Thelma Cardwell Research Day 2017
Wednesday, June 28
Ontario Institute for Studies in Education (OISE)
Auditorium (Room G162)
252 Bloor St. West
Dr. Lisa Richardson
Good Medicine: Lessons from Indigenous Health Education
Lisa Richardson is a clinician-educator in the University of Toronto’s Division of General Internal Medicine, and practices at the University Health Network. Her academic interest lies in the integration of postcolonial, indigenous and feminist perspectives into medical education. She is Faculty co-Lead in Indigenous Medical Education for the University of Toronto’s medical school and is an Assistant Professor in the Department of Medicine where she leads the new portfolio called Person-Centered Care Education. She currently holds the Wilson Centre’s Indigenous Health Education Investigator award, and is a previous AMS Phoenix fellow for her work related to teaching equity and cultural safety.
2017 Presentation Award Winners
Michelle Towell and Nicole Kerbrat
Ex-PLISSIT Enablement of Client Sexuality and Sexual Expression: A Mixed Methods Study
Most Innovative Methodology
Sponsored by Canadian Journal of Occupational Therapy
Ensieh Rafiei and Rana Solianik
Exploring Barriers and Enablers for Implementing Family-Centered Care into Iranian Practice Following a Pediatric Training Course
Gender & Health
The presentation that best addresses gendered health issues or uses a gender-based analysis in the research project. Sponsored by the ABI Research Lab and the Canadian Institutes of Health Research
Lily Nguyen and Gena Elane
Daughters’ Perceptions of Shared Caregiving with Siblings in Dementia Care
Sponsored by the Department of Occupational Science & Occupational Therapy
Leah Allerdings and Anita Mohan
Exploring How Occupational Therapists’ Lived Experience Shapes the Therapeutic Alliance
Kathryn Barton and Kylie Mallory
Occupational Performance Issues of Children with Hemiplegia after ABI
Mhairi Kay and Natalie Levine
The Role of Storytelling in Recovery from Mental Illness: A Scoping Review
Student Research Abstracts
Addressing Clients’ Sexual Health in Occupational Therapy Practice: A Mixed Methods Study
Abrielle Dodington and Catherine Smith
Supervisor(s): Kelli Young and Carol Heck
Background. Sexuality is an important aspect of health and well-being. Research has shown that while occupational therapists regard sexual health as a relevant domain of practice, clients’ sexuality is not adequately addressed. Purpose. The aim of this study was to understand beliefs, knowledge, comfort, barriers, facilitators, and practices of Canadian occupational therapists regarding addressing clients’ sexual health. Method. Canadian occupational therapists could access a link to the study questionnaire through their professional national/provincial website and e-bulletins. Descriptive statistics were used to summarize aggregate group data. Content analysis was completed for open-ended questions. Findings. While respondents (n=92) believed that addressing sexuality was a legitimate domain of practice, only one-third provided sexual assessment/education or counseling. Occupational therapists reported comfort with the topic, but identified lack of knowledge as a barrier to assessing and treating sexual issues. Implications. Implementation of context-specific training and institutional supports are required to better address client sexual health.
An Observational Descriptive Study of Dressing in Women with Hemiparesis Post-stroke
Hannah Jantzi and Jessica Coleman
Supervisor(s): Rosalie Wang, Debbie Hebert, and Milan Shahani
Other Team Members: Robyn Power, Tracy Ryan, Hafsa Iftikhar, Carolyne Seward, Ashley Whetham, Natasha Wortzman, Mojdeh Daeiolhagh
Background. Stroke survivors experience barriers to participation which can be exacerbated by challenges with clothing. Currently there is insufficient empirical research to inform adaptive clothing design for women with hemiparesis following stroke. Purpose. The aim of the study is to understand the person and clothing factors that influence donning and doffing of bras for women with hemiparesis post-stroke. Method. An observational descriptive qualitative design was used to capture the dressing process. Five female stroke survivors were video recorded donning and doffing a bra while describing their experience. A tabular task analysis was conducted on the video data to identify factors that influence dressing. Findings. Three donning and four doffing methods were observed. Influencing factors were identified as key movements, use of surfaces, participation of the affected arm, bra structure, fastenings, and practice. Selection of bra and dressing method related to the interaction of preference for bra style and functional ability. Implications. The findings will inform adaptive clothing design and contribute to improved recommendations regarding dressing and clothing selection for this population.
Canadian Occupational Performance Measure: User Experiences in a Multi-setting Stroke Care Continuum
Jing (Maria) Ma, and Andrea Stokes
Supervisor(s): Siobhan Donaghy, Beth Linkewich
Introduction. The Canadian Occupational Performance Measure (COPM) is a patient-reported outcome measure that helps guide the identification of issues of importance to a patient. It supports a partnership between patient and care provider in therapeutic goal setting and care planning processes. A multi-organizational stroke care initiative spanning the continuum from acute care to outpatient rehabilitation used the COPM as a patient-reported outcome measure, which presented a novel context for COPM use. Objectives. This study aimed to explore patient and clinician experiences with using the COPM as part of this integrated program, and how these perspectives shaped the delivery of client-centered care throughout the patient’s care journey. Methods. Semi-structured interviews were conducted with 8 clinicians and 3 patients in acute, inpatient and outpatient rehabilitation stroke care settings. Inductive thematic analysis was used to identify key themes from clinician and patient interviews. Findings. The analysis revealed that the COPM was a valuable communication tool, but there were opportunities to enhance its integration into practice and adapt its use along the continuum, especially for patients with cognitive challenges. Implications. This study indicates that the COPM can support the patient experience when used in a multi-setting stroke care continuum. It offers insights on next steps to consider in its implementation.
Care Conferences in Neuro-rehabilitation – Are They Meeting Expectations?: A Study Protocol
Alison Schwartz and Jennifer Diamond
Supervisor(s): Edith Ng, Debbie Hebert
Background: Collaboration amongst the interprofessional team strengthens healthcare systems, patient satisfaction, and improves patient outcomes. Care Conferences are used in rehabilitation settings as a way to promote collaboration and communication between the interprofessional team, patients, and caregivers. Currently, there is limited research exploring Care Conferences in the Brain Injury population. Our study will utilize a collaborative research design to examine the effectiveness of Care Conferences on the ABI Neuro-Physical Inpatient Service at Toronto Rehab University Centre, UHN.
