apprentissage autonome en stage et d’assurer un suivi formatif en groupe en classe. Si une grande partie de nos étudiants saisissent les enjeux clinico‐administratifs, il faut continuer d’en démontrer et d’en justifier la pertinence et de les outiller pour qu’ils soient des ergothérapeutes qui influencent le système. Poster Defense: Pas de clientèle spécifique, Éducation Forum «Communauté de pratique» lors de stages : Un outil prometteur Louisette Mercier (Programme d'ergothérapie, Université de Sherbrooke, Sherbrooke) Johanne Desrosiers [email protected] Introduction : Dans tout programme de formation en ergothérapie, les étudiants effectuent au moins 1000 heures de stage, parfois sur un territoire géographique fort étendu. Afin de favoriser l’établissement d’une communauté virtuelle de pratique pendant ces stages, un forum de discussion a été privilégié comme outil complémentaire de communication et de soutien à leur apprentissage. La participation à cette communauté de pratique pouvait prendre diverses formes, soit la formulation de questions, la production de réflexions, le partage de nouvelles informations (connaissances) ou encore la réponse à un questionnement ou à une réflexion déjà formulé. Objectifs : Cette présentation poursuit comme objectifs de décrire le fonctionnement de ce forum de discussion, de documenter son mode d’utilisation par les étudiants et d’aborder son apport tel qu’identifié par les deux premières cohortes d’étudiants‐utilisateurs. Méthode : Les données ont été recueillies sous forme de rencontre de type focus‐
group auprès des utilisateurs. Les résultats traitent du degré de satisfaction, des apports et de pistes d’amélioration possibles. Résultats : Parmi les résultats obtenus, les étudiants finissants ont mentionné d’une part que cette CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin communauté de pratique leur a inculqué le réflexe de partager leurs connaissances et, d’autre part, que cette forme de partage de données probantes ou d’expériences leur a permis de maximiser leur capacité de raisonnement clinique. Conclusions : Les résultats à ce jour encouragent la poursuite de cette stratégie pédagogique qui a permis aux étudiants de construire une communauté de pratique encourageant le partage et le soutien. Ce mode d’échange fait aussi l’envie de cliniciens‐superviseurs. Poster Defense: Adultes santé phys., Établissement Impact du cirque sur la participation sociale en déficience physique Frédéric Loiselle (Centre de réadaptation Lucie Bruneau, Montréal) Annie Rochette, Catherine Briand, Sylvie Tétreault, Michel Lafortune [email protected] Introduction : Pour les jeunes vivant une déficience physique et leurs parents, la transition à la vie adulte est une période d’énormes défis. Isolés et perdus une fois sortis de l’école, ils connaissent peu les ressources disponibles. Lorsque leurs dossiers médicaux sont transférés aux secteurs adultes, jeunes et parents utilisent la métaphore de la chute dans le vide! La réadaptation adulte éprouve de la difficulté à les rejoindre. C’est là, que prend tout le sens d’expérimenter le Cirque Social. Approche mise de l’avant depuis 15 ans et à travers le monde par le Cirque du Soleil. Leurs objectifs rejoignent ceux prônés en réadaptation physique : Favoriser, à travers l’engagement du jeune, diverses formes d’apprentissage misant sur l’optimisation de leur participation sociale. Objectif : Cette étude qualitative (orientation phénoménologique) veut explorer les retombées d’une nouvelle approche en réadaptation physique adulte sur la participation sociale de cette population, et ce, en fonction de leur perception et celle de leur parent. Méthode : Douze jeunes âgés de dix‐huit à vingt‐cinq ans, seront exposés au cirque social (intervention), pendant neuf mois. Quatre rondes d’entrevues semi‐structurées, ancrées sur le processus de production du handicap (PPH), portant sur le phénomène de la participation sociale seront menées auprès des jeunes et du parent avant l’intervention, à la mi‐course, à la fin et six mois plus tard. Résultats escomptés : Optimisation de la participation sociale chez cette population en favorisant une plus grande autonomie au quotidien. Conclusion. Étude innovatrice ouvrant la voie à l’ère de la réadaptation sociale. Poster Defense: Pas de clientèle spécifique, Communauté Impacts de l’évaluation de l’indépendance à l’hygiène par le personnel auxiliaire Annie Carrier (Université de Sherbrooke, Sherbrooke) Mélanie Levasseur [email protected] Introduction. Les ressources ergothérapiques sont insuffisantes pour répondre aux besoins croissants des clients âgés en perte d’autonomie à domicile. Pour combler l’écart entre ces ressources et besoins, certaines activités cliniques des ergothérapeutes, dont principalement l’évaluation de l’indépendance à l’hygiène, sont assignées au personnel auxiliaire (PA). La pertinence, spécialement en milieu communautaire, de cette pratique en progression suscite des débats et soulève plusieurs questionnements. Objectif. Cet atelier permettra de favoriser une réflexion et une discussion des participants quant aux impacts positifs et négatifs d’assigner des activités d’évaluation à domicile au PA non membre d’un ordre professionnel. Approche. Cet atelier sera divisé en trois parties. Premièrement, des positions divergentes sur la question (pour et contre), soutenues par les écrits scientifiques et juridiques pertinents, seront présentées (20 min). Ensuite, en petit groupe de 6 à 8 personnes, des questions suscitant la réflexion permettront d’orienter et de soutenir la discussion des participants (20 min). Finalement, les points de vue des participants seront échangés en plénière (15 min). Conséquences pour la pratique. Cet atelier permettra aux participants de réfléchir et de discuter sur l’assignation d’activités cliniques des ergothérapeutes, principalement l’évaluation de l’indépendance à l’hygiène. Ainsi, les participants seront mieux outillés pour juger de la pertinence et des impacts positifs et négatifs de cette pratique dans leur