Department of Occupational Therapy Works
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Item Wheeled mobility use outcomes: a systematic review protocol of measurement properties(Wolters Kluwer, 2024-09) Mendoza, Kiera; Loeser, Madison; Ouellet, Béatrice; Best, Krista L.; Paula, Rushton W.; Kenyon, Lisa K.; Hinrichs, Rachel J.; Chase, TonyNumerous tools have been developed to measure constructs related to wheelchair use. Currently, no toolkit comprehensively details assessments of wheeled mobility device use based on the quality of their measurement properties. The current review aims to systematically identify high-quality assessment tools that measure different aspects of wheeled mobility use. The objectives are two-fold: i) to synthesize outcome measures that assess use of wheeled mobility devices, and ii) to evaluate measurement properties of the assessment tools. The populations of interest are manual wheelchair users, power wheelchair users, and scooter users of any age, diagnosis, or setting. Instruments of any type will be included. The JBI methodology for systematic reviews of measurement properties will guide this review. A search strategy will be developed to search the following databases: MEDLINE (Ovid), Embase, CINAHL (EBSCOhost), PsycINFO (EBSCOhost), PsycTests (EBSCOhost), Web of Science, and Google Scholar. The article selection process, data extraction, and quality appraisal will be performed by 2 independent reviewers, with a third reviewer being consulted to achieve consensus. The methodological quality of the studies will be assessed through the Consensus Standards for the Selection of Measurement Instruments (COSMIN) Risk of Bias tool and the COSMIN Checklist. The quality of the pooled evidence and individual measurement properties will be graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the COSMIN Criteria for Good Measurement Properties recommendations. Measurement properties of each instrument will be described, with the goal of developing a toolkit that identifies appropriate assessment tools for wheeled mobility use outcomes.Item Bridging the Humanities and Health Care With Theatre: Theory and Outcomes of a Theatre-Based Model for Enhancing Psychiatric Care via Stigma Reduction(APA, 2022-12-22) Wasmuth, Sally; Pritchard, Kevin T.; Belkiewitz , Johnna; Occupational Therapy, School of Health and Human SciencesObjective: This article describes the rational, methods, implementation, and effectiveness of Identity Development Evolution and Sharing (IDEAS), an evidence-supported, narrative theater-based training that reduces stigma among health care providers to increase health care equity in psychiatric rehabilitation. Method: The IDEAS model has been used to reduce provider bias toward patients. From May 2017 to January 2020, we interviewed people from three patient groups who have been harmed by stigma, including Black women, transgender, and gender-diverse people, and people with substance use disorders. These interviews informed the creation of three theatrical scripts that were performed by professional actors for audiences of health care providers from January 2020 to May 2022. The performances aimed to raise conscious awareness of implicit provider biases and to provide a reflective opportunity to ameliorate these biases. The purpose of IDEAS is to improve experiences in health care settings such as psychiatric rehabilitation of patients from groups who have been harmed by stigma. We used paired-samples t tests to compare pre/postprovider stigma, measured via the Acceptance and Action Questionnaire-Stigma (AAQ-S). Results: Sociodemographic factors for providers who viewed IDEAS were similar across all three performances. IDEAS significantly decreased AAQ-S scores (t = 11.32, df = 50, M = 13.65, 95% confidence limit: [11.32, 15.97], p < .0001). Conclusions and implications for practice: IDEAS reduces provider stigma to support positive clinical encounters with diverse patient populations. These findings are relevant for psychiatric rehabilitation settings, which seek to establish positive rapport between providers and patients.Item Exploring autobiographical memory functions in Korean older adults: Development and application of the Korean version of Thinking About Life Experiences scale (TALE-K)(2021) Park, Sangmi; Lee, Chang Dae; Kim, Tae HuiObjective: The aim of this study was to develop a Korean version of the Thinking About Life Experiences scale (TALE-K) and to analyze the characteristics of autobiographical memory function (AMF) in community-dwelling older adults Methods: To develop TALE-K, a translation and back-translation procedure followed by an understanding test was performed. Then, a survey was conducted to examine the associations of AMF with psychosocial variables using TALE-K, Index of Well-Being (IWB), Meaning in life scale for older adults, Revised UCLA Loneliness Scale (RULS), Medical Outcomes Study Social Support Survey (MOS-SSS), Brief Resilience Scale (BRS). Results: Data from 75 community-dwelling older adults were used for the final analysis. The average scores of all three subscales of TALE-K were below 3 points (less frequent than occasionally). The correlation results showed that