HS1 PERSPECTIVES ON HOSPITAL TO HOME TRANSITIONS FOLLOWING BRAIN INJURY
Students: Jessica Wong and Erin Hawkins
Supervisors: Sarah Munce, Charissa Levy, and Linda Ngan
Background: Following acquired brain injury (ABI), the transition from hospital to home is a significant period that sets the stage for many long-term outcomes including psychological adjustment, occupational participation, and quality of life. Despite the significance of this period, individuals with ABI and their caregivers/families report unsatisfactory transition experiences marked by inadequate discharge planning and discontinuity of care. Objectives: This qualitative descriptive study aims to explore the unique hospital to home experiences of both individuals with ABI and their caregivers/families to help identify and inform quality improvement opportunities in transitional care planning. Methods: Three participants were recruited from rehabilitation centres and community-based organizations. Semi-structured interviews were conducted, followed by a thematic analysis to identify common themes across the data set. Outcomes: Participants desired information regarding ABI signs and symptoms, management, and relevant community supports and services prior to their discharge home. Participants identified social support and community programs as instrumental resources facilitating their hospital to home transition. Returning to daily life and returning to work were identified as major challenges. Conclusions: This research has the potential to contribute to the development and implementation of an ABI-specific transition strategy in both emergency department and inpatient rehabilitation settings.
HS2 OCCUPATIONAL THERAPY PRACTICE FOR TRANSITIONAL-AGE-YOUTH WITH DEVELOPMENTAL DISABILITIES AND MENTAL ILLNESS
Students: Umair Alam and Sierra Bahar
Supervisors: Suryani Hamdani and Lynn Cockburn
Background: Intellectual/Developmental Disabilities are chronic impairments appearing at birth or before the age of 18 limiting an individual’s ability to learn, understand, or use information. Despite an abundant level of occupational therapy services for the child sector of this population, little is known about the current state of such services for the transitional-age-youth of this population. Purpose: This scoping review explores the state of occupational therapy knowledge and practice for transitional-age-youth with intellectual/developmental disabilities or a dual diagnosis. Method: Research articles, review articles, and gray literature were searched. Data were collected through electronic journal databases and reference lists. Thematic analysis was used to chart key themes and the Canadian- Practice- Process- Framework was applied for an in- depth analysis of thematic results. Findings: Results showed transitional-age -youth with intellectual/developmental disability or a dual diagnosis are receiving sub-optimal level of occupational therapy services. Implications: To facilitate smoother transition, an increase in occupational therapy service delivery is needed to yield enablement in meaningful occupation and an improved quality of life.
HS3 DETERMINING THE NEED FOR 24-HOUR SUPERVISION: A CROSS-SECTIONAL SURVEY
Students: Ricky Ferri and Kendra Flemming
Supervisors: Emily Nalder, Mathew Rose, and Avelino (Jun) Maranan, Jr.
Background: Occupational therapists have an established role assessing the amount of care an individual’s needs following an injury or incident. Determining that an individual needs 24-hour supervision is one of the most economically significant decisions they can make and yet there are no established guidelines to inform this decision making. This can result in inconsistencies in what assessments occupational therapists use and what functional areas they assess. This can come to affect the quality of occupational therapists’ testimonies if their determinations are ever contested in court. Purpose: Explore how occupational therapists assess the need for 24-hour supervision, including; assessments used, modes of clinical reasoning, and confidence levels in their abilities to do so. Methods: Quantitative descriptive design. A cross-sectional, anonymous, online, self-report survey was distributed to occupational therapists nationwide. 90 responses were received and analyzed using quantitative descriptive statistics. Findings: Occupational therapist participants self-reported 166 different standardized assessments (113- person, 39- Occupation, 14- environment) used when determining for 24-hour supervision. The most frequently reported method of clinical reasoning was pragmatic reasoning (person, environment) and conditional reasoning (occupation). Finally, therapists reported their confidence levels of either confident (median=4) or very confident (median=5) across all subdomains of the CMOP-E. Implications: An understanding of how occupational therapists are assessing for 24-hour supervision can inform practitioners about what is currently happening in the field, provide researchers with foundational information to guide practice evaluations, and consensus building exercises regarding best practices for assessing the need for 24-hour supervision.
HS4 TRENDS IN OCCUPATIONAL THERAPY PRACTICE WITH ADULTS WITH DUAL DIAGNOSIS: A SCOPING REVIEW
Students: Rowan Cancelliere and Amy Yang
Supervisors: Lynn Cockburn, Suryani Hamdani, Jessica Rosales, Elyse Goodfield
Introduction: This scoping review endeavours to understand the work currently being done by occupational therapists who work with dual diagnosis adults. The review seeks to understand trends in occupational therapy practice, as well as identify gaps which hold potential for future intervention and role definition. Methods: ERIC, PsycINFO, MEDLINE, AMED, EMBASE, CINAHL, ASSIA, and AgeLine were searched. Articles published within a ten-year span (January 1, 2008 to December 31, 2018) were included. Terms related to intellectual and developmental disability, mental illness, and occupational therapy were searched. Results: Initial searches yielded 834 articles. After deduplication, 649 potentially relevant articles remained. Their titles and abstracts were screened. Of these articles, 20 met the inclusion criteria for full-text assessment. Two articles remained and were included in the scoping review. The reference lists of the two included articles were then examined. No potentially relevant articles were identified.