Methods/Design: This study is a mixed methods design utilizing interviews as the primary method of gathering information. Both qualitative and quantitative data will be captured through interviews conducted with patients and caregivers following the participant’s Care Conference. Demographic data will be analyzed using descriptive statistics and the data collected via semi-structured interviews will be analyzed using thematic analysis. An interprofessional research advisory committee and individuals from the Patient Partners Program at Toronto Rehab were consulted in developing the study protocol.
Discussion: Multidisciplinary feedback and ongoing evaluation from the interprofessional advisory committee and Patient Partners resulted in a collaborative research design, improving the quality of the study. The findings from this study may provide important information to members of the ABI Neuro-Physical Inpatient Service’s interprofessional team at Toronto Rehab regarding the structure, process and planning of Care Conferences. These recommendations will be considered in the improvement of Care Conferences at Toronto Rehab and may be useful for the improvement of Care Conferences across other ABI services.
Caring for Dementia: Identifying Practical Phases of Caregiving and Corresponding Support Needs
Samantha D’Souza and Jennifer Au
Supervisor(s): Kristina Kokorelias, Nira Rittenberg, Jill Cameron
Introduction: Informal (unpaid), live-in caregivers for individuals with dementia are at high risk for developing cognitive, affective, and physical health consequences. Available caregiver supports demonstrate inconsistent effectiveness, which may be due to poorly-timed delivery within the disease trajectory. Understanding the changing caregiving responsibilities and support needs throughout the trajectory is necessary to provide timely supports to enable better quality of life for both the caregiver and care recipient. Objective: This study aimed to understand the experiences of informal, live-in caregivers for individuals with dementia to identify the practical phases of caregiving responsibilities and corresponding support needs throughout the disease trajectory. Methods: Qualitative descriptive methodology and thematic analysis was implemented to collect and analyze semi-structured telephone interviews with four caregivers for individuals with dementia. Results: Participants described the phases of caregiving as initial symptoms, informal diagnosis, assistance with instrumental activities of daily living, community mobility, and assistance with activities of daily living. Supports desired by participants included early dementia education, informal and formal social support, community supports, and a healthcare professional to help navigate the system of available supports. Additional elements important to caregiving emerged, including accepting a new dementia reality, becoming a life navigator, and the impact of caregiver perceptions of healthcare interactions on feeling supported. Conclusions: Our results provide the foundation for future research to continue the development of a proposed caregiver support needs framework based on changing responsibilities. This framework may guide healthcare professionals to provide timely and appropriate support for caregivers for individuals with dementia.
Clinicians Perceptions of the Structured Assessment of Protective Factors for Violence Risk (SAPROF)
Brittney Williams & Bandhana Maheru
Supervisor(s): Thomas Domjancic, Zahra Jamal, Shaheen Darani, Treena Wilkie
Background. The SAPROF is a newly established tool, which analyzes protective factors for risk of violence. Little is known about clinicians’ experiences and perceptions of this tool. Therefore, understanding this may enhance its utility on inpatient forensic units. Purpose. To explore clinicians’ experiences on the process of implementing the SAPROF, and their perceptions on its value for assessing risk of violence for forensic psychiatric clients. Methods. An exploratory research design was used. Five front-line clinicians were recruited from a forensic rehabilitation unit, and semi-structured interviews were conducted for data collection. Data was analyzed using a thematic approach. Findings. Three themes were identified: (a) understanding of the client from a strengths-based point of view; (b) providing clinicians with a focus on how to help the client, and; (c) bringing in opportunities to collaborate as a team. Implications. Findings can improve best practice for assessing risk of violence in inpatient forensic units.
Clothing Experiences of Women with Hemiparesis
Carolyne Seward and Ashley Whetham
Supervisor(s):Rosalie Wang, Debbie Hebert, Milan Shahani
Introduction. Stroke is a leading cause of disability in Canada. Stroke survivors often experience hemiparesis which can result in physical discomfort and difficulty donning and doffing typical clothing. Currently there is a lack of suitable clothing for women with upper limb hemiparesis resulting from the gap in knowledge surrounding their clothing needs. This research aims to fill this gap and to subsequently inform the design of clothing appropriate for this population. This can increase their motivation to engage in occupations due to increases in self-confidence, social acceptance, and physical comfort.
Objective. The objective of this study is to understand the experiences that working-age women with hemiparesis have with clothing function, expression, and aesthetics.
Methods. A phenomenological approach guided 5 semi-structured interviews with women eighteen and older living with hemiparesis. Thematic analysis was used to examine the data and extract themes surrounding the clothing wants and needs of this population.
Results. The preliminary results indicate that women with hemiparesis experience challenges with dressing post-stroke, and modify their clothing choices to accommodate those challenges. Unmet clothing needs impact self-expression, confidence and clothing selection.
Conclusions. The findings from this study will highlight the clothing experiences of women with post-stroke hemiparesis, and will be used to inform the design of adaptive clothing that meets the functional, aesthetic, and expressive needs of this population.
Concussions in Youth Hockey: Evaluating Knowledge, Attitudes, and Practices of Coaches and Trainers
David Mathers and Natan Adelman
Supervisor(s): Nick Reed, Andrea Hickling, and Katherine Wilson
Introduction With over 600,000 registered hockey players in Canada, the management of concussions has become an important issue and a matter of public health. Education is a valuable predictive tool for concussion symptom identification and concussion management in youth sport coaches and trainers. There is currently a lack of information on how a coach or trainer’s knowledge, attitude, and intended practices are affected by concussion specific education. Objectives The aim of this study was to evaluate the effectiveness of a concussion education session on the knowledge, attitude, and intended practices of coaches and trainers on concussion and concussion management in minor hockey. Methods 436 coaches and 367 trainers from the Greater Toronto Hockey League completed written surveys before and after receiving a concussion education session. Knowledge, attitudes, and practices were assessed by comparing pre and post scores and analyzed by using a Paired Sample T-Test and Wilcoxon Signed-Rank Test. Results There was a significant increase in total knowledge score for coaches (32.41 to 35.83, p<0.001) and trainers (33.54 to 37.11, p<0.001), in total attitude scores for coaches (20.11 to 22.48, p<0.001) and trainers (22.44 to 24.47, p<0.001), and in total practice scores for coaches (16.88 to 18.08, p<0.001) and trainers (17.14 to 18.29, p<0.001) as a result of the concussion education session. Conclusion The concussion education session was successful at increasing knowledge, improving attitudes and intended practices of the coaches and trainers of the GTHL. Therefore, this concussion education session is recommended to be used as a concussion education tool in other youth sport leagues.