milieu, et d’en discuter avec leur employeur. Conclusions. Tous les ergothérapeutes sont concernés par l’assignation d’activités cliniques au PA non CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin professionnel. Considérant sa progression et ses impacts, il est impératif que les ergothérapeutes réfléchissent et discutent de cette pratique. Poster Defense: Enfants/ Adolescents santé phys., Éducation L’approche CO‐OP en milieu scolaire, une option réaliste? Marie‐Ève Lebeuf (, Trois‐Rivières) Noémi Cantin Marie‐È[email protected] Introduction : Les données probantes supportant l’utilisation de l’approche CO‐OP en milieu clinique avec les enfants ayant un trouble d’acquisition de la coordination (TAC) s’accumulent depuis au moins 15 ans. Toutefois, bien que les difficultés des enfants TAC touchent souvent l’engagement occupationnel à l’école, l’approche CO‐OP n’a pas encore été testée pour son efficacité dans le milieu scolaire. Objectif : Identifier les éléments piliers de l’approche CO‐OP et proposer comment celle‐ci pourrait être adaptée pour le système scolaire québécois. Méthodes : Un revue de la littérature est présentement en cours afin d’évaluer comment l’approche a été adapté à différentes populations et différents milieux. Ensuite, un répertoire des pratiques auprès des commissions scolaires de la province du Québec sera fait afin de d’examiner comment le contexte de pratique propre au milieu scolaire influencera la structure d’une intervention CO‐OP. Conséquences pour la pratique : Des recommandations spécifiques seront offertes aux ergothérapeutes travaillant en milieu scolaire afin qu’ils puissent avoir des pistes d’intervention possibles lorsqu’ils travaillent avec les enfants ayant un TAC. De ces recommandations découlera un protocole d’intervention qui sera par la suite testé en milieu scolaire afin de recueillir des données probantes supportant son utilisation. Conclusion : En plus de faire un portrait sommaire de la dispensation des services d’ergothérapie en milieu scolaire pour la province de Québec, l’exposé met en lumière les possibilités d’action pour promouvoir l’ergothérapie dans ce type de milieu ainsi que de proposer des recommandations concrètes quant à l’application d’une approche prometteuse pour les clientèles TAC. Poster Defense: Adultes Général, Éducation La conférence web au service de la réadaptation Karine Charbonneau (Hôpital Louis‐H. Lafontaine ‐ Centre de recherche Fernand‐Seguin, Montréal) Catherine Briand [email protected] Introduction : Pour soutenir l’accès, l’appréciation et l’application en clinique des meilleures pratiques de réadaptation en santé mentale, il importe de proposer de nouveaux moyens d’enseignement et de formation continue qui unissent les forces des intervenants et des étudiants et permettent un réseautage entre étudiants, chercheurs et intervenants de la santé mentale. Objectifs : L’objectif de notre étude est d’identifier et de tester un outil de conférence web adapté aux personnes non initiées, Elluminate Live. Les objectifs spécifiques sont 1) d’identifier les études qui ont documenté l’utilisation en enseignement et formation continue de la conférence web, et 2) de tester la conférence web auprès d’un groupe restreint d’utilisateurs potentiels. Méthodes : Les études qui ont documenté l’utilisation en enseignement et formation continue de la conférence web ont été identifiées à partir de six différentes bases de données. Ensuite, la conférence web a été testée auprès d’un groupe restreint d’utilisateurs potentiels qui, suite à l’essai, ont donné leur appréciation via une entrevue semi‐structurée. Résultats : Les participants ont apprécié les différentes fonctions offertes par l’outil de conférence web Elluminate ainsi que sa simplicité. Ils ont rapporté que la conférence web permettait l’échange de connaissance, l’analyse critique et qu’ils utiliseraient cet outil dans le cadre de leurs fonctions. Ils ont par contre présenté certaines appréhensions sur le plan informatique et en lien avec la sécurité informatique institutionnelle. Conclusion : La conférence web est un outil intéressant d’enseignement et de formation continue permettant le réseautage. Elle occasionne cependant certains défis. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Adultes Général, Éducation La perception du rôle d'érudit en réadaptation de l'accident vasculaire‐cérébral Barbara Fillion (Université de Montréal, Montréal) Annie Rochette [email protected] Introduction : Les professionnels de la réadaptation de l'accident vasculaire cérébral (AVC) ont la responsabilité d’offrir des services de qualité ancrés dans les données probantes. Ceci relève de leur rôle d'érudit selon les différents cadres de compétences disciplinaires (CanMEDS ou autres). Objectif : Documenter la perception du rôle d'érudit chez les professionnels de la réadaptation de l'AVC, dont les ergothérapeutes. Méthode : Étude qualitative exploratoire d'orientation phénoménologique via des entrevues individuelles. Utilisation d'un guide d’entrevue prétesté. Critères d’inclusion : travailler en réadaptation de l'AVC depuis au moins deux ans. Transcription intégrale (verbatim) du contenu audio. Codification exhaustive à l'aide du logiciel QDA‐Miner. Contre‐codification de 10 % de l'ensemble du corpus. Résultats : La taille de l'échantillon est de 11 participants, majoritairement des femmes (n=9/11) dont l'âge moyen est 40,7 ans ± 11,2. Ils ont en moyenne 10,4 ans ± 7,3 d’expérience auprès de la clientèle AVC. Les thèmes principaux émergeant de l'analyse sont : 1) le rôle d’érudit est méconnu et dévalorisé, par rapport à d'autres tâches cliniques, en se limitant à la lecture d'articles scientifiques, 2) les participants valorisent les savoirs tacites et l'expérience tout en exprimant une perception négative de la recherche et 3) la pratique réflexive se révèle peu développée. Conclusion : Il semble y avoir un écart entre le rôle d'érudit tel que décrit par les cadres de compétences et la façon dont il est mis en action en pratique clinique, où il est