British Journal of Occupational Therapy

Goal-setting in client-centred occupational therapy is often problematic. The Assessment of Client's Enablement was developed to measure the gap between an occupational therapist's and client's ratings of occupational performance. This study examines the reliability and convergent validity of the assessment.

The assessment was used by 22 occupational therapists with 44 clients. Convergent validity was examined between the assessment (client, occupational therapist and gap scores), Canadian Occupational Performance Measure performance and Functional Independence Measure scores. Test–retest reliability was assessed by intraclass correlation coefficient. Forty-four clients participated in the test–retest reliability study.

Good-to-moderate correlation was found in the assessment scores (intraclass correlation coefficients of 0.86, 0.95 and 0.78 for client, occupational therapist and gap scores, respectively). The validation study was completed by 34 clients. The correlation between Canadian Occupational Performance Measure and Assessment of Client's Enablement scores was significant (client score, Spearman’s Rank Order Correlation (rs) = 0.47; occupational therapist score, rs = 0.45). The correlation between Functional Independence Measure and the assessment's occupational therapist scores was significant (rs = 0.43).

The study confirms the reliability and convergent validity of the Assessment of Client's Enablement. The assessment requires less time to administer than similar instruments and requires no formal training, making it feasible in rehabilitation settings.

Traffic safety may be affected if a licence holder has experienced illness or injury that may have an impact on cognition. Occupational therapists are involved in assessing cognitive functions that might affect a patient’s ability to drive a car using different evaluation tools in different countries and settings. The aim of this study was to look at the predictive value of some of the assessment tools available to occupational therapists for making judgements about resuming driving after cognitive impairment due to brain trauma or disease.

A retrospective study based on clinical data from 204 patients referred to a specialist department for recommendations on ability to drive after brain injury or disease. All patients underwent three assessments: stroke drivers screening assessment, useful field of view and simulated driving skill. In addition, an on-road assessment was added in 76% of the sample.

Useful field of view had the highest sensitivity (78%) and, combined with the results from the simulator, the sensitivity was 87%. The specificity for the two methods was 55%.

The results from useful field of view and a simulator test combined best predicted the final recommendation from the multi-professional team discussion on which clients should be recommended not to resume driving.

Limitations in fine motor functioning and cognitive performance are frequently reported in multiple sclerosis. Studies about dual-task costs in multiple sclerosis generally explore walking and postural performance. This study aims at exploring dual-task costs when simultaneously performing fine motor and cognitive tasks.

Eighty people with multiple sclerosis and 80 matched controls performed the nine-hole peg test and the months backward test under single and dual-task conditions. Differences in performance over time were analysed with the paired t-test; differences in dual-task costs between groups were analysed with independent t-tests.

People with multiple sclerosis and controls showed a significant decrease in fine motor and cognitive performance in dual-task conditions compared to single-task conditions (P < 0.01). People with multiple sclerosis with limited hand capacity showed larger dual-task costs for cognitive performance compared to other hand capacity groups (P < 0.05). Individuals with multiple sclerosis with lower cognitive capacity showed larger dual-task costs for fine motor performance (P < 0.01).

Both people with multiple sclerosis and controls experience dual-task costs. People with multiple sclerosis with limited hand function showed an increased dual-task cost of cognitive performance and individuals with limited cognitive capacity showed a higher dual-task cost for fine motor performance. Therefore, occupational therapists should focus on cognitive or fine motor aspects during dual-task training dependent on individuals' capacities.

This study examines the validity and distribution characteristics of the PROMIS® pediatric upper limb measures in a sample of young people with cerebral palsy.

Data are a cross-sectional subset of a larger prospective study of the responsiveness to change of PROMIS® pediatric measures following surgery to improve functioning in young people with cerebral palsy. Ninety-three participants between the ages of eight and 21 years completed the PROMIS® pediatric mobility and upper limb computer adaptive tests and short forms in conjunction with a set of static “legacy” measures of physical functioning, including a parent-report of upper limb function.

The PROMIS® Pediatric upper limb short form demonstrated acceptable internal consistency (Cronbach’s alpha = 0.85). PROMIS® pediatric upper limb computer adaptive tests and short form mean values (42.1(11) and 43(10.4), respectively) were nearly 1 SD below normal, which is appropriate when a generic measure is used in a sample of young persons with cerebral palsy. The PROMIS® pediatric upper limb computer adaptive tests had a higher frequency of ceiling effects (29.50%) compared to the short form (18.30%).

Results of this study suggest that the PROMIS® pediatric upper limb computer adaptive tests and the short form are valid indicators of upper limb function in young people with cerebral palsy. The item bank can be replenished to address ceiling effects.

Little is known about how occupational therapy could assist women survivors of breast cancer and their partners who experience activity and role limitations during survivorship. This study sought to obtain views and consensus among occupational therapists regarding their potential role and the barriers and enablers to this potential service.

We used a three-round classical Delphi process to determine the views of occupational therapists (n = 40), and sought consensus (70%) for 49 statements concerning barriers and enablers affecting occupational therapy service provision during survivorship. Thematic analysis was used to determine themes and descriptive statistics to determine consensus level and median for statements.

Forty-six statements showed consensus. Themes identified were: (a) women and partners experience unmet needs; (b) gaps exist regarding supportive care; (c) access to comprehensive survivorship support is required; (d) barriers to occupational therapy exist; and (e) occupational therapists offer many supports to improve activity and role engagement for women and partners.

Occupational therapy is well-positioned to affect improvements in occupational engagement and role participation for women survivors of breast cancer and their partners. However, many barriers are identified. Occupational therapists must advocate the value of occupational therapy during survivorship to facilitate women’s engagement in meaningful activities and roles.

Emotional intelligence competencies assist occupational therapists in responding in a manner that enables them to be effective healthcare practitioners.

This longitudinal study tracked the emotional intelligence of occupational therapy and business students using the Emotional Quotient Inventory 2.0 at three time-points over the final 16 months of their university programme.

Undergraduate occupational therapy students (n = 139 at time-point 1; n = 52 at time-point 3) completed a mean of 117 days of practice education. Before occupational therapy students commenced placements, emotional intelligence scores were significantly lower than population norms in self-regard, self-expression, assertiveness, independence, problem-solving, stress management, stress tolerance and flexibility. By the end of their programme, students reported significant increases in the emotional intelligence realms of total emotional intelligence score, self-perception, decision-making, self-actualisation, emotional self-awareness, independence and reality testing. However, assertiveness, problem-solving and stress tolerance remained relatively low, and other emotional intelligence domains remained below the population norms. The business students who did zero practice placements showed no increase in any emotional intelligence domains over the same period.

Emotional intelligence skills are malleable and can improve during practice placements. Supervisors and employers should encourage students and new graduates to practice their emotional intelligence skills under supervision and then provide feedback, so they are better prepared for the emotional demands of healthcare workplaces.