TALE-K total score was significantly associated with IWB and the Meaning in life scale for older adults. The multiple linear regression results presented that higher AMF was significantly associated with higher IWB, along with having siblings, higher meaning in life and resilience, and lower loneliness. Conclusion: Including a validation study of TALE-K, studies for understanding the characteristics of AMF in older adults using TALE-K are needed.Item Psychometric properties of self-reported instruments for occupational balance: A COSMIN-based systematic review(Taylor & Francis, 2023-08-14) Park, Sangmi; Lee, Chang DaeIntroduction Instruments being used currently to evaluate Occupational Balance (OB) are all self-report outcome measures which demand robust psychometric properties for precise assessment. This study aimed to systematically review the psychometric properties of the current OB instruments. Methods For this systematic review, COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 were adopted. Peer-reviewed articles published between January 2010 and February 2021 were searched for in PubMed, Cochrane, Web of Science, and PsycINFO databases. Search terms were full names and abbreviations of the OB instruments: Life Balance Inventory (LBI), Meaningful Activity Wants and Needs Assessment (MAWNA), Occupational Balance Questionnaire (OBQ), and Occupational Balance-Questionnaire (OB-Quest). Results Of the 400 articles identified in a systematic database search, 12 studies from 10 articles were analysed. Five instruments, including the revised version of the OBQ (i.e., OBQ11), were analysed within the COSMIN taxonomy. The LBI demonstrated ‘high’ evidence for insufficient structural validity. The others demonstrated ‘moderate’ or ‘high’ evidence for indeterminate structural validity. Less than sufficient structural validity led to indeterminate internal consistency across five instruments, and their quality of evidence varied from ‘very low’ to ‘high’. The MAWNA and OBQ demonstrated ‘very low’ evidence for sufficient reliability. Conclusion OB instruments with psychometric properties of sufficient overall ratings supported by ‘high’ quality of evidence are unavailable. Further studies are required to clarify the concept of OB, to examine more diverse psychometrics of OB instruments, and to consolidate their robustness.Item Occupational Therapy Intervention for Preventing Prescription Opioid Use Disorder in Older Adults(American Occupational Therapy Association, 2020-11) Lee, Chang Dae; Voelbel, Gerald TItem Postoperative Delirium Prevention as Standard Practice in Occupational Therapy in Acute Care(2020) Lee, Chang Dae; Chippendale, Tracy L; McLeaming, LizPostoperative delirium (POD) is common, especially among older adults, and can significantly impact health and rehabilitation outcomes. Research evidence suggests that a multicomponent intervention is most effective for delirium prevention. Given that this intervention includes diverse components, interdisciplinary collaboration among members of the healthcare team is essential. This paper presents how occupational therapists, as part of the interdisciplinary acute care team, contribute to preventing POD and embed their unique value, skills, and strengths in each component of the collaborative intervention. This paper also argues that POD preventive care should be standard practice for occupational therapy in the acute care setting.Item The relationship between active, balanced participation and well-being in older adults in the United States: A time-use perspective(Taylor & Francis, 2021-03-07) Lee, Chang Dae; Kim, Moon Young; Lee, Mi Jung; Kang, Jaewon; Foster, Erin RThe purpose of the study was to investigate the association between occupational balance and well-being in older adults. The sample was 2,142 older adults (aged 65 and older; mean age=73.4; 59.6% female) from the American Time-Use Survey (ATUS). Work and leisure time use was reported as the amount of time (min) spent on work and leisure occupations in the 24-hour day. A median split of total time spent on both work and leisure was used to create 4 time-use groups: high work high leisure = active balanced; high work-low leisure = work-focused; low work-high leisure = leisure-focused; and low work-low leisure = inactive balanced. Well-being was rated from 0 (the worst possible life) to 10 (the best possible life). Results showed that the active balanced group had significantly higher well-being than the inactive balanced group, after controlling for perceived health and well-restedness (p<0.05). There were no significant differences between any other group combinations (e.g., leisure-focused vs. work-focused and work focused vs. active-balanced). These findings are consistent with the occupational science literature indicating the importance of active participation in both work and leisure occupations for higher well-being and extended to the older adult population.Item Depressive Symptoms Mediate Associations between Subjective Memory Complaints, Cognitive Ability, and Instrumental Activities of Daily Living(Taylor & Francis, 2023-04-10) Lee, Chang Dae; Foster, Erin R.; Goverover, YaelObjectives: Cognitive ability (CA) and