peu valorisé. Peut‐on augmenter sa valeur? Poster Defense: Pas de clientèle spécifique, Théorie La recherche clinique qualitative est‐elle utilisée ? Manon Guay (Université de Sherbrooke et Centre de recherche sur le vieillissement, Sherbrooke) Johanne Desrosiers, Marie‐France Dubois [email protected] Introduction: La recherche clinique qualitative proposée par Crabtree et Miller (1999) et Miller et Crabtree (2000, 2003) invite les intervenants en santé, dont les ergothérapeutes, à s’intéresser aux questions de recherche qui émergent de leur pratique clinique quotidienne afin de favoriser des changements de pratique. Cette méthode est présentée dans différents ouvrages de référence, mais est‐elle vraiment utilisée ? Objectif : Recenser les articles scientifiques illustrant l’application de la recherche clinique qualitative. Méthode : Les mots clés Miller et Crabtree, apparaissant proches l’un de l’autre, ont été recherchés dans les bases de données en santé pour la période de 1999 à 2009. RÉSULTATS : Parmi les 2251 articles identifiés, 567 référent aux auteurs Miller et Crabtree. Toutefois, seulement sept offrent des précisions méthodologiques en lien avec la recherche clinique qualitative. De plus, Freundlich, Avery et Padgett (2007) sont les uniques auteurs qui rapportent avoir utilisé ce devis dans le but d’explorer la perception des détenteurs d’enjeux sur la sécurité des adolescents vivant dans les familles d’accueil de New York (États‐Unis). Conclusions : Malgré le fait que la recherche clinique qualitative soit proposée depuis plus d’une décennie, ses exemples d’application sont extrêmement rares. Pourtant, les repères offerts par Miller et Crabtree sont clairs et facilement applicables. Ils sont particulièrement utiles aux ergothérapeutes qui souhaitent intégrer la recherche à leur pratique quotidienne. Poster Defense: Adultes Psych./Soc., Communauté ESGR_SM ou comment évaluer la sécurité à domicile de la clientèle en santé mentale Marjorie Désormeaux‐Moreau (, Trois‐Rivières) Claire Dumont [email protected] Raison d’être : Dans le cadre du maintien à domicile de clientèles ayant des problèmes de santé mentale, la question de la sécurité devient incontournable. Aucun outil pour évaluer la sécurité à domicile de cette clientèle n’est actuellement disponible. Objectifs : Cette étude comporte deux volets : (1) concevoir un outil d’évaluation de CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin la sécurité à domicile spécifique à la clientèle en santé mentale, ici nommé l’Évaluation de la sécurité à domicile et de la gestion des risques pour la clientèle en santé mentale (ESGR_SM) et (2) évaluer la validité de contenu de cet outil d’évaluation. Méthode : Il s’agit d’une recherche de développement. La validation de contenu de l’outil d’évaluation prévoit la consultation d’experts du domaine. La population cible de cette recherche est ainsi constituée d’ergothérapeutes travaillant auprès d’une clientèle qui souffre d’un trouble de santé mentale et qui vit à domicile. Dix ergothérapeutes seront recrutés pour évaluer la validité de contenu au moyen d’une grille et elle sera ensuite estimée de façon quantitative à l’aide de l’indice de validité de contenu. Les commentaires ajoutés par les experts seront quant à eux traités suivant une méthode d’analyse qualitative. Conséquences anticipées pour la pratique : L’ESGR_SM représentera un outil de travail qui pourra aider les cliniciens à apprécier trois aspects de la sécurité à domicile (l’occupation, l’environnement et la personne) en une seule évaluation et conséquemment, guider leurs recommandations et leurs interventions sur ce plan. Conclusion : Ultimement, cette étude pourrait contribuer à la mise en place de meilleures conditions de maintien à domicile pour les personnes souffrant de troubles mentaux. Poster Defense: Adultes Psych./Soc., Communauté Le SeR: un outil projectif et interactif méconnu Marlène Falardeau (UQTR, Trois‐Rivières) [email protected] Introduction : Comment évaluer et explorer efficacement le concept de soi et les relations interpersonnelles de personnes ayant des problèmes affectifs afin d’améliorer leur participation occupationnelle? Au‐delà des nombreuses modalités en vigueur, il existe un outil méconnu : le SeR. À l’aide d’un échiquier et de jetons, la personne crée une scène qui sera discutée et transformée. Objectifs : L’exposé vise à faire connaître le SeR (Soi et Relations) et ses utilisations en ergothérapie, en s’appuyant sur une recherche qualitative. Méthodes : Le SeR a été administré à des femmes fréquentant une clinique externe en santé mentale. À l’aide de l’outil, elles ont représenté leur enfance, leur adolescence, leur vie actuelle et leur futur tel qu’elles l’imaginaient. Une analyse thématique a été utilisée pour traiter les données (16 rencontres). Résultats : Le SeR permet à la personne, et ce, en très peu de temps, de s’exprimer en profondeur sur ses diverses relations significatives. À travers cette expérience, elle apprend à se connaître et à découvrir un sens à ses occupations pour améliorer sa qualité de vie. Les participantes ont mentionné avoir été agréablement étonnées de la puissance thérapeutique de cet outil qui contraste avec la simplicité de ses consignes et de ses matériaux. Conclusions : Le SeR revêt une valeur thérapeutique considérable et il est facile d’utilisation autant pour le thérapeute que pour le client. Avec la pénurie actuelle d’ergothérapeutes, cet outil d’évaluation et d’intervention gagnerait à être connu; il s’est montré un catalyseur efficace de l’atteinte d’objectifs personnalisés. Poster Defense: Pas de clientèle spécifique, Théorie Les théories éthiques contemporaines peuvent‐elles être au service de la pratique de l’ergothérapie? Marie‐Josée Drolet (UQTR, Trois‐Rivières) marie‐[email protected] Introduction : L’éthique occupe une place de plus en plus prégnante dans nos sociétés démocratiques contemporaines, à la fois eu égard à l’éthique publique, à l’éthique de la recherche, à l'éthique des affaires, à l'éthique de l'environnement