搜索结果：Journal of occupational rehabilitation

The lived experiences of peer mentors with spinal cord injury (SCI) provide distinct value in the rehabilitation process and contribute to improved outcomes. When combined with traditional therapy, peer mentorship programs can enhance life satisfaction among individuals living with SCI. To explore the impact that peer-led mentorship programs and interventions have on the rehabilitation outcomes for individuals with a spinal cord injury (SCI). PubMed, MEDLINE, PsycINFO, CINAHL, ERIC, Cochrane Database of Systematic Reviews, MedNar, and OpenGrey were searched between 2014 and 2024. The Cochrane Risk of Bias 2 tool was adapted and used to assess risk of bias in the included studies. Inclusion criteria included individuals with SCI who participated in peer mentorship and reported outcomes on quality of life, well-being, independence, or activities of daily living (ADLs) or instrumental ADLs. Exclusion criteria included interventions conducted via telehealth or reported outcomes of social participation. Five articles were analyzed for synthesis, which included individuals 18 yr and older with an SCI. Findings support peer mentorship as an important component of rehabilitation. Findings may have limited generalizability across different settings and populations because of the small number of available studies and variability in study designs, interventions, and outcome measures. None of the articles reviewed included occupational therapists. This review highlighted the benefits of peer mentorship in enhanced life satisfaction. Findings support peer mentorship as an important component of rehabilitation. Future research should examine the benefits of incorporating peer-led intervention programs across the continuum of care, including occupational therapy, in enhancing best practices in SCI rehabilitation. Plain-Language Summary: Peer mentorship programs can help people with spinal cord injuries adjust to daily life by providing guidance, support, and encouragement that professionals without lived experience may not offer. This review found that peer mentoring can improve psychological well-being and health management and reduce unplanned hospital visits. Evidence is limited because of the small number of studies and variations in study design; however, the results suggest that meaningful benefits may be present. Further research is needed to determine the most effective way to implement peer mentorship across rehabilitation settings.

The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. We estimated 1·17 billion (95% uncertainty interval 1·06-1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5-15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0-121·2) increase in prevalent cases and 24·2% (11·4-41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127-228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1-2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8-7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8-20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7-3014·1] per 100 000) than among males (1900·2 [1399·8-2510·8] per 100 000), and peaked in the 15-19 years age group (2617·3 [1850·6-3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7-1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9-4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1-2469·3) per 100 000 for middle SDI to 2184·1 (1606·1-2890·3) per 100 000 for high SDI. A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. Gates Foundation, Queensland Health, and University of Queensland.

Geriatric rehabilitation (GR) aims to optimise functional capacity and social participation in older adults through multidisciplinary care. Healthcare professionals (HCPs) play a key role, and a deeper awareness of patients' lived experiences may enhance the quality of care. Virtual Reality (VR) offers an innovative way for HCPs to step into the perspective of older adults and experience rehabilitation through their eyes. Recent studies increasingly highlight VR's potential to foster empathy and communication skills. To explore whether a VR movie can enhance HCPs' understanding and empathy regarding older adults' experiences during GR. In a mixed-methods design we combined structured questionnaires and focus groups. HCPs from four GR organisations viewed a 15-minute VR movie showing the rehabilitation process from the viewpoint of an older adult which was scripted based on earlier studies on this topic. After viewing, participants completed a questionnaire or took part in focus groups discussing their experiences. In total, 160 HCPs completed the questionnaire and 18 participated in a total of three focus groups. Most participants (85%) reported increased awareness of older adults' experiences, and 95% indicated that they would recommend the VR movie to colleagues. Thematic analysis identified three key themes reflecting how HCPs, when adopting the older adult's perspective, perceived the rehabilitation experience: (1) feeling overwhelmed, (2) being dependent and vulnerable and (3) lack of clarity in staff routines. Participants additionally suggested practical improvements in daily care. The VR movie appears to be an effective educational tool in raising understanding and empathy among HCPs in GR.