Creating the Daily Activity Log for Youth with Concussion
Adriana Carranza and Sophie Hopkins
Supervisor(s): Nick Reed, Dayna Greenspoon
Introduction: Youth with concussion are vulnerable to experience prolonged concussive symptoms, which can affect their ability to return to their daily activities (McCrory et al., 2013). Current best practice recommends rest and a gradual return to activity. Unfortunately, there are no validated tools to help youth manage their symptoms and activity. Therefore, creating a tool to meet this need may assist youth in their return to activity. Aim: The aim of this study was to support the development of a validated activity tracking and symptom management tool, the Daily Activity Log for Youth with Concussion (DALY-C), to be used by youth alongside clinicians, to help youth manage post-concussion symptoms in their return to activities. Methods: Five youth aged 12-17 years who had a previous concussion participated in this descriptive qualitative study. Youth completed the log based on their previous day’s activities and then participated in a cognitive interview where they were asked about their experiences and opinions using the log. Data collected was coded using the Question Appraisal System (QAS) to identify problematic areas of the DALY-C. Results: Seven improvements in the DALY-C were identified. One was identified within the Mood section, one under Activities, three in Effort, one in Challenge, and one general suggestion. Conclusion: This study was an important step in the validation process of the DALY-C as information collected was used to modify the log. It is hoped the DALY-C will provide youth post-concussion with a symptom management tool to assist them with their return to occupations.
Daughters’ Perceptions of Shared Caregiving with Siblings in Dementia Care
Lily Nguyen and Genalyn Elane
Supervisor(s): Emma Tang Poy, Elizabeth Younie, Jill Cameron, Nira Rittenberg, Marina Bastawrous, Kristina Kokorelias
Background. Dementia is a growing concern for Canadians over age 65. Many individuals with this condition rely on adult children for caregiving support, with daughters primarily taking on the primary caregiver role. Research indicates that negotiating caregiving responsibilities within a sibling unit can lead to stress and burden, however little is known about how siblings collaborate to share caregiving tasks in the context of dementia. Purpose. Our study sought to explore the experiences of adult daughters sharing care responsibilities with their siblings for a parent with dementia. Method. A link to an online mixed-methods survey was distributed through social media, a psychoeducational group and community organizations. Descriptive statistics and a qualitative descriptive approach was used to analyze the data. Findings. Thirty-four daughters responded to the survey. An overarching theme of shared caregiving was identified and defined as an inherently unequal practice of dividing and fulfilling a supportive role for a family member requiring assistance. Within this overarching theme, two subthemes emerged: (a) operational factors facilitating and constraining shared caregiving, and (b) consequences of sharing care. A cross-cutting theme of expectations versus the reality of the caregiving situation was also identified. Implications. The findings highlight the importance of understanding shared caregiving among siblings in the context of dementia. Occupational therapist clinicians can utilize these findings to support the planning of health professional programs and services to better support adult child caregivers negotiating care with their siblings.
Development and Evaluation of a Crowd-sourcing App for Age-friendly Communities
Eryn Weldon and Jacob C.K. Leung
Supervisor(s): Alex Mihailidis, Barry Trentham
Background. The rise of smartphone use amongst older adults (OA) can facilitate the promotion of age-friendly communities (AFCs). The need for a platform where OAs can provide input about AFCs led to the creation of Age-CAP. In this mobile app, OAs can rate areas based on the ‘WHO Age-friendly Cities’ (2002) guidelines and search the database for ratings of specific locations. Initial usability ratings and user feedback denoted the need for improvement. Purpose. (1) Integrate feedback from OAs to improve Age-CAP and, (2) Create and evaluate usability of revised Age-CAP. Method. Mixed methods approach to user-centred design with participants (aged 65+), utilizing focus groups, interviews, and the System Usability Scale (SUS). Findings. Participants found the concept to be beneficial, but highlighted the need for improved simplicity, readability, and functionality. Thus, a web-based app was designed. The new version of Age-CAP scored in the 70th percentile on the SUS. Feedback indicated the app had excellent readability and relevant content, but required further modification. Implications. Information collected in the app has the potential to inform community development initiatives for stakeholders in age-friendly communities- including occupational therapists.
Digital Picture Frames and the Long Term Inpatient Experience: A Randomized Controlled Trial
Diane Brownlee and Lori Caplan
Supervisor(s): Sean Kidd, John Spavor
Additional Authors: April Collins, Shay Rosen, Marcia Hopcraft, Gursharan Virdee, and Sheng Chen
Acknowledgements: Joe DeMatos, Nathaniel Sorongon
Purpose. This study investigated the effectiveness of digital picture frames (DPF) regarding aspects of autonomy, interactions with staff, perception of room space and experience in recovery for long term inpatient clients diagnosed with SMI. This study expands on a feasibility study that investigated the impact of DPFs on inpatient client stays and found evidence of a positive influence on aspects of the inpatient client’s experience in recovery. Methods. In a psychiatric facility in a large urban city, 20 participants were randomized into either the intervention (DPF) or control (without DPF) group for four weeks. Using a mixed methodological approach, a pre- and post- intervention questionnaire, a semi-structured interview for the intervention group, and a focus group for staff were used to measure feasibility and outcomes associated with DPFs on inpatient client experiences. Results. In qualitative interviews, DPFs demonstrated a positive influence on the social and physical environment of the participants by improving their interactions with friends and general feeling of their room. Furthermore, the DPF had a positive impact on their mood and increased sense of autonomy. However, these results were not reflected in the questionnaires comparing pre-test and post-test between control and intervention groups. Conclusions. The results demonstrate the potential benefits of incorporating digital technology to facilitate the recovery journey. DPFs can be used as a means for facilitating therapeutic relationships, increasing autonomy, and promoting recovery on inpatient mental health units. Limitations include sample size and engagement of unit staff.
Does Photography Enhance Communication and Social Participation for Aphasia?
Tara Bassett and Marina Cremonese
Supervisor(s): Emily Nalder, Ruth Patterson
Introduction: Previous research has shown that individuals with aphasia experience decreased participation in many domains of life, and are at an increased risk for losing contact with their family and friends. These psychosocial consequences result from a reduced ability to communicate effectively with others. This suggests a need for social programs that could increase communication strategies and social participation for individuals with aphasia.
Objective: The aim of this study was to determine if a ten-week photography course increases social participation and communication skills.
Methods: We observed six individuals with aphasia participating in a photography group run by March of Dimes’ Aphasia and Communication Disabilities Program (ACDP). Analysis of video footage from weekly meetings was used to explore how often and how well participants are communicating in meetings. Pre-test/post-test questionnaires and observational measures were used to determine if participants experienced changes in social participation and communication skills by the end of the ten weeks.
