British Journal of Occupational Therapy

Screening driving ability is challenging in psychiatry due to the fluctuating nature of psychiatric diagnoses, psychosocial factors, and the impact of medications. An examination of best practice and a literature review yielded few results, highlighting the need for the development of a driving screening framework. The goal was to develop a clinical reasoning guide, agreed upon by psychiatric occupational therapists, to improve systematic driving screening for this population.

A series of surveys distributed to occupational therapists examined the key components to consider, utilizing a modified Delphi technique. Data from 94 completed questionnaires over three rounds were filtered, analyzed, summarized, and redistributed. Survey distribution and guideline amendment continued until consensus was achieved.

The Saskatchewan Psychiatric Occupational Therapy Driving Screen (SPOT-DS) has been developed as the first comprehensive clinical reasoning guide for screening drivers with psychiatric conditions.

The SPOT-DS can assist in protecting clients’ driving privileges, while ensuring public safety on the roads by providing a systematic approach to screening drivers. Further testing on its validity is warranted.

Virtual reality has the potential to assist occupational therapists in preparing patients for discharge by facilitating discussions and providing education about relevant practical issues and safety concerns. This study aimed to explore the feasibility of using a virtual reality intervention to support patient discharge after stroke and pilot its use.

Practical aspects of delivering a virtual reality intervention prior to discharge were explored by means of a non-randomised feasibility study and a subsequent pilot randomised controlled trial. Factors considered included eligibility, recruitment, intervention delivery, attrition and suitability of outcome measures. Outcome measures included standardised assessments of stroke severity, mobility, health-related quality of life, functional ability, satisfaction with services and concerns about falling.

Thirty-three participants were recruited in total: 17 to the feasibility study and 16 to the pilot trial. At 1-month follow-up, 14 participants (82%) were re-assessed in the feasibility study and 12 (75%) in the pilot trial. The main difficulties encountered related to recruitment, particularly regarding post-stroke cognitive impairments, the presence of mild deficits or illness.

It was feasible to recruit and retain participants, deliver the intervention and collect outcome measures, despite slow recruitment rates. These findings could inform the design of a definitive trial.

The accomplishment of social roles and the satisfaction derived from participating in social roles are two important concepts in occupational therapy. Despite their importance, not much is known about how the two concepts differ. The objective of this study was to explore and compare the clinical and environmental factors correlated with accomplishment and satisfaction in social roles.

This secondary analysis used data from a nested mixed method study. Participants (n = 88) were Canadian adults, living with a range of neurological conditions. Linear regression analysis was used to identify factors that significantly affected the accomplishment and satisfaction of five social role domains (responsibility, interpersonal relationships, community life, employment and recreation).

The variable of mobility was significantly associated with accomplishment of all five social role domains. Stigma, however, surfaced as the most important variable for satisfaction with social roles. It was significantly associated with all social role domains except employment.

From this analysis it appears that social role accomplishment and satisfaction have distinct correlates. Stigma is an important correlate of social role satisfaction that needs to be understood in more depth and addressed by occupational therapists so individuals with neurological conditions can maximize their satisfaction with social participation.

Primary Sjögren’s syndrome is the third most common systemic autoimmune rheumatic disease, following rheumatoid arthritis and systemic lupus erythematosus, and results in dryness, fatigue, discomfort and sleep disturbances. Sleep is relatively unexplored in primary Sjögren’s syndrome. We investigated the experiences of sleep disturbances from the viewpoint of primary Sjögren’s syndrome patients and their partners and explored the acceptability of cognitive behavioural therapy for insomnia.

We used focus groups to collect qualitative data from 10 patients with primary Sjögren’s syndrome and three partners of patients. The data were recorded, transcribed verbatim and analysed using thematic analysis.

Five themes emerged from the data: (a) Experience of sleep disturbances; (b) variation and inconsistency in sleep disturbances; (c) the domino effect of primary Sjögren’s syndrome symptoms; (d) strategies to manage sleep; (e) acceptability of evidence-based techniques. Sleep disturbances were problematic for all patients, but specific disturbances varied between participants. These included prolonged sleep onset time and frequent night awakenings and were aggravated by pain and discomfort. Patients deployed a range of strategies to try and self-manage. Cognitive behavioural therapy for insomnia was seen as an acceptable intervention, as long as a rationale for its use is given and it is tailored for primary Sjögren’s syndrome.

Primary Sjögren’s syndrome patients described a range of sleep disturbances. Applying tailored, evidence-based sleep therapy interventions may improve sleep, severity of other primary Sjögren’s syndrome symptoms and functional ability.

Adolescents' motor competence influences their physical, social and emotional development. Parent-reported assessments may not be truly representative of their adolescent's motor difficulties. This study examined the congruency between parent- and self-reported motor competence in 133 parent-adolescent dyads.

The adolescent-reported Adolescent Motor Competence Questionnaire (AMCQ; ≤83) and the parent-reported Developmental Coordination Disorder Questionnaire 2007 (DCDQ-07; ≤57) cut scores classified 133 (M_age = 14.5 years) adolescents into high and low motor competence. Parents also completed the Swanson, Nolan and Pelham IV (SNAP-IV) for descriptive purposes.

A moderate correlation (r = 0.56, P < 0.001) was found between the AMCQ and the DCDQ-07 scores. Overall, 42 low motor competence cases were identified by both measures (AMCQ and DCDQ-07). Parents identified more boys (11) than girls (9) with low motor competence, whereas more female adolescents (22) self-reported low motor competence than boys (18). A high proportion agreement (0.82) was seen, which was principally due to the 91 (68.4% of sample) high motor competence case agreements.

Parents identified fewer motor difficulties in their adolescent, especially for girls. Self-report motor assessments may be more realistic for adolescents as they are aware of their own capabilities. Such measures are also more likely to identify previously undiagnosed adolescents with low motor competence.

Occupational therapy pre-registration programmes are increasing their academic entry criteria globally to positively impact on professional practice. However, there is a lack of evidence of how a range of variables influence student outcomes.

An observational, retrospective cohort design measured previous degree, age, ethnicity and gender, on final academic and practice placement outcomes of previous MSc Occupational Therapy (pre-registration) students (n = 153). Pearson’s product-moment correlation and one-way ANOVA tests were performed on the data to assess any significant relationships between variables.

There was a significant positive correlation between final academic percentage and practice placement outcome, r = .245, n = 121, p = .007. Previous degree significantly correlated with final academic outcome, r = .333, n = 153, p = .000, but not with higher practice placement performance. Gender, ethnicity and age did not correlate with student outcomes. Students with previous degrees in the arts performed slightly better than those with social sciences.

Prior academic ability significantly predicts academic but not necessarily practice placement outcomes on an MSc Occupational Therapy programme. Although more academically able students appear to develop skills for practice to a higher standard, other student values-based attributes should be measured prior to admission. Research exploring the best combination of academic and interpersonal skills for recruitment is required.