Chronic kidney disease and treatment have a severe and detrimental impact on life participation, reducing independence, autonomy, physical and cognitive function requiring a multidisciplinary approach. Occupational therapists have comprehensive skills in enabling independence and quality of life, yet the role in a kidney team is poorly understood. To identify occupational therapy services for adults diagnosed with kidney disease which will inform future practice, service planning and role definition. Following Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR guidelines, PubMed, Scopus, PsycINFO-OVID, ProQuest, and CINAHL were searched from inception to 15 December 2025. The population of interest was adults at any grade of kidney disease, the concept being occupational therapy services/models of care, and the context of any service setting. Results were transferred from Endnote to Covidence, duplicates removed and the title and abstract of articles screened. The full text of the remaining articles was assessed by two researchers, and themes were identified in alignment with the research questions. The search provided 1603 results, with 434 duplicates removed leaving 1169 articles. Following title and abstract screening, 40 papers remained for full text review, resulting in 23 studies for data extraction and analysis. Themes identified included types of occupational therapy interventions, grade of disease progression when interventions were undertaken, models of care and service location. The most reported occupational therapy roles related to activities of daily living, equipment prescription and mental health interventions. While the occupational therapy role for patients with kidney disease is evolving worldwide, notably over the past 5 years, it is still underutilised. Further research is required to inform the development of clinical practice guidelines for clear role delineation.

In a new long-term transitional rehabilitation service following acquired brain injury, occupational performance problems are analysed. The objective was to describe these problems and the participants' prioritization, and also to describe the changes between admission and discharge. Another objective was to describe changes in assessed independence-related disability. Observational clinical study. Young adults (18-25 years), (n = 46), who had earlier undergone traditional medical rehabilitation following acquired brain injury. The Canadian Occupational Performance Measure (COPM) was used on both admission and discharge. Independence-related general disability was assessed using the Glasgow Outcome Scale-Extended (GOSE). Patients identified 122 occupational performance problems as important. Most problems were in socialization (3/7), community activities (1/3), and finding paid or unpaid work (1/4). Self-rated levels of performance and satisfaction in COPM were significantly higher on discharge compared with admission. The range of GOSE scores increased from 4-6 to 4-8 between admission and discharge. Young adults with acquired brain injury tend to prioritize rehabilitation goals to reduce difficulties in establishing relationships and/or in professional life. On discharge, ratings of implementation and satisfaction of performance were distinctly elevated, while assessed global disability was decreased. The results highlight the need for transitional rehabilitation for patient-centred remediating measures.

Diabetic foot ulcers (DFUs) affect approximately 25% of people with diabetes and are associated with decreased quality of life, high healthcare costs, recurrent wounds, and amputation risk. Standard DFU care emphasizes offloading to promote healing; however, adherence is often poor due to behavioral, psychosocial, and everyday life challenges. These gaps highlight the need for person-centered interventions that support DFU self-management within daily routines. To systematically adapt a Lifestyle Redesign® occupational therapy intervention (LR-OT) for DFU self-management using the ADAPT-ITT framework. An iterative, stakeholder-engaged adaptation process was conducted across the first seven ADAPT-ITT phases: Assessment, Decision, Administration, Production, Topical Experts, Integration, and Training. Activities included targeted literature synthesis, theater testing with individuals with DFUs and DFU care providers, iterative material development, and expert consultation. Adaptation efforts focused on refining intervention content, delivery, and training supports to DFU-specific care demands while retaining alignment with LR-OT core elements. The ADAPT-ITT process yielded an interventionist-ready, DFU-specific LR-OT package, including patient-facing materials, an interventionist resource guide, and a conceptual mapping linking LR-OT theoretical elements to DFU-targeted management activities. Stakeholder input informed coordinated refinements to content, session structure, and delivery to support feasibility within DFU care contexts. Application of the ADAPT-ITT framework supported a transparent, stakeholder-informed, and reproducible process for adapting an evidence-based occupational therapy intervention for a high-risk and medically complex population. This work illustrates how lifestyle-focused interventions can be systematically adapted for specialty care contexts, with subsequent testing needed to evaluate fidelity and effectiveness. #NCT06278935. Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes. They can interfere with daily life, often return after healing, and may lead to amputation. A key part of DFU care is “offloading,” which involves special footwear or casts to reduce pressure on the foot. Many people find it hard to use these devices consistently because everyday responsibilities, discomfort, emotional stress, and limited support. This project focused on adapting an occupational therapy program called Lifestyle Redesign® to better support people managing DFU in their daily lives. Rather than creating a new program, the research team used a structured adaptation process called ADAPT-ITT to modify an existing evidence-based intervention so it better fit the realities of DFU care. The process involved gathering input from people with DFUs, healthcare providers, and clinical experts through focus groups, interviews, review of materials, and expert consultation. The adaptation process resulted in new patient materials and resources for occupational therapists that address offloading use, foot checks, emotional well-being, and integrating DFU care into daily routines. This work shows how occupational therapy interventions can be thoughtfully adapted and integrated into multidisciplinary teams to support DFU self-management in specialty care settings.