qu'à l'éthique professionnelle. Or, les théories éthiques normatives contemporaines que sont l’utilitarisme (Bentham, 2008; Mill, 1988), le déontologisme (Kant, 1980, 1985 et 1986) et l’éthique des vertus (MacIntyre, 2006) demeurent abstraites et loin de la pratique professionnelle. La question se pose dès lors de leur utilité et de leur applicabilité à la pratique de l’ergothérapie. Ces théories éthiques normatives peuvent‐elles aider les ergothérapeutes à résoudre les dilemmes éthiques qu’ils rencontrent dans leur pratique professionnelle? Ces théories peuvent‐elles outiller le raisonnement éthique des ergothérapeutes? Objectif : L’objectif de cette présentation est de montrer l’utilité et l’applicabilité de ces trois théories éthiques normatives à la pratique de CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin l’ergothérapie (Purtilo & Doherty, 2010; Seedhouse, 2009). Approche : Analyse documentaire des grands textes fondateurs de ces théories éthiques en faisant ressortir les valeurs et les principes utiles et applicables à la pratique de l’ergothérapie (Provencher, 2008). Conséquences pour la pratique : Rendre plus concrète l’éthique normative et la compétence professionnelle du Profil de la pratique de l’ergothérapie au Canada (ACE, 2007). Conclusion : L’exposé se veut une introduction générale à ces trois grandes théories éthiques normatives et montre la pertinence de les utiliser pour résoudre les dilemmes éthiques liés à la pratique de la profession ergothérapique. Poster Defense: Pas de clientèle spécifique, Communauté Lignes directrices : Recherche évaluative en réadaptation à base communautaire Marie Grandisson (Université d'Ottawa, Ottawa) [email protected] Raison d'être : La réadaptation à base communautaire (RBC) est une stratégie de développement communautaire inclusif visant l’égalisation des opportunités pour les personnes ayant des incapacités. Après plus de trente ans d’existence dans les pays à faible et moyen revenu, l’insuffisance des études scientifiques solides nuit grandement à la reconnaissance et l’avancement des programmes de RBC (Finkenflugel, Wolffers, & Huijsman, 2005). En conséquence, les personnes ayant des incapacités demeurent souvent exclues des initiatives pour améliorer la santé mondiale. Le manque de lignes directrices pour soutenir la recherche évaluative en RBC contribue certainement à cette situation qui a des répercussions majeures sur le rôle de l’ergothérapeute en santé mondiale. Objectifs : Proposer des lignes directrices pour faciliter la recherche évaluative RBC. Méthodes : Une recension systématique des écrits et un questionnaire complété en ligne par des experts sont utilisés. La théorisation enracinée combinée à des analyses quantitatives de regroupements sert à créer et valider la théorie substantive qui soutiendra les recommandations des lignes directrices. Résultats : Un cadre de référence pour l’évaluation de programmes en RBC est proposé : celui‐ci intègre les principales composantes de la matrice RBC au processus d’évaluation de Green et Kreuter (2005). Les recommandations pour l’évaluation de programmes seront présentées. Conclusions : Cette étude propose des lignes directrices qui peuvent faciliter et appuyer le travail des ergothérapeutes en santé mondiale. Elle est utile aux ergothérapeutes impliqués en évaluation de programmes communautaires incluant des personnes ayant des incapacités. Poster Defense: Adultes Psych./Soc., Établissement L'utilisation du modèle de Kawa en santé mentale adulte Ingrid Gilbert (Étudiante, Université du Québec à Trois‐Rivières, Shawinigan) [email protected] Introduction : Le modèle Kawa a été conçu pour être utilisé comme principe de base aux discussions avec des clients vus en ergothérapie (Turpin & Iwama, 2011, p. 173). Cependant, les cliniciens Richardson, Jobson & Miles (2010) communiquaient des doutes quant à l'utilisation du modèle avec des clients ayant des difficultés d'abstraction. La nouveauté de ce modèle fait en sorte qu'il y a peu d'information sur sa pertinence clinique, ce qui justifie le bien‐
fondé de mener une étude sur ce sujet. Objectif : L'objectif de cet exposé est de présenter les résultats d’une étude exploratoire sur l'applicabilité du modèle Kawa auprès de jeunes adultes présentant un problème de santé mentale. Méthode : La collecte de données a été réalisée auprès de trois clients, par l’entremise d’entrevues individuelles semi‐dirigées, en utilisant comme toile de fond le modèle Kawa. L'analyse des données du dessin de la rivière s’est réalisée via la stratégie du modèle mixte avec le modèle Kawa comme guide de classification. Conséquences pour la pratique : L’utilisation du modèle Kawa a permis à ces clients de cibler les difficultés qu’ils rencontrent dans leurs occupations, sans qu'ils soient influencés par des choix de réponses fournis à l'avance. Conclusion : Cette étude contribue à l'augmentation de nos connaissances sur la pertinence d'utiliser ce modèle auprès de ce type de clientèle dans l'établissement des objectifs thérapeutiques de leur plan d'intervention. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Poster Defense: Adultes Psych./Soc., Communauté Mesurer la charge de travail mentale: Bilan des outils actuels Valérie Tremblay‐Boudreault (, ) Marie‐José Durand, Marc Corbière Introduction: L'intensification du travail observée au cours des dernières années exige des ergothérapeutes de prendre en compte la charge de travail mentale dans leurs interventions en réadaptation au travail. Toutefois, il n'y a pas de consensus sur la façon de définir ce construit, ni sur la façon de le mesurer, complexifiant ainsi le choix d'un outil. Objectif: Dresser le bilan des différentes approches de mesure de la charge de travail mentale en considérant leurs forces et leurs limites respectives. Méthodes: L'identification et l'évaluation des référents empiriques actuels de la charge de travail mentale ont été réalisées à l'aide d'une analyse de concept (Walker et Avant, 2005). Cette approche prévoit une série d’étapes systématiques, ayant