Results: Questionnaire results suggest there was no significant change in participants’ quality of life, social participation, or communication after the group ended. This could be due to a small sample size and limited intervention time. Strategies used by facilitator and participants were explored and suggestions provided for future group facilitators, as well as limitations.
Conclusions: Facilitators use a variety of strategies to engage participants in a photography group designed for people with aphasia. Future research should explore social participation and communication changes with a larger sample.
Effectiveness, Social Significance, User Satisfaction of E-Mental Health Interventions: A Scoping Review
Fiza Nadeem and Diane Park
Supervisor(s): Rosalie Wang
Background: E-mental health can augment or be an alternative to conventional mental health services. Many of the commercially available e-mental health interventions have not been researched. Objective: We aimed to examine effectiveness, social significance and user-satisfaction of commercially available e-mental health interventions in the research literature. Method: The framework outlined within the Joanna Briggs Institute for scoping reviews was used. Findings: Results are mixed regarding whether e-mental health is accessible and affordable. There is evidence of e-mental health being used to support symptom and medication management and providing social support. Information on user-satisfaction is very limited. Implications: E-mental health has the potential to play a crucial role in the provision of mental health care. However, many interventions have yet to be researched. In the future, more rigorous research is recommended to determine whether e-mental health is accessible and affordable, and whether the interventions are effective in achieving their stated purpose.
Examining Innovative Technology Use and Implementation in Classrooms to Support Inclusive Education
Megan Yang and Danielle Brown
Supervisor(s): Julia Foster and Vera Roberts
Introduction: With the rapid proliferation of technology, there are ever-increasing possibilities for integrating technology into the classroom to support the occupational performance and engagement of students. While existing literature focuses on the benefits of classroom technology and its barriers to implementation, there is a paucity of research exploring specific strategies utilized for creatively integrating and adapting technology to achieve inclusive education goals. Objectives: The aim of this multi-method qualitative study was to better understand the innovative ways that educators, parents, and students are implementing technology to support inclusive education. Methods: Data was collected through an online survey (n=78), followed by three focus groups with students and educators from a technology-rich school. Data was analyzed using thematic analysis to identify four themes. Results: Key findings of the study were that: (1) using mainstream devices mitigated stigma and allowed students to be more fluent with technology; (2) direct instruction followed by increased choice enhanced students’ technological independence and proficiency; (3) providing creative opportunities to demonstrate learning allowed educators to capitalize on students’ strengths; and (4) providing leadership opportunities to students promoted confidence to use technology in the classroom. Conclusion: The most effective implementation strategies were those that capitalized on student motivation, and were student-centred and strengths-based in nature. Findings from this study will inform future educational resource development and contribute to best practices for inclusive education. With an increased awareness of ways technology can support classroom learning, occupational therapists will be better positioned to serve the needs of teachers and students.
Experiences of AccessTO’s Volunteer Partnerships
Sezgi Ozel and Nisha Goel
Supervisor(s): Barry Trentham, Jill Stier
Introduction. As an advocacy initiative, AccessTO is a blog-based website that highlights barrier-free venues using audits completed by volunteer occupational therapists (OT)/student OTs and persons with disabilities (PWD). AccessTO’s paired training and audit processes are thought to be beneficial for auditor skill development and learning, as well as the quality of audit outputs. Objective. The purpose of this study is to explore AccessTO volunteer experiences of the training and audit processes. An examination of partner experiences can identify opportunities to improve AccessTO audit outcomes. Methods. Part of a larger program evaluation, this project uses a qualitative case study design. AccessTO volunteers, who have received training and completed an audit with a partner, participated in descriptive qualitative interviews. Interview topics included history with AccessTO, motivation to volunteer, partner roles, communication processes, and learning. Thematic analysis was used to identify key themes relating to how volunteers experience the collaborative processes and partnership. Results. Four main themes emerged. Volunteers had different understandings of accessibility based on their roles, past experiences, and AccessTO’s physical emphasis. Through the partnership, volunteers’ views of accessibility broadened as they learned new perspectives from one another. Volunteers learned life skills including problem-solving, knowledge dissemination, and advocacy, and OTs/student OTs specifically learned skills that supplemented their professional lenses. Finally, volunteers identified opportunities for further development of AccessTO, such as making training more inclusive and explicitly outlining all responsibilities associated with an audit. Conclusion. Examining volunteer experiences and partnership dynamics informed AccessTO program evaluation and development efforts, and provided insight into the nature of advocacy partnerships between occupational therapists and PWD.
Exploring a Dual-Task Protocol for Concussed Youth and Their Non-concussed Peers
Kelsey Gamble and Stephanie Raheb
Supervisor(s): Karolina Urban, Nick Reed, Anne Hunt, Katherine Wilson
Objectives: To investigate the potential of a grip strength and reaction time dual-task protocol to identify differences in performance between concussed and non-concussed youth.
Design: Prospective cross-sectional.
Methods: Two individuals who sustained a concussion at least two weeks prior to testing, and eight healthy controls between the ages of 13-18 years old were recruited from Holland Bloorview Kids Rehabilitation Hospital. Participants completed grip strength and reaction time tasks individually (single-task) and concurrently (dual-task) in both hands. For both the single and dual-tasks, participants were asked to squeeze a dynamometer with their maximal strength. Reaction time was tested by having participants press a button as quickly as possible after hearing an auditory tone. Dual-task cost was calculated, representing the change in performance when completing grip strength and reaction time concurrently, due to the added cognitive challenge of combining the tasks.
Results: Descriptive statistics show a dual-task cost to completing grip strength and reaction time concurrently in both groups. Additionally, the dual-task cost of this protocol is greater on reaction time than maximal grip strength performance. In the control group, reaction time was significantly slower for the left (t = 14.508, p = 0.000) and right (t = -3.670, p = 0.005) hands between the third single-task trial and the first dual-task trial. Additionally, left grip strength was lower between these two trials (t = -2.444, p = 0.037).
Conclusions: This novel dual-task protocol could prove to be an objective and sensitive measure following concussions and has the potential to inform concussion management guidelines.