(1) Background: Driving enables participation and independence for persons with disabilities; however, Korea lacks standardized driver rehabilitation guidelines and clearly defined occupational therapy roles. Current evaluations at the National Rehabilitation Center (NRC) rely heavily on instructors' experiential judgment, resulting in inconsistent fitness-to-drive decisions. This study developed and field-tested a comprehensive driving evaluation (CDE) tailored to the Korean service context, integrating structured off-road functional assessment with on-road driving evaluation through a collaborative occupational therapist-driving instructor model. (2) Methods: The off-road assessment was refined through a literature review, an analysis of the ICF Core Set for driving rehabilitation, expert surveys, and a workshop with 10 occupational therapists. The on-road assessment was adapted from international tools and validated by NRC driving instructors and an expert committee. The CDE was field-tested with 30 persons with physical disabilities, cerebral palsy, or auditory disabilities enrolled in the NRC Driving Education Program. Eligibility for independent driving was classified as "eligible" or "doubtful." (3) Results: The CDE was feasible within existing workflows. Off-road deficits predicted on-road difficulties, and cases with discordant judgments benefited from combined assessment. (4) Conclusions: The CDE offers a structured alternative to experience-based evaluations and supports interprofessional collaboration, providing foundational evidence for standardized driver rehabilitation in Korea.

Occupational therapy plays a crucial role in the rehabilitation and recovery of individuals facing acute psychiatric challenges. However, the practice within acute psychiatric inpatient settings is often fraught with unique challenges that can hinder effective intervention. This qualitative study is aimed at exploring the multifaceted obstacles and challenges that occupational therapists encounter in these environments. This study utilized a qualitative approach with conventional content analysis. A total of 14 participants were involved, comprising active and experienced therapists, individuals currently hospitalized in acute settings, and psychiatrists. After obtaining ethical approval and informed consent, in-depth, unstructured interviews were conducted in accordance with the research objectives. Purposeful sampling and maximum diversity strategies were employed to select and invite participants, who subsequently underwent in-depth, semistructured interviews. The interviews were meticulously recorded and subsequently transcribed. The transcribed texts were subjected to analysis through the inductive qualitative content analysis. The challenges associated with implementing occupational therapy interventions in acute psychiatric inpatient settings were categorized into five main areas: patient engagement, therapist safety concerns, burnout and high work pressure, lack of standard facilities and space, and unawareness of the need for such interventions. Considering the various challenges faced by occupational therapists in acute psychiatric inpatient settings, a comprehensive and coordinated approach is essential. Issues such as patient engagement, therapist safety concerns, burnout and high work pressure, lack of standard facilities, and unawareness of the need for such interventions all impact the effectiveness of therapy. Ongoing training and education, coupled with supervision and mentorship, can empower therapists and promote self-care practices to mitigate burnout. Fostering interdisciplinary collaboration, conducting regular meetings to discuss patient progress, and ensuring role clarity among team members are essential to facilitate comprehensive care. Providing adequate facilities and resources, ensuring safe working conditions, and raising awareness about the importance of occupational therapy are crucial.