recours à la recension d'écrits. Les écrits en français et en anglais couvrant la période de 2000 à 2011 ont été considérés. Des mots‐clés pertinents ont été recherchés dans plusieurs sources (dictionnaires, bases de données, ouvrages de référence et sites internet spécialisés).Résultats: Des quatre grandes approches de mesure identifiées, les mesures subjectives semblent être celles qui répondent le plus aux besoins des ergothérapeutes en réadaptation au travail. Certains outils, comme le NASA‐Task Load Index (Hart et Staveland, 1988) et le journal de bord (Coutu et al., 2011) offrent des options intéressantes, mais leurs limites questionnent leur utilisation en réadaptation au travail. Conclusion: En attendant la conception d'un questionnaire répondant aux besoins des cliniciens en réadaptation au travail, cette analyse appuie l'utilisation des approches subjectives actuelles selon les recommandations pratiques proposées. Poster Defense: Enfants/ Adolescents Général, Administration Politique de santé Modèle d’évaluation des besoins et trouble d’acquisition de la coordination Emmanuelle Jasmin (Université de Sherbrooke, Sherbrooke) Jacques Joly, Sylvie Tétreault [email protected] Introduction : La prévalence du trouble d’acquisition de la coordination (TAC) est estimée à 6% chez les enfants de 5 à 11 ans. Ces enfants présentent de la difficulté à planifier, à organiser et à exécuter des mouvements pour réaliser leurs activités de la vie quotidienne (AVQ), ainsi que leurs activités et apprentissages scolaires. C’est souvent à l’école primaire que le TAC devient plus apparent et que ces enfants sont référés vers les services d’ergothérapie. Cependant, il ressort qu’au Québec, peu de services d’ergothérapie sont offerts à ce groupe et qu’aucune étude de besoins n’a été réalisée. Or, l’étude de besoins est une étape recommandée pour la planification et l’élaboration des services. Objectif : Proposer un modèle d’évaluation écosystémique pour identifier et prioriser les besoins des enfants ayant un TAC au primaire. Méthodes : Le modèle a été élaboré à partir d’une recension des écrits et du modèle écosystémique de Bronfenbrenner, auquel a été intégré le modèle du processus de production du handicap et la théorie de la motivation de Maslow. Il sera mis à l’essai auprès de deux enfants ayant un TAC, âgés entre 6 et 12 ans. La collecte de données inclura des questionnaires et des entrevues semi‐dirigées, ainsi qu’une analyse documentaire des dossiers de l’enfant. Résultats prévus : La mise à l’essai permettra de compléter ou modifier, le cas échéant, le modèle d’évaluation. Conclusion : Ce projet apportera des pistes de solutions et de réflexion pour mieux identifier et prioriser, d’un point de vue écosystémique, les besoins des enfants ayant un TAC. Poster Defense: Pas de clientèle spécifique, Éducation Modèle de collaboration université‐clinique pour les stages Marie‐Josée St‐Pierre (Université du Québec à Trois‐Rivières, Trois‐Rivières) Nancy Gilbert [email protected] Introduction : La pénurie de places de stage demeure une préoccupation bien présente pour l’ensemble des programmes universitaires. La collaboration étroite entre le milieu universitaire et les milieux cliniques représente un gage de réussite (Jensen et Cristy, 2010). Pour favoriser la participation des ergothérapeutes à la supervision, CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin l’élaboration d’un modèle de collaboration inspiré des travaux sur la gestion du changement (Rondeau, 1999) est amorcée par un établissement du réseau de la santé. Des conditions de succès tenant compte de la réalité de chacun y sont déployées. Objectifs : Présenter l’opérationnalisation et les retombées d’un modèle de collaboration entre université et milieu clinique. Méthodes/approche: L’affiche détaille le modèle, les étapes d’implantation et l’approche utilisée d’amélioration continue. Un questionnaire d’évaluation de la satisfaction a été administré à tous les ergothérapeutes et à leurs supérieurs. L’évaluation du milieu clinique par les étudiants et la recension de l’offre de stage pour ce milieu ont été réalisées. Résultats : Les résultats mettent en évidence la valorisation des ergothérapeutes, l’appui dans leur rôle de superviseur et le respect de leurs préoccupations par le programme universitaire. Les étudiants apprécient la cohérence entre les deux instances qui facilite leur intégration dans le milieu clinique. L’augmentation de l’offre de stage par l’utilisation de modalités de supervision novatrices est également à souligner. Conclusion : Ces résultats positifs appuient l’importance pour les programmes universitaires d’établir des modèles de collaboration structurés avec les milieux cliniques et précisent les incitatifs qui motivent les ergothérapeutes à contribuer à l’excellence de la formation clinique. Poster Defense: Adultes Général, Communauté Participation sociale à long‐terme chez l’enfant avec une maladie neuromusculaire Catherine Blackburn (Université de Sherbrooke, Sherbrooke) Jean Mathieu, Cynthia Gagnon [email protected] Introduction. La participation sociale à long‐terme associée aux rôles sociaux chez les enfants avec une maladie neuromusculaire est peu documentée et les interventions ergothérapiques sont souvent très restreintes lors du passage à l’âge adulte. Objectifs: Explorer la participation sociale associée aux rôles sociaux chez les adultes présentant la forme infantile de la dystrophie myotonique de type 1 (DM1). Méthode. Une revue rétrospective des dossiers a été effectuée chez les personnes atteintes de la forme infantile de DM1 (n = 63; vivant : plus de 12 ans) suivies dans une clinique des maladies neuromusculaires. La collecte des données a été réalisée à l’aide d’une grille d’extraction standardisée et d’une validation avec la gestionnaire de cas et le neurologue. La grille a été élaborée à partir de la classification du Processus de Production du Handicap. Résultats. Les personnes atteintes sont âgées entre 13‐54 ans. Les résultats pour l’ensemble des catégories