Exploring Concussion Knowledge, Attitudes, and Practices in Minor Hockey
Vanessa Gaglia and Alexandra Cogliano
Supervisor(s): Nick Reed, Andrea Hickling, and Katherine Wilson
Rationale. There is an increasing concern for the high incidence of concussion in youth hockey players. While research has investigated the concussion knowledge of youth athletes, the concussion-related knowledge, attitudes, and practices of minor hockey coaches and trainers is not known. Given the vital role of coaches and trainers in recognizing a concussion, supporting removal from play, and ensuring safe return-to-play, it is important to understand the current concussion knowledge, attitudes, and practices of minor hockey coaches and trainers, and whether demographic variables influence these factors. Objectives. The objective of this study is to describe the concussion knowledge, attitudes, and practices of minor hockey coaches and trainers. This study also seeks to determine how demographic variables, as well as knowledge and attitudes, may affect the practices of coaches and trainers. Methods. This study examines the data from a concussion knowledge, attitudes, and intended practice survey completed by coaches and trainers. Descriptive statistics were used to examine demographic information and concussion knowledge, attitudes, and intended practices. Practice Implications. The results of this study inform the development and implementation of concussion education sessions that better meet the needs of minor hockey coaches and trainers, including a focus on recognition of emotional symptoms and return-to-play protocol. Conclusions. This study provides a greater understanding of the current concussion knowledge, attitudes, and practices of minor hockey coaches and trainers. It will help guide future education initiatives that will enable coaches and trainers to recognize concussions and properly manage their athletes’ return-to-play.
Exploring How Occupational Therapists’ Lived Experience Shapes the Therapeutic Alliance
Anita Mohan and Leah Allerdings
Supervisor(s): Jane Davis
Background. Therapeutic use of self can involve using lived experience of mental illness, which has been found to be an effective tool in guiding clients’ recovery process. Therapeutic use of self was identified by occupational therapists as the most important skill in practice. Research has not captured how lived experience of mental illness shapes occupational therapists’ current practice and therapeutic use of self while building a therapeutic alliance. Purpose. This study aims to explore how occupational therapists’ lived experience of mental illness shapes their therapeutic use of self and ability to form therapeutic alliances within occupational therapy practice in a mental health setting. Method: Narrative interviews focusing on mental illness recovery and career trajectory were undertaken with two occupational therapists practicing in mental health. Crosscutting themes were generated from the narratives to illustrate how lived experience shapes practitioners’ work with their clients. Findings Participants viewed their lived experience as enhancing their empathetic capacity with clients. Lived experience contributed to self-awareness of how they use themselves in alliances, as well as their own limitations to empathizing. Empathetic capacity permeated through practice elements such as the therapeutic use of self, therapeutic alliance, boundaries, and disclosure. Implications. Findings suggest that practitioners with lived experience need to recognize and consider how that experience will shape the way they form alliances with their clients and how they deliver services.
Exploring Occupational Identities of Young Stroke Survivors
Zoë McRury Smith and Jessica Gosselin
Supervisor(s): Emily Nalder, Rhona Anderson
Introduction: Young stroke survivors are in different stages of life than “typical” stroke patients, and often struggle with poorly age-adapted rehabilitation. Stroke can affect participation and sense of self. Objectives: The aim of this study is to understand, from the perspective of young stroke survivors (age 18-45) how identity changes post-stroke. Further, it will look at how the concepts within the Model of Human Occupation can help to understand this change from an occupationally-based perspective. Methods: Six young stroke survivors participated in 50-90-minute narrative interviews. Interviews included conversations surrounding if and how stroke has affected their identity and participation post-stroke. Narrative analysis was used to understand experiences and identify themes across the stories. Findings. Three themes related to change in identity and participation post-stroke were identified: change in family role/identity, transition in worker role, and sense of competence. Practice implications: By better understanding how changes in participation and identity come about, occupational therapists can create and provide better age-adapted rehabilitation for young stroke survivors, which may include a focus on returning to paid work and changes in intimate relationships.
Exploring Occupational Therapy’s Role with Adolescent Eating Disorders: A Scoping Review
Caroline Carncross and Kelsea Liotta,
Supervisor(s): Rama Arora-Persaud, Cheryl Fiske, and Melanie Stuckey
Background. Eating disorders are serious mental illnesses that impact daily occupations. Research on interdisciplinary treatment of eating disorders is growing to establish best practices for adolescent assessment, treatment, and recovery; however, the role of occupational therapy has yet to be explored. Purpose. This scoping review explored the role of occupational therapy in the assessment, treatment, and recovery of adolescents with eating disorders and identified gaps in the literature. Method. A search strategy was developed to identify relevant literature in Medline, PsycINFO, EMBASE, and CINAHL databases and eleven occupational therapy journals. Thematic analysis was used to collate and summarize the data. Findings. Forty-nine articles were reviewed in full, of which three met inclusion criteria. Four themes emerged surrounding practice setting, assessments, treatments, and frames of reference. Implications. The literature describes occupational therapists’ use of an occupational lens to assess and treat, however, gaps in knowledge remain and future research is needed.
Examining the Needs of Stakeholders on Inclusive Education and Technology Use
Naisargee Patel and Cong Hui (Peggy) Guo
Supervisor(s): Julia Foster, Vera Roberts
Background. Technology-supported education can facilitate the occupational role for students with varying abilities; however, constantly changing technology introduces new barriers to its implementation for inclusive education. Purpose. The study examined the technology-related needs of stakeholders (educators, parents, and students) in effective implementation of technology-supported education. Methods. This mixed methods study involved stakeholders from Ontario’s education system to participate in a quantitative online survey and subsequent qualitative focus groups. Descriptive statistics and thematic analysis were used to analyze the quantitative and qualitative data, respectively. Findings. Parents reported receiving less support on technology use in the classroom than educators and students. Also, students and educators identified negative school culture, insufficient resources and training and ineffective instruction as the primary gaps in technology-supported education. Implications. There is a strong need for occupational therapists to assist with developing programs and resources to address identified gaps and fulfill the occupational role of students.
Examining Usability and Enjoyment of Several Virtual Reality Therapy Games in Children with Cerebral Palsy
William Farr and Joshua Green
Supervisor(s): Elaine Biddiss and Virginia Wright
Background. Virtual reality therapy (VRT) has shown promise in improving motor outcomes in children with cerebral palsy (CP) when used in clinical settings. In developing a specific game to be tested in a home setting, usability and enjoyability must be examined. Purpose. To quantify and explore the quality of usability and enjoyment with several games to better understand their effectiveness. Method. Twelve children aged 5-19 with CP played a variety of games. Their experiences with usability and enjoyability were quantified using a custom questionnaire. Qualitatively, subjective comments and observations were recorded. Univariate quantitative analysis and qualitative content analysis were used. Findings. The analysis demonstrates that certain games demonstrate high usability and enjoyability suggesting they may be effective home-based systems. Implications. Games with high usability and enjoyment have potential as viable home-based motor interventions. Games with negative results can be improved through the feedback obtained.