Hip and knee pain are leading contributors to disability, reduced quality of life, and health care burden in Canada. Primary care is often the first point of contact for patients with these conditions, yet timely and appropriate care is limited due to provider shortages and system pressures. Interest is growing in interprofessional primary care models that integrate physiotherapists to enhance care delivery for musculoskeletal conditions such as hip and knee pain. This study aims to communicate the protocol and analysis plan for a trial with two objectives: (1) to evaluate the effectiveness of a physiotherapist-led primary care model for hip and knee pain on physical functioning (primary outcome), pain intensity, quality of life, global rating of change, patient satisfaction, and adverse events, compared to usual physician-led primary care; and (2) to assess the impact of this model on health care system and societal outcomes, including access to care, health care use, productivity loss, and cost-effectiveness. A process evaluation will examine implementation, potential mechanisms, and patient experiences. A cluster randomized controlled trial involving 14 primary care organizations randomized equally to either a physiotherapist-led or usual physician-led primary care model for patients with hip and knee pain. Patients were recruited over 1 year, with data collected at baseline and at 3, 6, 9, and 12 months. The intervention integrates a physiotherapist as the initial point of contact within the primary care team for patients seeking care for hip or knee pain. It includes four components: (1) comprehensive assessment and screening, (2) brief individualized interventions during the initial visit, (3) guidance for accessing additional health care resources, and (4) follow-up physiotherapy for patients with unmet needs. Effectiveness will be assessed using linear mixed regression, accounting for clusters and prespecified covariates. The multimethods process evaluation will include descriptive and comparative analysis of implementation, mediation analysis to explore potential mechanisms, and qualitative exploration of patient experiences. This research was funded in December 2022. Primary care sites (clusters) were recruited and randomized in June and July 2023, respectively. Patient enrollment occurred from October 2023 through November 2024. The final patient follow-up survey was completed in November 2025. Extraction of data from electronic health records is expected to finish in December 2025. Data analysis will begin after data collection is complete and will follow the predefined protocol and analysis plan. No interim analyses are planned. Findings from this trial will provide actionable evidence on whether integrating physiotherapists into primary care teams for hip and knee pain improves patient outcomes and health care system efficiency. Effectiveness and process evaluation evidence will inform policymakers and health system leaders on the adoption and implementation of interprofessional, team-based primary care models. ClinicalTrials.gov NCT06358521; https://clinicaltrials.gov/study/NCT06358521. DERR1-10.2196/89006.

Stroke often causes spasticity, impacting mobility and quality of life. Botulinum Toxin type A (BTX-A) and Dry Needling (DN) are treatments that reduce spasticity, although Botulinum Toxin type A injections can cause adverse effects. No studies have directly compared their effects at spinal, muscular, functional, quality-of-life, and cost-effectiveness levels. This study aims to determine the spinal mechanisms of BTX-A and DN on post-stroke lower limb spasticity, while also assessing feasibility, safety, and exploratory effects at muscular, functional, quality-of-life, and cost-effectiveness levels. This is a protocol of a proof-of-concept, feasibility randomized clinical trial including 90 participants from Canada, Belgium, and Spain who experienced a first stroke in the previous 12 months and present plantar flexor spasticity. Time since stroke (0-12 months) will be recorded and explored as a potential modifier of treatment response. Participants will be randomly assigned to receive either one session of BTX-A or 12 weekly sessions of DN. Blinded evaluators will assess outcomes before, during, and after treatment, with a 4-week follow-up. The primary outcome will be spinal mechanisms of spasticity, measured using the Tonic Stretch Reflex Threshold and its velocity sensitivity. Secondary outcomes will assess: a) muscular architecture and echotexture (measured with ultrasound); b) muscle tone/resistance using the Modified Ashworth Scale; c) gait and mobility (instrumented analysis, Timed Up and Go, 10-Meter Walk Test); d) muscle strength with dynamometry; e) quality of life with the EuroQoL questionnaire; and f) cost-effectiveness (analytic model). The findings will provide preliminary data to inform a future definitive trial. This research project has secured funding from the NEURON ERA-NET 2022 call, supported by the European Union's Horizon 2020 program (GA 964215) and co-funded by the European Union-Next Generation, and has undergone peer review. Ethical approval has been obtained from Spain, Canada, and Belgium. The study is registered in ClinicalTrials.gov (NCT06296082) and the Clinical Trials Information System (CTIS) under the number 2024-510866-18-00. The study protocol is registered on Zenodo (https://doi.org/10.5281/zenodo.20034064). Clinical Trials NCT06296082; https://clinicaltrials.gov/study/NCT06296082.