seront présentés mais les analyses préliminaires démontrent une faible participation sociale à tous les niveaux. Parmi ceux‐ci, la majorité ont éprouvé des difficultés scolaires importantes (95.2%) et parmi ceux éligibles à l’emploi seulement 2% travaillent. Une forte proportion (73.0%) nécessite une forme de supervision ou d’aide pour demeurer à domicile. Conclusion. Cette étude a permis d’établir un premier profil qui démontre un pronostic réservé face à la participation sociale à long‐terme chez cette population. Elle permettra de réfléchir sur les services à offrir en ergothérapie lors de la transition des services pédiatriques vers l’adulte pour favoriser la participation sociale associée aux rôles sociaux. Poster Defense: Pas de clientèle spécifique, Administration Politique de santé Pratique professionnelle et gestion par programme. Comment concilier les deux Rachel Gervais (The Ottawa Hospital, Ottawa) Gina Doré [email protected] Introduction: Vers la fin des années 1990, certains hôpitaux canadiens ont vécu une fusion de plusieurs sites et sont passés d’une structure de département à celle par programme. Après douze ans de gestion par programme, une restructuration de la discipline en ergothérapie devint essentielle afin de mieux soutenir la pratique professionnelle et la qualité de la distribution des services aux usagers. Objectifs:Démontrer les avantages d’une restructuration professionnelle en ergothérapie centrée sur la pratique professionnelle dans un environnement de gestion par programme. Approche: Suite à la création de nouveaux postes de coordonatrice de la pratique professionnelle en ergothérapie, le gestionnaire en ergothérapie a voulu démontrer au directeur général de l’établissement les avantages de la restructuration. Un outil a été développé. La compilation et le suivi mensuel ont permis de CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin démontrer l’accomplissement de dix‐sept nouvelles initiatives en lien avec la restructuration. Ces initiatives seront présentées. Conséquences pour la pratique: La restructuration a permis une meilleure gestion de l’information et d’assurer un meilleur soutien professionnel. Une rencontre individuelle auprès de 47 ergothérapeutes a confirmé leur niveau de satisfaction.Conclusion :Une structure de pratique professionnelle en ergothérapie peut coexister avec une structure par programme et s’avère bénéfique pour la discipline en termes de soutien à la pratique professionnelle. Depuis, cette approche a été implantée dans cet établissement par les gestionnaires des autres professions de la santé Poster Defense: Adultes Psych./Soc., Éducation Processus de changement personnel en santé mentale : Un cadre conceptuel Danielle‐Edith Finlay (Université d'Ottawa, Ottawa) Marie‐Eve Pagé, Marie‐Eve Ricard, Claire‐Jehanne Dubouloz [email protected] Introduction : Mieux comprendre le processus de changement personnel de nos clients suivi en santé mentale est essentiel à nos interventions cliniques. Objectif : Cette recherche vise à construire un cadre conceptuel décrivant le processus de changement personnel chez ces adultes. Méthode : Une recherche documentaire des articles publiés entre 2007 et 2010 dans la base de données Medline (136 articles) a permis d’identifier six études qualitatives répondant aux critères d’inclusion et qui explorent ce processus de changement personnel. Une méta‐analyse a été faite avec les études sélectionnées. Résultats : Cette analyse a permis la conceptualisation d’un cadre conceptuel du processus de changement personnel de clients suivi en soins de santé mentale. Ce processus démontre qu’un individu vivant avec une maladie mentale doit passer par un processus de changement personnel complexe pour obtenir un nouveau sens à ses expériences et à sa vie. Le phénomène de transformation personnel a été associé dans cette exploration à la transformation identitaire. Conséquence pour la pratique : Le cadre conceptuel proposé démontre l’importance et la pertinence en tant qu’ergothérapeute d’être alerte au processus de changement vécu par ces clients. Ainsi, ces professionnels peuvent mieux comprendre et intervenir selon les besoins de la personne durant la démarche ergothérapique. Conclusion : La méta‐analyse a identifié un processus de changement complexe et générateur de compréhension sur le client en soins de santé mentale. Poster Defense: Personnes âgées Général, Communauté Profil des activités instrumentales : étude pilote auprès d’une population âgée Guillaume Paquette (Centre de recherche de l’Institut Universitaire de gériatrie de Montréal (CRIUGM), Montréal) Nathalie Bier, Carolina Bottari [email protected] Introduction : Le vieillissement cognitif normal se caractérise par des difficultés au niveau des fonctions exécutives (FE). Chez la clientèle âgée, les écrits suggèrent que l’indépendance lors des activités instrumentales de la vie quotidienne (AIVQ) est liée aux FE. Objectif : Explorer la faisabilité d’utiliser le Profil des activités instrumentales (PAI) dans le vieillissement. Cet outil permet d’évaluer le niveau d’indépendance dans les AIVQ en considérant les FE. Le PAI a été validé auprès d’une population cérébrolésée adulte. Méthodes : Le PAI a été administré au domicile des participants. Les tâches la préparation d’un repas chaud pour des invités surprises, la réalisation d’un budget et l’obtention d’une information. Des analyses quantitative (scores d’indépendance) et qualitative (verbalisations et comportements observables) de chaque tâche ont été réalisées. Les analyses quantitatives selon le cadre du PAI varient de dépendance (score de 0) à indépendance sans difficulté (score de 4). Résultats : L’utilisation du PAI auprès d’une clientèle âgée sans trouble cognitif (n=23; A=75,1 ± 5,9 ans; S=11H; MMSE=29,2 ± 1,0; scolarité= 12,1 ± 3,0) s’est très bien déroulée dans son ensemble avec quelques difficultés notées pour la compréhension de certaines consignes. Les résultats suggèrent une indépendance avec difficultés pour l’ensemble des tâches (3,5 ± 0,9) avec plus de difficulté pour les tâches obtenir une information et faire un budget (2,8 ± 1,2 et 2,7 ± 1,1 CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin respectivement). Conclusion : Les résultats suggèrent la possibilité d’utiliser le PAI auprès de la clientèle âgée et que ces personnes présentent des difficultés au niveau des FE se reflétant dans certaines de leurs AIVQ. Poster Defense: Adultes Psych./Soc., Administration Politique de santé Réadaptation et troubles mentaux graves: Enjeux et pistes d’action Catherine Briand (Université de Montréal, Montréal) Nicole Leduc, Hélène Racine, Helen‐Maria Vasiliadis, Jean‐