‘Ex-PLISSIT Enablement’ of Client Sexuality and Sexual expression: A Mixed-Methods Study.
Nicole Kerbrat and Michelle Towell
Supervisor(s): Kevin Reel, Sylvia Davidson
Rationale. Sexuality and sexual expression are an integral part of the human experience and are associated with health and well-being. Occupational therapists report that client sexuality and sexual expression are rarely addressed in practice. Low comfort and perceived lack of competence with this topic are commonly cited barriers. A profession-specific conceptual model, the Ex-PLISSIT Enablement model, was developed to reduce disparity by orienting practitioners to intervention principles, enabling approaches, and points for reflection on practice to improve client enablement. Objective. This study aimed to understand participants’ level of comfort and competence addressing client sexuality and sexual expression and their perception of the clinical utility of the Ex-PLISSIT Enablement model. Method. Using a convergent mixed-methods design, eighty-nine Ontario occupational therapists and occupational therapy students completed an online anonymous survey. Results. The majority of participants agreed they were comfortable enabling client sexuality within the scope of occupational therapy, but less felt competent to do so in their current practice. Participants indicated their comfort and competence were impacted by client age, gender, and diagnosis or disability type. Participants deemed the Ex-PLISSIT Enablement model a useful guide to practice and identified the need to develop their skills through practical experience and professional development. Conclusions. The Ex-PLISSIT Enablement model was considered a useful practice support resource and there appears to be merit in pursuing research on the model. In addition, further education and training are required to increase occupational therapists’ perceived competence enabling client sexuality and sexual expression with diverse client populations.
Exploring Barriers and Enablers for Implementing Family-Centered Care into Iranian Practice Following a Pediatric Training Course
Ensieh Rafiei and Rana Solianik
Supervisor(s): Debra Cameron and Heather Colquhoun
Introduction: Educational programs are being designed to promote evidence-based practice (EBP) to improve health outcomes in developing countries, such as Iran. However, there is limited evidence assessing the effectiveness of such programs in changing the practices of allied health practitioners (AHP). Thus, a deeper understanding of the factors affecting the success of knowledge translation (KT) is needed. The aim of this descriptive, qualitative study is to explore the barriers and enablers to KT after the administration of a pediatric educational course on family-centered care (FCC) to Iranian AHP. Methods: Informed by the Theoretical Domains Framework (TDF), semi-structured interviews were conducted with Iranian AHP who participated in the course. Direct content analysis was performed for mapping data to related TDF domains. Consequently, belief statements, reflecting the participants’ core thoughts, were generated within each domain. A TDF domain was deemed relevant in changing clinical behavior (FCC), according to the strength and frequency of the beliefs, and the presence of conflicting beliefs within the domains. Results: Five of the eleven TDF domains were identified as relevant to Iranian AHP’s ability to implement FCC. Key beliefs that were identified within these domains include therapists’ perceived inability to provide sufficient education and effective intervention to families due to time constraints and limited resources (Environment and resources). Therapists also believed that in order to implement FCC, they needed a system for planning and evaluating its delivery in everyday practice contexts (Behaviour regulation). Conclusion: The findings contribute to the current understanding of the barriers and enablers to implementing FCC among Iranian AHP, following an educational intervention. This will support the future design of training programs in a similar context, and inform interventions developed to facilitate FCC into AHP practices.
Lived Experiences of Occupational Therapists in Transitioning to Leadership Roles
Ravneet Batth and Sasha Shams
Supervisor(s): Andrea Duncan
Several studies on leadership in occupational therapy have discussed the key qualities of leadership and its importance, though little is known about the transition process into leadership roles. This research examined the lived experiences of occupational therapists who transitioned from a clinical to a leadership role and identified the supports and challenges that were found to be important. Semi-structured interviews were used to gain insight into the transition process of five occupational therapy Professional Practice Leaders. NVivo software was used to organize and analyze the qualitative data. Among the participants, six common themes emerged: (1) intrinsic motivation (2) support systems (3) an occupational therapy perspective (4) changes in interpersonal relationships (5) systemic factors and (6) steep learning curve. The findings of this study highlight the importance of leadership-specific education, family support, extensive clinical experience, and implementation of leadership-specific resources in the occupational therapy curriculum.
Motivational Interviewing in Vocational Rehabilitation for Persons with Disabilities
Christine Elizabeth Friesen and Yunbei Long
Supervisor(s): Emily Nalder
Other team members: Judy Quillin, Deborah Pal
Introduction: Motivational interviewing (MI) is used in vocational rehabilitation (VR) to help persons with disabilities acquire employment. However, evidence describing its use and influence on employment outcomes is limited. Objectives: To examine if a client’s initial stage of change correlates with employment outcomes and how VR specialists use MI strategies according to initial stage of change. Methods: A retrospective chart review was performed using data from 15 employment centres in Ontario. Correlation analyses were used to quantitatively examine the association between initial stage of change and employment outcomes. Subsequently, charts were thematically analyzed to understand the MI strategies in relation to clients’ readiness for change. Results: Initial stage of change was significantly associated with all four employment outcomes: employment status (p<0.001), employment duration (p<0.001), vocation type (p<0.001), and employment level (p = 0.012). Certain MI strategies were used across all stages of change (reflective listening and collaboration), while other MI strategies were more prominent in the Pre-contemplation and Contemplation stages (raise problem awareness and develop discrepancy), in the Contemplation and Preparation stages (empower clients and support self-efficacy), and in the Action stage (develop change plan). Conclusions: These results suggest that initial stage of change is correlated with employment outcomes and that appropriate MI strategies were used according to initial stages of change. This study has important implications for occupational therapy practice in VR as it emphasizes the need to consider readiness to change. Further, MI training may be an important skillset for VR professionals.
Negotiating Identities: Exploring Disability from the Perspective of Young Adults with Intellectual/Developmental Disabilities
Jasmine L. Cowen
Supervisor(s): Rebecca Renwick
The identities of people with intellectual/developmental disability (IDD) have long been described as stigmatized and objectively given. However, IDD identity has more recently been re-imagined as multifaceted and negotiable. Building on this new line of research, this study examines the fluid, intersectional, and performative nature of identity from the perspectives of young adults with intellectual/developmental disabilities (IDD). This qualitative descriptive secondary analysis was conducted on partial data from videotaped semi-structured interviews with 11 young adults with IDD drawn from a larger project seeking their perspectives on friendships, community participation, and quality of life. Particular attention is paid to the intersectionality of identities involving the label of IDD with other self-described identities. Modified grounded theory analysis revealed four key categories: self-defining identities, negotiating identities within close relationships, belonging to identity-based communities, and negotiating space for identities in society. The findings highlight the relevance of intersectional, fluid, and performative interpretations of identity to those of young adults with IDD, and can inform the broader understanding of identity as an area of enquiry.
