British Journal of Occupational Therapy

Falls prevention is a key activity for general practitioners, occupational therapists and other allied health professionals. Despite evidence for multidisciplinary community-based interventions, uptake of falls prevention is variable. General practitioners are crucial in identifying older people at risk of falls and referring for intervention.

This research aims to identify the current practice of general practitioners in falls prevention and to identify opportunities for occupational therapists in particular to extend their role in falls prevention in primary care.

A total of 4000 paper surveys were mailed to randomly selected general practitioners within 209 clinical commissioning groups in England. Online surveys were also distributed via clinical commissioning groups to approximately 3200 general practitioners. Descriptive analysis of the data was undertaken.

A total of 152 general practitioners responded. More than half indicated they were familiar with the UK guidelines for falls risk screening, but less than a third implemented these. Only 31% routinely asked older people if they had fallen. Whilst 90% identified occupational therapists as providing evidence-based falls prevention, only 74% referred to occupational therapy.

There are gaps in general practitioners’ falls prevention referral practices to occupational therapists and allied health professionals. Better general practitioner pathways could enhance the quality of falls-prevention care for older people at risk.

The benefits of engaging in sport and other free-time activities empower youth to learn social and life skills. There is little research evidence that participation builds competence for livelihoods development of youth with disabilities. This article investigates the capacity of non-governmental organisations to extend the outcomes of participation in these activities for livelihoods development. It argues that occupational therapists employed in non-governmental organisations could play this key role.

The study utilised an exploratory, intrinsic case study design to provide meaningful, context-related knowledge and insight about real-life events. Twenty disabled youth and 12 parents of disabled children, between the ages of 18 and 37 years, were selected through five non-governmental organisations in an urban metropole and town, and two rural farming communities in South Africa.

Two themes emerged: first, family as anchor and catalyst for social and economic inclusion; and second, creating capacity for inclusive environments, systems and services to maximise resources for livelihood development.

Occupational therapists in non-governmental organisations are well positioned to facilitate capacity-building of a community-based inclusive workforce to ensure systems for public service delivery are accessible and affordable. Then, the social and life skills developed through sport and free-time activities may enable the livelihoods development of all youth.

Cancer survivors experience persistent symptoms such as pain, fatigue, anxiety and depression post-treatment, resulting in social isolation and decreased activity participation. A 6-week, occupation-focused, self-management programme, OptiMal, was delivered to cancer survivors. A mixed methods approach was employed to explore the impact of the programme. For the purpose of addressing the focus of this paper, only qualitative data were extrapolated.

A qualitative description design was undertaken with survivors to explore their perceptions of the impact of OptiMal on cancer survivorship and opinions of the programme. Qualitative data were collected through focus groups and semi-structured interviews post-intervention and at 3 months follow-up. Data were analysed using thematic analysis.

Four OptiMal programmes were delivered with 26 individuals of mixed cancer diagnoses over an 18-month period. Following thematic analysis, two themes emerged: 1. Supporting the transition to survivorship; 2. Programme design and delivery. The content and design of OptiMal was reported to meet cancer survivors' needs. However, many survivors stated that they would have benefited from it earlier post-treatment.

An occupation-based group programme, OptiMal, appears to assist cancer survivors to transition from treatment to survivorship. However, many survivors stated that they would have benefited from the programme earlier post-treatment.

Although working with communities using community-centred approaches like community development has been identified as an important occupational therapy domain of practice, occupational therapists continue to struggle to clarify their roles and processes in this area of practice. From a study that aimed to describe the practice process of occupational therapists working in community development, this article presents key findings regarding how occupational therapists described their work with individuals and communities, providing a conceptualization of how to situate their work with individuals within a broad community context.

Using interpretive description, individual interviews and focus group discussions were conducted via telephone with 12 occupational therapists from across Canada between February 2014 and March 2015.

There was some uncertainty amongst participants regarding the definition of community development. Four layers of community-centred practice were inductively derived from the data: individual, group, community of interest, and systems. The latter two touch on community development.

The conceptualization that emerged from this study can assist occupational therapists in reflecting on current practice and furthering an appreciation of how their work with individuals can include a community focus, responding to calls within the profession to look beyond the individual.

Stress has been identified as a risk factor in both physical and mental illness and can negatively impact on an individual’s ability to participate in daily occupations. There has been an increased emphasis on addressing mental health in a primary care context using a health promotion approach. The purpose of this pilot study was to explore the acceptability of a primary care 6-week stREss maNagemEnt and Well-being (RENEW) programme.

This pilot study used a mixed methods convergent parallel design. Twelve individuals with self-reported experiences of stress participated in the programme. The Canadian Measure of Occupational Performance, Hospital Anxiety and Depression Scale, and visual analogue scales for stress, concentration, sleep and appetite were administered at three time points. A focus group and individual interviews explored participants’ experiences of the programme and impact on occupational participation.

There were statistically significant improvements in occupational performance and satisfaction, anxiety and self-reported stress. Study participants reported that attendance at the programme increased their awareness of stress and gave them strategies to manage their stress.

The positive findings from this pilot study suggest that the RENEW programme has potential as a health promotion intervention in primary care that warrants further investigation.

Occupational therapists and physiotherapists in a Swedish municipality answered a web-based survey about their reablement interventions.

There were overlapping areas as well as differences regarding the focus of occupational and physiotherapy interventions. Regarding the duration of interventions, occupational therapy was implemented over a short time span in contrast to physiotherapy, which had a longer duration. Both professions used valid and reliable instruments to a very limited extent.

If other areas than self-care and mobility are to be addressed within reablement there is a need to critically reflect on the focus, content and duration of reablement interventions. Valid and reliable assessments can be utilised to a greater extent to guide goal-setting, the focus of interventions and to evaluate effects.

Refractory breathlessness occurs at rest or on minimal exertion and persists chronically despite optimal treatment of the underlying cause. The burden and prevalence of breathlessness is high, yet symptoms remain under-treated and those affected struggle daily with the condition. This study aims to gain a greater understanding of the lived experience of refractory breathlessness and its effect on daily activities.

Participants were recruited from a Sydney-based outpatient breathlessness clinic. An exploratory qualitative approach was undertaken with individual, semi-structured interviews, using NVivo software to conduct thematic analysis. The study recruited consecutive patients until thematic saturation was reached.

Six participants were interviewed and four main themes identified. 1. Living on the edge, referring to the extreme feeling of breathlessness experienced by patients; 2. Social meanings of breathlessness, describing the significance of social support; 3. Reduced to the basics, referring to the effect breathlessness has on basic daily tasks; and 4. Sources of security, which describes the measures participants take to protect themselves from their own breathlessness.

Participants noted the importance of functional participation for improved engagement and quality of life. There is scope to develop specific interventions and occupational therapy services incorporating self-management and equipment prescription for people with dyspnoea.