To investigate the effectiveness of maintenance interventions postexercise therapy on physical activity (PA), physical function, fitness, health-related quality of life, adverse events, hospitalisation and return to work in people with chronic conditions. In this umbrella review, a narrative synthesis was conducted. Risk of bias was assessed using the Risk of Bias in Systematic Reviews tool. The quality and certainty of evidence were evaluated using Grading of Recommendation, Assessment, Development and Evaluation. Medline, Embase and CINAHL were searched from inception to 20 August 2024. Systematic reviews of randomised controlled trials (RCTs) investigating the effectiveness of maintenance interventions following exercise therapy in people with chronic conditions. From 10 931 results, 19 systematic reviews (136 unique RCTs) were included. Reviews included people with chronic respiratory disease (n=64), cardiovascular disease (n=54), chronic low back pain (n=4) or knee/hip osteoarthritis (n=14). Most reviews had an unclear risk of bias (n=10). We identified three types of maintenance interventions based on delivery mode: primarily digital, primarily inperson and a mixed category comprising exclusively digital, inperson or hybrid delivery. Beneficial effects were found for digital health interventions on subjective PA (standardised mean difference (SMD) 0.37, 95% CI 0.05 to 0.69, low certainty), but no beneficial effects were found for inperson booster sessions (very low to low certainty). Mixed maintenance interventions showed beneficial effects for health-related quality of life (MD 0.28 points 95% CI 0.05 to 0.52; SMD 0.22 95% CI 0.03 to 0.41; MD -2.69 points 95% CI -4.49 to -0.9; moderate certainty), objective PA (SMD 2.14 95% CI 0.9 to 3.38, low certainty) and objective physical function (SMD 0.48 95% CI 0.19 to 0.77, low certainty). We found no effect or inconsistent effects for fitness, adverse events, hospitalisation and return-to-work (low to moderate certainty). Maintenance interventions may help people continue to be physically active and improve physical function and health-related quality of life. However, this is based on low certainty of evidence. The remaining outcomes were generally inconsistent or indicated no effects. Digital maintenance interventions show some beneficial effects for PA but higher-quality studies are needed across various chronic conditions. CRD42024579734.

Taste and smell disorders are predominant symptoms of acute SARS-CoV-2 infection and can persist in individuals with post-acute sequelae of SARS-CoV-2 infection (PASC), commonly referred to as Long COVID. These sensory impairments continue to significantly affect daily life and wellbeing, yet clinical understanding and care strategies remain insufficient. There is an ongoing need to address the specific healthcare requirements of this population. The aim of this study was to describe the experiences and perceptions of individuals with Long COVID related taste and smell disorders regarding symptom management and the challenges affecting continuity of care. A qualitative descriptive study was conducted in 2024 in the Community of Madrid (Spain) using purposive sampling. Data were collected through in-depth interviews and analyzed using thematic analysis, an approach appropriate for examining patient experiences in healthcare. Twelve participants with previously confirmed SARS-CoV-2 infection and persistent loss and/or impairment of taste and smell were interviewed. Four themes were identified: (a) Implications of Long COVID taste and smell disorders, (b) Expectations regarding prognosis and symptom cure, (c) Professional approach and symptom management, (d) Barriers and facilitators to continuity of care. Findings highlight the clinical and social relevance of taste and smell disorders in Long COVID and illustrate how qualitative methods can capture patient perspectives that may inform future mixed-methods research.

This study outlines the revision and content validity process for the Domestic and Community Skills Assessment, Third Edition (DACSA-3). The DACSA-3 is an occupational therapy instrumental activities of daily living (IADL) assessment, which can be used to assess a person with a mental health condition. The DACSA-3 was developed by considering past development and research, technology changes, and current occupational therapy theories. Nine content experts (occupational therapists with mental health experience) were involved in a qualitative and quantitative review of the DACSA-3 to establish content validity using the content validity ratio (CVR) and content validity index (CVI), with recommended minimum thresholds of 0.78. The DACSA-3 was reviewed by two content reviewers (professionals with lived mental health experience) to ensure that recovery oriented language was included. The Initial Interview was retained and updated. The Supporting Interview was removed, because it lacked construct validity. The Observation Checklist was renamed to Context List and updated to include environmental and personal factors that may influence task performance. The Objective Assessment subtests were updated and reduced from 17 to 14 subtests. The money handling, personal presentation, and postage handling subtests were removed, because they were no longer relevant or did not fit the occupational category of IADL. The scoring criteria for each subtest were improved by aligning with the rating scale definitions to prevent discrepancies between ratings and clinical judgement. The CVR of DACSA-3 items ranged from 0.78 to 1.00, and the CVI of the DACSA-3 was 0.98. The DACSA-3 is a revised, contemporary occupational therapy assessment of IADL, which has content validity. The CVR and CVI exceeded the minimum recommended thresholds, and thus, the content validity of the DACSA-3 was established. Modifications were made to the DACSA-3 to reduce the administration time and it no longer contains a screening tool. This study describes how the Domestic and Community Skills Assessment, Third Edition (DACSA‐3) was updated. The DACSA‐3 is an occupational therapy test. It can be used to measure the living skills of people with a mental health condition. The update considered earlier research, changes in tasks over time, and current occupational therapy theories. Two content reviewers checked the test to ensure current mental health language was used. Nine occupational therapists then reviewed it step by step to confirm that it was a good measurement of living skills. The Initial Interview was kept and updated. The Supporting Interview was removed because it was not considered a good measurement. The Observation Checklist was renamed the Context List and updated. The subtests were reduced from 17 to 14. The money handling, personal presentation, and postage handling subtests were removed. They were no longer relevant or did not fit with other living skills. The scoring was also improved to reduce differences between ratings and therapist judgement. Overall, the DACSA‐3 is a current test of living skills. It takes less time to complete and no longer includes a screening tool.