Louis Denis [email protected] Introduction : La littérature scientifique pour la réadaptation des personnes atteintes de troubles mentaux graves (TMG) identifient clairement les pratiques psychosociales à privilégier et celles qui sont fondées sur l'évidence scientifique (EBP – evidence based practices). Cependant, malgré qu’elles soient connues, les EBP ne sont pas encore assez intégrées. Objectif : L’objectif de cette conférence est de comprendre pour 3 régions du Québec les enjeux d’implantation des EBP et les actions à prioriser pour mieux répondre aux besoins de réadaptation de la population atteinte de TMG. Approche méthodologique : Le projet proposé est une étude de cas multiples où chaque cas est une région du Québec qui a pour mission d’offrir une gamme de services à sa population atteinte de TMG. Une collecte de données par entrevues et par consultation de documents officiels a permis de schématiser la programmation de réadaptation des 3 régions et de situer les enjeux et écarts en matière d’EBP. Résultats : Les résultats ont permis de situer plusieurs enjeux concernant l’accessibilité, la globalité, la coordination et la continuité des services et d’identifier, en concertation avec les gestionnaires de chaque région, des pistes d’action pour améliorer l’offre de services. Conclusion: Ces résultats amènent à réfléchir sur les rôles et les pratiques des ergothérapeutes au sein de réseaux locaux de services et sur comment ils peuvent arriver à déployer davantage leurs expertises dans des contextes de pénurie de ressources professionnelles. Poster Defense: Pas de clientèle spécifique, Communauté Représentations du rôle de l'expert en habilitation des occupations Martine Brousseau (UQTR, Trois‐Rivières) Marjorie Desormeaux‐Moreau, Marie‐Josée St‐Pierre [email protected] Introduction: La thématique de l’étude de l’appropriation du langage des occupations a peu fait l’objet de recherches empiriques. Elle s’avère essentielle à la supervision des futurs ergothérapeutes compte tenu que la formation des ergothérapeutes repose en partie sur des compétences décrites dans le Profil de la pratique de l’ergothérapie au Canada (ACE, 2007). Objectifs de la recherche : Cette présentation expose comment des ergothérapeutes superviseurs de stage se représentent les compétences reliées à « l’expert en habilitation des occupations ». Quel vocabulaire les cliniciens utilisent‐ils pour parler des occupations? Que signifie habilitation des occupations? Comment les cliniciens se représentent‐ils les six compétences associées au rôle d’expert en habilitation. Méthodes : Les résultats présentés proviennent d’une étude qualitative descriptive réalisée auprès de 56 ergothérapeutes superviseurs de stage. Les données ont été analysées par la méthode de comparaison. Résultats: Malgré que le langage associé à l’habilitation des occupations soit peu utilisé, les exemples rapportés reflètent une pratique centrée sur le client et ses occupations. Les principaux thèmes émergeant des entrevues sont présentés. Conclusion : L’appropriation du vocabulaire associé à l’expert en habilitation des occupations se fait aisément dans des groupes de discussion dans un contexte de collaboration université‐milieu clinique. Poster Defense: Enfants/ Adolescents Général, Administration Politique de santé Soutien aux parents d'enfants handicapés ‐ Exploration de stratégies novatrices Sylvie Tétreault (Université Laval, Québec) Hubert Gascon, Normand Boucher, Pascale Marier Deschênes, Pauline Beaupré, Monique Carrière, Geneviève Piérart, Isabel Margot‐Cattin, Pierre Margot‐Cattin [email protected] CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin Introduction : De plus en plus, l’ergothérapeute doit s’impliquer dans le développement de ressources d’aide pour les parents ayant un enfant handicapé. Comme ils assument de lourdes responsabilités, il faut s’interroger sur les façons de les soutenir efficacement. Objectif : La présente étude concerne le développement et la validation de stratégies de soutien destinées aux familles vivant avec un enfant handicapé. Elle vise aussi à les prioriser. Méthodologie : Un devis mixte (quantitatif et qualitatif) a été utilisé pour répondre aux objectifs. Des entretiens téléphoniques auprès d’informateurs‐clés ont été réalisés, afin de documenter les formes de soutien actuellement offertes. Également, une description des services proposés par près de 300 organismes œuvrant dans six pays (Australie, Belgique, Danemark, France, Suède, Suisse) et trois provinces canadiennes (Alberta, Ontario, Québec) a été complétée. À partir de ces données, 40 stratégies novatrices ont été dégagées puis priorisées lors de forums communautaires. Un forum électronique a aussi été utilisé. Résultats : D’abord, 39 membres d’organisations publiques ou communautaires du Québec ont été consultés. Puis, 77 intervenants et gestionnaires des autres régions ont fourni des informations sur les services offerts. Au total, 350 fiches décrivant les ressources ont été remplies. Quant à la priorisation des 40 stratégies, 187 personnes ont participé à 20 forums communautaires à travers le Québec. Six moyens de soutenir les familles sont ressortis en priorité. Conclusion : La concrétisation du soutien pour ces familles passe par l’investissement d’intervenants dédiés et l’ergothérapeute doit jouer un rôle‐clé dans l’amélioration de leurs conditions de vie. Poster Defense: Adultes santé