Conclusion: The review conducted examined occupational therapy literature concerning work with adults over the age of 21 who have dual diagnosis (both developmental disability and mental illness). Two papers fit the inclusion criteria. Common themes included habituation fostering self-determination; context; fostering belief in own abilities; occupation-based assessments; and use of occupation to foster skills.
HS5 RETENTION IN GROUP-BASED DIABETES CARE PROGRAMS: A MULTIPLE-CASE STUDY DESIGN
Students: Ahlam Awata and Alexandra Dzubina
Supervisor: Andrea Duncan
Other Team Members: Husayn Marani, Upasana Saha, Christiana Martine, and Arrani Senthinathan
Background: Type 2 diabetes (T2D) is the most common form of diabetes in Ontario. T2D can result in health complications and high healthcare costs. Many group-based programs have the potential to be effective in preventing the onset and progression of T2D. One issue identified in these programs is participant retention. While previous studies have identified factors that contribute to retention, there is limited qualitative about how and why such factors contribute to retention. This study sought to explore the perspectives of educators on retention factors in group-based diabetes programs. This study then explored how these perspectives compared across the different programs. Methods: A qualitative multiple case study was used to understand retention factors across six cases (n = 6). The diabetes educators participated in a semi-structured interview, following which the data was transcribed verbatim. The data were then analyzed using a within-case thematic analysis and cross-case analysis. Results: The following study was able to provide insight regarding five themes program educators have identified that impact retention among their participants. The themes that influenced retention included: individual factors, logistical factors, social factors, program factors, and strategies to improve retention. Conclusion: The findings of this study provided insight regarding factors that impact participant retention across group-based diabetes programs. The retention themes that were identified in this study can inform the approaches of diabetes educators to promote retention in their programs.
HS6 COMMUNITY MENTAL HEALTH SERVICE PROVISION, FUNDING MODELS, AND CONSUMER OUTCOMES
Students: Rachel Duncan and Sara Argueta
Supervisor: Andrea Duncan
Background and Objective: It is poorly understood how different community mental health funding contexts impacts service provision practices and outcomes. This study’s objective is to explore how public funding models influence provider processes and service outcomes in community mental health settings. Methods: This study uses a realist synthesis approach, which seeks to understand the interactions between context, mechanisms, and outcomes of services. Studies included were published from 2008 to 2018 and found within the databases MEDLINE, CINAHL and EMBASE. A final sample of 11 articles were included. Findings: Many funding contexts were identified: Medicaid, grants – federal, state and private, universal public funding, public funding care packages, free-choice market, payment by results, and state funding from income tax. Regardless of funding context, common provider processes emerged: increased staff, innovative partnerships, intra-organizational leadership, service expansion, and staff training. Conclusions: This study provides preliminary research into interpreting how organizations can use certain provider processes within their funding context to influence service outcomes, which has implications for Canada’s community mental health system.
HS7 PATIENT AS TEAM MEMBER: EXPLORING ACTIVE PATIENT PARTNERSHIPS AT ST. JOHN’S REHAB
Students: Taylor D’Souza and Hannah Steigner
Supervisors: Sander Hitzig and Siobhan Donaghy
Background: Over the last decade, growing evidence has emerged demonstrating the positive impact of patient engagement on patient outcomes and experiences. However, there is a lack of clarity on what the term ‘patient engagement’ means regarding decision making and goal setting. This study was developed to better understand the factors influencing this gap, and reveal opportunities for enhanced active partnership between patients and their clinical teams. Objectives: The aim of this study is to gather information on the experience and perspectives of clinicians, patients and their families regarding the factors that influence patient engagement in rehabilitation decision making and goal setting. Methods: Approximately 12 clinicians and 5 patient and family members receiving care at Sunnybrook St. John’s Rehabilitation Hospital will participate in this qualitative study. A series of focus groups and interviews will be conducted to better understand their experiences and perspectives. The perspectives of clinicians, patients and their families on patient engagement will provide insights on how to enhance the care experience for patients at St. John’s Rehab. Implications: This study will provide insights on how patient partnerships can be fostered by interprofessional teams in a rehabilitation setting, supporting active engagement and an enhanced care experience for patients.
HS8 ADMISSION FACTORS THAT PREDICT OCCUPATIONAL THERAPY STUDENTS’ PRACTICUM SUCCESS
Students: Adam Mohamed and Markus Ott
Supervisors: Behdin Nowrouzi-Kia and Jill Stier
Objectives: This study explored which admission factors predicted competency-based fieldwork evaluation for occupational therapists (CBFE-OT) scores for successful applicants to a Canadian Master of Science in Occupational Therapy (MScOT) program. Methods: Using a quasi- experimental ex post facto design, 446 admitted MScOT applicants’ scored admission packages and letters of reference were analyzed and then correlated with midterm and final CBFE-OT scores across four practicum placements. Regression analyses were completed for significant correlations. Results: For final evaluations of successful applicants in physical health settings for fourth practicum placement, admission package scores were positively correlated with CBFE-OT scores. Alternatively, grade point average was negatively correlated with CBFE-OT scores. Objectives: Success on an MScOT practicum placement demands a different subset of skills than achieving success academically.