The Ergonomic Risk Assessment for Musculoskeletal Disorders in Office Workers (ERAMO) questionnaire is used by office workers, practitioners or researchers to screen for ergonomic risk factors in the office environment. The study aims to establish the validity and reliability of the Turkish version of ERAMO questionnaire among office workers. A total of 116 office workers, 67 women and 49 men, participated in the study. Reliability was assessed through test-retest reliability and internal consistency measures. Validity was evaluated by structural, content, and face validity analyses. Floor and ceiling effects were examined to provide a comprehensive evaluation. ERAMO's correlation with pain intensity, New York Posture Rating (NYPR), and Short Form-36 (SF-36) was also examined. ERAMO demonstrated high reliability, with an intraclass correlation coefficient (ICC) value of 0.802 and a Cronbach's α of 0.890. Structural validity was affirmed through both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA revealed four factors, accounting for 61.888% of the total variation. ERAMO's total score exhibited no floor or ceiling effect. ERAMO exhibited correlations ranging from poor to moderate (-0.185 to -0.413) with pain intensity, NYPR, and SF-36 subscales. ERAMO has demonstrated high reliability and good validity. ERAMO can be used to evaluate ergonomic risks among Turkish-speaking office workers.

Performance-based tests (PBTs) objectively assess functional capacity and are increasingly applied in fibromyalgia (FM) to complement patient-reported outcomes (PROMs). However, evidence regarding their reliability, especially considering patients' socio-occupational status, is limited. This study aimed to determine test-retest reliability of a standardized PBT battery in women with FM and to examine the influence of employment status on measurement stability. A total of 119 women were assessed (89 with FM). The battery included the 6 min walk test (6MWT), handgrip strength test (HST), and 8 feet up and go test (8FUGT). Test-retest reliability was examined using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest real difference (SRD). Analyses were conducted for the total FM group and socio-occupational subgroups (actively working, claiming disability, and permanent disability). All PBTs demonstrated excellent test-retest reliability. Measurement stability was consistently higher in controls. Absolute reliability indices confirmed acceptable measurement stability. However, the claiming disability group showed markedly higher SEM% and SRD% for HST, suggesting reduced reproducibility. The 6MWT and 8FUGT maintained excellent reliability and stability across all groups. PROMs showed good-to-excellent reliability. PBTs showed excellent reliability in women with FM. However, reliability varied across socio-occupational groups, particularly for HST in patients claiming disability. PROMSs showed lower reliability than PBTs.

Often unrecognized and frequently overlooked, the inclusion of social determinants of health in stroke management is critical to improving outcomes. Using the National Institute of Neurological Disorders and Stroke working group Determinants of Inequities in Neurological Disease, Health, and Well-being framework, this article reviews structural, social status, intermediate, intrapersonal, and biological determinants of health inequities and their impact on equity in neurologic health after stroke. It is imperative that social determinants of health are evaluated as a requirement for effective stroke prevention and rehabilitation. To optimize secondary stroke prevention and improve stroke outcomes, it is critical to include social determinants of health as components of poststroke management, starting during the acute hospitalization and continuing through outpatient management. Interdisciplinary services, such as social work, care coordination, behavioral health, physical and occupational therapy, speech and language pathology, and chaplaincy, provide additional resources to help stroke survivors and their caregivers.