instrumental activities of daily living (IADL) performance are essential for productive aging. Therefore, it is important to understand if other common issues such as subjective memory complaints (SMCs) and depressive symptoms are related to CA and IADLs, and explore the nature of those relationships. This study aims to explore 1) the associations between SMCs, depressive symptoms, CA, and IADL performance and 2) the role of depressive symptoms in these associations. Method: The study sample included 1,621 community-dwelling oldest-old from the Health and Retirement Study. Results: SMCs were significantly and positively associated with cognitive decline and limitations in IADL performance. Additionally, depressive symptoms mediated the associations between SMCs and cognitive decline and between SMCs and limitations in IADL performance. Conclusion: Depressive symptoms associated with SMCs negatively affect CA and IADL performance. Therefore, healthcare providers should consider and assess SMCs and depressive symptoms in the oldest-old.Item Subjective memory complaints and social participation among older adults: results from the health and retirement study(Taylor & Francis, 2021-08-14) Lee, Chang Dae; Park, Sangmi; Foster, Erin RObjectives: This study aims to examine whether subjective memory complaints (SMC) contribute to social participation among older adults. Method: The study sample was 4,713 community-dwelling older adults aged 65 years and older from four waves (2010, 2012, 2014, 2016) of the Health and Retirement Study. Hierarchical linear modeling analysis was used to examine the association of SMC with social participation after controlling for factors influencing social participation. Demographic factors (i.e. age, gender, and perceived socioeconomic status) were entered in block 1, health-related factors (i.e. health conditions, perceived health, instrumental activities of daily living, memory-immediate and delayed, and depressive symptoms) were entered in block 2, environmental factors (i.e. perceived social support and strain from spouse, child, family, and friend) were entered in block 3, and SMC was entered in block 4. Results: The result showed that factors significantly contributing to social participation are age (standardized β = –0.08, p < 0.01), perceived socioeconomic status (β = 0.16, p < 0.001), perceived health (β = 0.15, p < 0.001), instrumental activities of daily living (β = 0.12, p < 0.001), memory-immediate and delayed (β = 0.09, p < 0.001; β = 0.08, p < 0.001, respectively), social support from spouse and friend (β = 0.04, p < 0.05; β = 0.13, p < 0.001, respectively), social strain from friend (β = 0.07, p < 0.001), and SMC (β = –0.05, p < 0.001). The demographic factors explained 9.5%, health-related factors explained 8.5%, environmental factors explained 2.4%, and SMC explained 0.1% of the variance in social participation. Conclusion: This finding suggests that SMC may contribute to social participation in older adults.Item Subjective Memory Complaints Predict Decline in Memory, Instrumental Activities of Daily Living, and Social Participation in Older Adults: A Fixed-Effects Model(American Occupational Therapy Association, 2023-08-21) Lee, Chang Dae; Foster, Erin RImportance: Although subjective memory complaints (SMCs) have been suggested to be associated with future memory impairment, limitations in instrumental activities of daily living (IADLs), and social participation restriction, these associations are still inconclusive. Objective: To determine whether changes in SMCs over time predict decline in memory, IADLs, and social participation in older adults. Design: Longitudinal study. Setting: Community. Participants: Sample 1 included 2,493 community-dwelling older adults drawn from the Health and Retirement Study (HRS) data collected between 2004 and 2018. Sample 2 included 1,644 community-dwelling older adults drawn from the HRS data collected between 2008 and 2018. Outcomes and Measures: Self-reported SMCs, memory function, self-reported IADL performance, and self-reported social participation. Results: The mean age of Sample 1 at baseline was 70.16 yr; 1,468 (58.88%) were female. In Sample 1, immediate and delayed memory (all ps < .001) and IADL performance (p < .01) declined over time. Increases in SMCs over time significantly predicted future immediate and delayed memory declines (p < .01 and p < .001, respectively) and future IADL performance decline (p < .001), after controlling for depressive symptoms. The mean age of Sample 2 at baseline was 71.52 yr; 928 (56.45%) were female. In Sample 2, social participation declined over time (all ps < .001). Increases in SMCs over time significantly predicted future social participation decline (p < .05), after controlling for depressive symptoms. Conclusions and Relevance: Increases in SMCs predict future decline in memory, IADL performance, and social participation after accounting for depressive symptoms. What This Article Adds: SMCs can be used as an early indicator of future memory impairment, IADL limitations, and social participation restrictions in older adults. Furthermore, interventions that minimize SMCs may help older adults achieve successful aging.