Occupational Performance Issues of Children with Hemiplegia after Acquired Brain Injury
Kylie Mallory and Kathryn Barton
Supervisor(s): Janet Bernstein, Janet Woodhouse, Dayna Greenspoon, and Nick Reed
Background. Children with hemiplegia secondary to acquired brain injury have achieved functional goals through modified constraint-induced movement therapy (mCIMT) programs. However, little is known regarding the occupational performance issues (OPIs) identified during these programs. Purpose. This study categorizes and examines the frequency of OPIs identified by children (or their caregivers) who participated in the group-based mCIMT program Helping Hand. Methods. This retrospective, exploratory study used descriptive statistics to categorize the OPIs identified using the Canadian Occupational Performance Measure (COPM) for 46 Helping Hand clients, prior to program participation. Findings. The identified OPIs were diverse, and differed in frequency and level of specificity. The OPIs varied based on age and COPM respondent, as clients and caregivers had differing OPI priorities, and age groups showed developmentally-appropriate changes in OPIs. Implications. Identification of OPIs should involve children, balance client-centredness with specificity, and be understood by clinicians, to guide program development and intervention.
Occupational Therapists’ Experiences of Working with Older Spousal Dementia Caregivers
Alexandra Tabora-Paz and Ella Haley
Supervisor(s): Deirdre Dawson, Ifah Arbe, Jill Cameron
Background. Older spousal caregivers of individuals with dementia demonstrate cognitive and functional declines which can negatively affect quality of life and spousal care. Understanding occupational therapists’ experiences with this population may highlight current issues in dementia care practice and may elucidate unique interventions. Purpose. This study aimed to explore 1) occupational therapists’ current knowledge and clinical practices with older spousal caregivers and 2) occupational therapist’s differences/similarities with other informal dementia caregivers. Method. Using a qualitative descriptive design, semi-structured interviews were conducted with five occupational therapists. Following a thematic analysis approach, interviews were transcribed, and analyzed for themes. Findings. Four themes identified that occupational therapists view caregivers as clients, observe differences between older spousal caregivers and adult children caregivers, have different clinical interactions with caregivers, and perceive the health care system to impact their role. Implications. Development of individualized services are necessary to address older spousal caregiver’s unique needs.
Occupational Therapists’ Perspectives of Financial Management Rehabilitation for Brain Injury Survivors
Elizabeth Cambridge and Holly Pearson
Supervisor(s): Lisa Engel, Deirdre Dawson
Background. There is limited research describing how occupational therapists address financial management (FM) after acquired brain injury (ABI). ABI survivors are at risk for loss of FM independence, associated with decreased community engagement, and self-efficacy. Purpose. To explore the clinical practice of occupational therapists to understand how they are addressing FM in their practice setting. Methods. Data were collected through semi-structured qualitative interviews with seven occupational therapists across different practice settings and analyzed using the thematic framework approach. Findings. Four themes emerged: (1) therapists consider clients’ reported FM needs when treatment planning, (2) therapists use components of standardized assessments to identify possible FM challenges, (3) therapists value functional activities to address FM, and (4) therapists address FM differently between practice settings, often reflective of recovery stage. Implications. Understanding how occupational therapists address FM after ABI will facilitate the development of best-practice guidelines for FM rehabilitation.
Occupational Therapy Perspectives on Medical Assistance in Dying: Qualitative Study
Betty Tran and Serena Lu
Supervisor(s): Kevin Reel
Introduction: Occupational therapists (OTs) in various practice contexts may encounter inquiries about MAiD, and may be part of healthcare teams responding to formal requests for MAiD. Limited literature exists concerning the perspectives of OTs on MAiD, and understanding these perspectives may suggest possible emerging occupational therapy roles in response to its implementation. Objectives: This study aims to qualitatively explore the perspectives of OTs and student OTs in Canada on MAiD. The study also aims to explore the potential roles OTs may have as both independent practitioners and members of the healthcare team now that MAiD is accessible. Methods: An anonymous online survey collected both quantitative and qualitative data to explore OT perspectives on MAiD. Thematic qualitative analysis was used to identify main themes emerging from qualitative data. This paper will report themes and link them to descriptive quantitative data previously reported. Results: Central themes include “autonomy” and “capacity”, and potential roles were identified: instilling meaning to remaining life, providing psychosocial support, and maintaining quality of life. Conclusions: As a result of the recent decriminalization of MAiD, there may be roles that OTs can adopt as part of providing high quality end-of-life care, as many respondents consider it within their scope and competence.
Recovery-oriented Experience at a Partial Hospitalization Program for Adults Living with Psychosis
Sarah Ohana and Nicole Ranieri
Supervisor(s): Avelino (Jun) Maranan, Kaitlyn Lee
Background. Partial hospitalization programs deliver recovery-oriented services for individuals living with mental illness. Research suggests that clinicians believe they provide recovery-oriented services in partial hospitalization programs. Though the recovery model is a common framework in partial hospitalization programs, client perspectives on recovery experiences are limited in the literature. Purpose. To explore recovery experiences from perspectives of clients engaged at a partial hospitalization program. Methods. Four participants enrolled in a partial hospitalization program participated in qualitative semi-structured interviews. A thematic analysis was conducted to explore recovery themes and five themes emerged. Findings. Themes identified included: program culture promotes structure and learning, provides a space for positive social interactions, creates pathways for community and occupational engagement, transitional space that encourages individuals to move forward, and experienced and perceived challenges to recovery. Implications. Client perspectives on recovery may improve service delivery and client care by occupational therapists and clinicians at partial hospitalization programs.