phys., Communauté Téléréadaptation : Ses impacts sur l’empowerment et la pratique centrée sur le client Mélanie Levasseur (Centre de recherche sur le vieillissement, Sherbrooke) Émilie Breton, Noémie Royer, Michel Tousignant [email protected] Introduction: La téléréadaptation, définie par l’utilisation des technologies de télécommunications pour prodiguer à distance des traitements de réadaptation, est une pratique innovante permettant potentiellement d’augmenter l’accessibilité et l’efficacité des services. Toutefois, la téléréadaptation soulève des préoccupations, dont certaines sur l’empowerment et la pratique centrée sur le client. Actuellement, à notre connaissance, aucune étude n’a documenté l’impact de la téléréadaptation sur ces deux fondements de la réadaptation. Objectif : Explorer l’impact de la téléréadaptation sur l’empowerment et la pratique centrée sur le client. Méthode: Une étude qualitative de cas multiples a été réalisée impliquant deux programmes de réadaptation (téléréadaptation et face‐à‐face). Au total, six clients and quatre physiothérapeutes ont été interviewés. Une à deux entrevues semi‐dirigées ont été réalisées avec chacun des participants. Les entrevues ont été enregistrées, transcrites et codées selon une analyse de contenu thématique. Résultats: Grâce à la téléréadaptation, le client pourrait s’impliquer davantage dans son traitement et avoir une confiance en soi accrue. La téléréadaptation pourrait toutefois diminuer la libre expression du client. De plus, principalement dû au contact humain limité incluant l’absence du touché et à une communication plus difficile (langage corporel moins perceptible), la téléréadaptation pourrait restreindre la pratique centrée sur le client. Conclusion: Avant une utilisation étendue de la téléréadaptation, il serait important d’étudier davantage son impact sur l’empowerment et la pratique centrée sur le client. Des stratégies afin de diminuer l’impact potentiellement négatif de la téléréadaptation sur la pratique centrée sur le client doivent aussi être investiguées. Poster Defense: Enfants/ Adolescents Général, Communauté Transfert des connaissances : Le cas des couvertures et vestes lestées Jacques Gauthier (Ordre des ergothérapeutes du Québec, Montréal) Sylvie Beauchamp [email protected] Introduction : Une évaluation systématique de la littérature scientifique montre que la sécurité et l’efficacité des couvertures et des vestes lestées utilisées auprès d’enfants ne sont pas démontrées par des données probantes. Une stratégie de transfert des connaissances a été élaborée afin d’en favoriser un usage approprié et sécuritaire CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin par les divers utilisateurs. Objectif : Décrire la stratégie de transfert des connaissances appliquée. Méthode : Analyse du contexte d’utilisation, consultation d’experts, mobilisation des parties prenantes. Résultats : L’analyse contextuelle réalisée en cours d’évaluation a permis d’identifier les parties prenantes (ex. : ergothérapeutes, psychoéducateurs, enseignants) et les milieux concernés comme l’école, la garderie et le centre de réadaptation. Des interactions avec des experts ont permis de dégager les enjeux légaux et éthiques (ex. : utilisation dans un but de châtiment corporel ou de contention), de sécurité (ex. : absence de formation du personnel) et d’efficacité de la pratique (ex. : évaluation non systématique des résultats des interventions). Un comité constitué de représentants de trois ministères, de deux ordres professionnels et de deux organismes d’évaluation a ensuite été créé pour élaborer des stratégies communes et des outils intersectoriels et interdisciplinaires de transfert des connaissances (manuel, affiche, dépliant et vidéo). Conclusion : Les interactions avec des experts, étape essentielle du processus d’évaluation, ont été suivies d’une démarche active de mobilisation des parties prenantes afin de permettre l’appropriation des résultats de l’évaluation et de favoriser une prise de décision éclairée sur l’utilisation des couvertures et vestes lestées. Poster Defense: Adultes Général, Établissement Validation de la version française du Life Balance Inventory Nadine Larivière (Université de Sherbrooke, Sherbrooke) Judith Boisvert, Mélanie Levasseur, Eugénie Pinsonnault [email protected] Introduction. L’équilibre de vie est l’un des concepts fondamentaux de l’ergothérapie. Il n’existe actuellement aucun outil disponible en français permettant de bien le mesurer. Objectifs. Cette étude visait à traduire de l’anglais vers le français le Life Balance Inventory, questionnaire ergothérapique sur l’équilibre de vie subjectif (objectif 1) et de vérifier la validité convergente de la version française avec la santé et la qualité de vie perçues (objectif 2). Méthodes. Une validation transculturelle suivant la méthode de Streiner et Normand (2008) a été utilisée (objectif 1). Pour l’objectif 2, une étude descriptive transversale est en cours de réalisation auprès de 152 adultes âgés de 40 ans et plus, avec ou sans incapacité physique. Trois questionnaires sont administrés, soit l’Inventaire de l’équilibre de vie, le SF‐36 et l'Indice de qualité de vie. Résultats. Le processus de traduction dans les deux sens fut réalisé de façon indépendante par plusieurs ergothérapeutes bilingues provenant de différents domaines de pratique. La justesse de la traduction fut vérifiée par un traducteur professionnel. Un pré‐test fut complété avec huit participants. Des analyses préliminaires descriptives de 21 adultes sans incapacité ont été effectuées jusqu’à présent. La situation la plus fréquente est d’être en couple, avec des enfants et à l’emploi. En moyenne, les participants ont un équilibre de vie moyen dans toutes les dimensions : relations, activités stimulantes, identité personnelle et santé (entre 2,27 et 2,40 sur 3,0). Conclusions. L’Inventaire de l’équilibre de vie est un outil prometteur pour la recherche et la pratique des ergothérapeutes francophones. CAOT Conference  2012  Congrès de l’ACE June 6‐9 juin