As organisations increasingly prioritise inclusive employment, more people with disabilities are entering the workforce. Hearing loss, a common yet often invisible disability, presents a significant and under-recognised occupational health challenge. This scoping review synthesises evidence on how individuals with hearing loss navigate workplace demands and examines the implications for occupational health policy and practice. A scoping review of literature published between 2010 and 2025 was conducted following PRISMA-ScR guidance. Systematic searches were completed across Scopus, PubMed/MEDLINE, and Web of Science to identify studies examining hearing loss in relation to work participation and occupational health outcomes. Eligible studies were synthesised using thematic analysis. Thirty-four studies met inclusion criteria across diverse countries and occupational settings. Four interrelated themes were identified: (1) individual strategies for managing hearing loss at work, including communication approaches and decisions around disclosure; (2) workplace accommodations, encompassing technological and environmental supports, training and organisational initiatives, and social connectedness, alongside persistent gaps between policy intent and practice; (3) occupational health and wellbeing outcomes, including psychosocial impacts, work-related fatigue, need for recovery, identity negotiation, and occupational stress; and (4) multi-level recommendations addressing individual, organisational, and policy domains to support sustainable employment. Hearing loss in the workplace presents substantial occupational health implications, including psychosocial stress, communication barriers, and increased need for recovery after work. Workplace accommodations show potential to support inclusion and improve health outcomes, yet implementation remains inconsistent. Further research is needed to rigorously evaluate occupational health interventions and accommodations, particularly within low- and middle-income contexts where evidence is limited.

To examine the inter-rater reliability and construct validity of a Movement Quality Score (MQS) within the Standard Physical Therapy Assessment (SPTA) across diagnostic groups. Cross-sectional study. Eighty-four hospitalized patients undergoing rehabilitation for neurological, musculoskeletal, or internal medical conditions were included. Inter-rater reliability was assessed in 68 participants independently evaluated by 2 physiotherapists. The MQS was scored using the SPTA component. Inter-rater reliability of the summed score was analysed using the intraclass correlation coefficient (ICC [2,1]). Construct validity was examined using Spearman's rank correlations between the MQS and the Functional Independence Measure (FIM) motor total score and its subdomains (self-care, sphincter control, transfers, and locomotion), as well as other SPTA components. The MQS demonstrated excellent inter-rater reliability (ICC [2,1]&#x2009;=&#x2009;0.93). It showed a very strong correlation with the FIM motor total score (&#x3c1;&#x2009;=&#x2009;0.91, p&#x2009;<&#x2009;0.001), with strong associations for transfers and locomotion (&#x3c1;&#x2009;=&#x2009;0.92) and self-care (&#x3c1;&#x2009;=&#x2009;0.86). The correlation with sphincter control was lower (&#x3c1;&#x2009;=&#x2009;0.68). The MQS demonstrates excellent reliability and strong construct validity, supporting its use as a movement-focused complement to activities of daily living-based assessments in heterogeneous rehabilitation populations.

Determining whether individualized occupational therapy (OT) can be feasibly and safely provided to intensive care unit (ICU) patients is essential. The aim of this study is to investigate the feasibility and safety of providing individualized OT programs in the ICU based on functional assessment outcomes. This study was designed as a retrospective cohort study. The study was conducted in the ICU of a tertiary university hospital. Patients referred for ICU rehabilitation who met predefined ICU OT inclusion and exclusion criteria and initiated ICU OT between February 2021 and December 2023 were included. Based on functional evaluation, each patient's individualized OT program was classified into cognitive training, functional and activities of daily living (ADLs) training, or a combination of cognitive training and functional and ADL training. Feasibility was assessed based on eligibility, initiation and interruption rates, time to OT initiation, missed or deferred sessions, and adherence to the intervention framework. Safety was evaluated by whether OT sessions were discontinued or prescriptions were terminated owing to adverse events based on predefined criteria during OT delivery. Among 828 patients referred for ICU rehabilitation, 184 (22%) met eligibility criteria, and 158 patients initiated the ICU OT program. Among these, 55 patients (34.8%) completed all prescribed OT sessions, whereas 103 (65.2%) did not, yielding a program interruption rate of 65.2%. The median time from OT prescription to the first session was 1 day. No sessions were canceled owing to patient refusal, and only one session (0.15%) was deferred because of agitation. Only one adverse event (hypotension) occurred during OT delivery. Individualized ICU OT can be feasible and safe to be implemented for ICU patients who meet predefined eligibility criteria when interventions are guided by structured functional assessments and clearly defined criteria for treatment discontinuation or termination.