Reliability and Validity of the Youth Evaluation of Products Scale for Augmentative and Alternative Communication Devices
Christina Swett and Christopher Welton
Principal Investigator (Lead Supervisor): Stephen Ryan
Supervisor(s): Anne Marie Renzoni, Tracy Shepherd
Introduction. Many youth with disabilities use augmentative and alternative communication (AAC) devices, however there does not currently exist a sound evaluation tool for determining the opinions of users towards their devices. Objective. The objective of this study was to estimate the internal consistency and examine the construct validity of the AAC version of the Youth Evaluation of Products scale (YEP-AAC) for young people between the ages of 13 and 21 years. Methods. An anonymous mail-out survey was conducted of 195 youth and their parents,. All had received AAC services at a children’s rehabilitation centre within the last 3 years. Responses from the YEP-AAC were analysed to estimate Cronbach’s alpha for internal consistency. Construct validity was examined through comparison with measures of functional communication as reported by youth and parents. Results: 21 parent responses and 19 youth responses were obtained. The YEP-AAC demonstrated internal consistency above Cronbach’s alpha of 0.7 for all three of the subscales. The total scale YEP-AAC also demonstrated moderate correlation with both the Youth (rho=.582, p>0.05) and Parent (rho=.529, p>0.05) F2FC. Conclusions: The YEP-AAC demonstrated acceptable alpha coefficients for all of its subscales as well as the scale overall. Moderate, significant correlation with the Parent and Youth F2FC scales was also demonstrated, providing emerging support for the validity of the YEP-AAC. Practice Implications. Knowing the attitudes of youth towards’ their devices will help occupational therapists better understand the AAC device needs and preferences of their clients.
Services and Supports that Facilitate Employment for Adults Living with Mental Illness and a History of Homelessness
Erin AuCoin and Yarima Gonzalez
Supervisor(s): Bonnie Kirsh
Introduction. Individuals with mental illness (MI) experience high risk of homelessness and unemployment. Housing and supported employment services are used to address these challenges. While evidence demonstrates what makes these programs effective for individuals with MI, little is known about what elements of supported employment programs facilitate employment for individuals with MI and a history of homelessness. Understanding what elements of supported employment benefit these individuals can help programs better meet the unique challenges of this population. Objectives. This qualitative study aims to identify what elements of supported employment facilitate employment and are most valuable for individuals with MI and a history of homelessness, from the perspectives of service providers and consumers. Methods. Service providers and consumers were recruited through a community mental health organization and participated in semi-structured interviews exploring barriers to employment and what elements they found most beneficial to employment efforts. Thematic analysis was used to identify elements of supported employment that contributed to vocational outcomes. Results. Three themes were identified: housing as a foundation to employment, an individualized approach to unique needs, and “it’s not just about employment.” Conclusions. The service model that was found to be effective for this population is consistent with best practice in supported employment research. However, there are unique needs that must be addressed before and during the employment process. Addressing these needs and being stably housed prior to employment were found to facilitate positive vocational outcomes for individuals with mental illness and a history of homelessness.
Staff and Patient Perspectives on Falls Risk in an Inpatient Geriatric and Medical Rehabilitation Program
Samantha Annecchiarico and Vithurry Sivaloganathan
Supervisor(s): Jessica Casey, Rachel Devitt
Objective. To understand the perspectives of medically complex patients and staff in a hospital’s geriatric and medical rehab units regarding application and effectiveness of falls prevention strategies. Method. A sample of 28 inpatients and 19 clinicians from a rehabilitation hospital in Toronto, Ontario participated in a descriptive quantitative study. Surveys were administered to patients and staff to collect data to describe frequency of perspectives specific to falls risk. Data was abstracted from patient participant health records and all data was managed, stored, and analyzed on Excel. Results. The perspectives on communication and the hospital’s physical environment related to falls risk differed between patients and staff. Patients perceived the falls prevention strategies to be more effective than staff participants. Discussion. Falls prevention strategies should be provided consistently by staff and the purpose of strategies should be communicated to patients in order to create a hospital-wide understanding of strategies currently being used.
Supporting Family Caregivers in the Context of Legal Assisted Dying
Carly Daubert and Aisha Farnum
Supervisor(s): Jill Cameron, Kevin Reel
Background. Medical assistance in dying (MAiD) can significantly impact family caregivers involved in emotionally demanding decisions regarding end of life care. Existing literature has not explored the occupational needs of family caregivers during legal assisted dying. Understanding their needs regarding MAiD can inform best occupational therapy practice. Purpose. This study gathered preliminary insight into attitudes and perspectives of family caregivers regarding MAiD, and aimed to inform development of support for this population. Methods. A mixed method design was used. Five participants completed an online survey. Quantitative data was summarized descriptively and qualitative data was analyzed with a general thematic analysis. Findings. One main theme and three subthemes emerged: universal perception of support as central to the role of family caregivers, complex and varied experience of emotions by family caregivers, the need for knowledge and education, and lack of awareness of existing resources for support. Practice Implications. Findings will facilitate occupational therapists’ understanding of family caregivers’ emotional needs when caring for an individual seeking MAiD.
The Role of Storytelling in Recovery from Mental Illness: A Scoping Review
Mhairi Kay and Natalie Levine
Supervisor(s): Bonnie Kirsh, Heather Colquhoun
Background: Storytelling is an approach that has increasingly been recognized as an effective tool in mental health recovery, however, an understanding of how storytelling achieves this aim remains unclear. Purpose: The aims of this scoping review are to describe how storytelling is being studied and the mechanisms through which it enables recovery from mental illness. Methods: A scoping review was conducted using the methodological framework outlined by Arksey and O’Malley (2005). A systematic search of peer-reviewed databases was conducted, the data was extracted, charted, and presented thematically. Findings: Five dominant themes (i.e. connection, identity transformation, mobilizing change, motivation to help self and others, and connecting to/expressing emotions). These themes were found to mediate the relationship between storytelling and mental health recovery. Implications: This scoping review has laid the groundwork for developing a more unified understanding of how storytelling can be studied and used to enable mental health recovery.
Work Aspirations and Expectations of Youth with Physical Disabilities
Winnie Lieu and Cara Uy
Supervisor(s): Sally Lindsay
Background. Many youth with physical disabilities want to and are in the process of obtaining employment. While literature speaks to barriers influencing this occupational transition, there remains a limited understanding of their work aspirations and expectations. Purpose. This study described aspirations and expectations that youth with physical disabilities have regarding employment. Method. A qualitative descriptive design was used. 16 youths with physical disabilities aged 15-25 discussed their experience transitioning to work through online discussion forums in a peer e-mentoring program (Lindsay et al., 2017, in press). These forums were analyzed through a thematic analysis under the Person-Environment-Occupation model to identify major themes. Findings. This study found seven themes addressing the aspirations and expectations of youth with physical disabilities, at the personal, environmental, and occupational levels. Implications. Guidance counselors, parents, occupational therapists, and policy makers can incorporate the identified employment obstacles into their roles to better support youth work transition.