To Örebro University

The aim of the present study was to investigate the quality of housing support provided in housing services for people with psychiatric disabilities living in ordinary housing with housing support from the residents' perspective, by using the QPC-H instrument. A sample of 174 residents in ordinary housing, receiving housing support from 22 housing support services in nine Swedish municipalities, participated in this study. The results show that the quality of psychiatric care in housing services was mainly rated highly as measured with the QPC-H instrument. The dimensions Encounter and Secluded Environment were the aspects that were rated as the two with the highest quality of housing service. The dimensions Participation and Secure Environment were rated as those with the lowest quality. There were more residents who totally disagreed with the statements in the dimensions Participation and Housing Specific than in the other dimensions. The perceived lower quality in Encounter, Participation, Support and the Housing Specific dimensions was associated with a low frequency of psychiatric outpatient clinic contacts. A conclusion is that the support staff could be more observant regarding the residents' need for support and also talk more with them about what could be done to assist them. It also seems important that the support staff discuss with the residents regarding how they can help them to feel more secure in their accommodation.

Purpose - The purpose of this paper is to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Housing (QPC-H) and briefly describe the residents' perception of quality of housing support. Design/methodology/approach - A sample of 174 residents from 22 housing support services in nine Swedish municipalities participated in the study. Confirmatory factor analysis (CFA) revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care (QPC) family of instruments. Findings - CFA revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the QPC family of instruments. The internal consistency of the factors was acceptable except in the case of secure and secluded environment, probably due to few numbers of items. With this exception, the QPC-H shows adequate psychometric properties. Social implications - The residents' ratings of quality of housing service were generally high; the highest rating was for secluded environment and the lowest for participation. This dimension would thus seem to indicate an important area for improvement. Originality/value - The QPC-H includes important aspects of residents' assessment of quality of housing service and offers a simple and inexpensive way to evaluate housing support services from the residents' perspective.

Background/aims: The aim of the present study was to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care - Daily Activities (QPC-DA) and to briefly describe the day centre attendees' perception of the quality at community-based day centre services.

Methods: A sample of 218 attendees from 14 community-based day centre services in seven municipalities in Sweden participated in the study.

Results: Confirmatory factor analysis revealed that the QPC-DA consists of six dimensions and has a factor structure that to a large extent corresponds to that found in other studies of quality in psychiatric care settings, such as inpatient, outpatient, forensic inpatient, and housing support for people with psychiatric disabilities. The internal consistency of the factors was satisfactory and thus the QPC-DA showed adequate psychometric properties. The attendees' ratings of quality of community-based day centre services were generally high. The highest rating was for the encounter dimension and the lowest for the participation and the secluded environment dimensions, indicating areas for improvement.

Conclusion/significance: The QPC-DA includes important aspects of the attendees' assessment of quality of community-based day centre services and offers a simple and inexpensive way to evaluate quality from their perspective.

Creative activities have historically been used in occupational therapy, and although their usage has declined in recent decades, they are still used in Swedish practice. The aim of this study was to better understand how occupational therapists use creative activities in practice. A web-based survey was sent to 520 occupational therapists, of which 304 (58.5%) responded. The main reason identified for using creative activities was to strengthen the client's occupational performance, well-being and self-esteem. The expected outcomes of applying creative activities were to support the client in self-expression and experiencing joy and desire. More than half of the occupational therapist respondents did not use creative activities to the extent they desired. Creative activities in occupational therapy are still used as a vital treatment to strengthen the clients' occupational performance abilities. The survey has looked at only a professional perspective on effectiveness of applying creative activities in occupational therapy. More research is needed to evaluate how occupational therapists internationally apply creative activities. There is also a need to gain information from the client's perspective on the therapeutic value of creative activities.

Background: Mobility problems and cognitive deficits related to transferring or moving persons suffering from dementia are associated with dependency. Physical assistance provided by staff is an important component of residents' maintenance of mobility in dementia care facilities. Unfortunately, hands-on assistance during transfers is also a source of confusion in persons with dementia, as well as a source of strain in the caregiver. The bidirectional effect of actions in a dementia care dyad involved in transfer is complicated to evaluate. This study aimed to develop an assessment scale for measuring actions related to transferring persons with dementia by dementia care dyads.

Methods: This study was performed in four phases and guided by the framework of the biopsychosocial model and the approach presented by Social Cognitive Theory. These frameworks provided a starting point for understanding reciprocal effects in dyadic interaction. The four phases were 1) a literature review identifying existing assessment scales; 2) analyses of video-recorded transfer of persons with dementia for further generation of items, 3) computing the item content validity index of the 93 proposed items by 15 experts; and 4) expert opinion on the response scale and feasibility testing of the new assessment scale by video observation of the transfer situations.

Results: The development process resulted in a 17-item scale with a seven-point response scale. The scale consists of two sections. One section is related to transfer-related actions (e.g., capability of communication, motor skills performance, and cognitive functioning) of the person with dementia. The other section addresses the caregivers' facilitative actions (e.g., preparedness of transfer aids, interactional skills, and means of communication and interaction). The literature review and video recordings provided ideas for the item pool. Expert opinion decreased the number of items by relevance ratings and qualitative feedback. No further development of items was performed after feasibility testing of the scale.

Conclusions: To enable assessment of transfer-related actions in dementia care dyads, our new scale shows potential for bridging the gap in this area. Results from this study could provide health care professionals working in dementia care facilities with a useful tool for assessing transfer-related actions.

Aim: To study the inter- and intra-rater reliability of a newly developed assessment scale, the Dyadic Interaction in Dementia Transfer Assessment Scale (DIDTAS).

Methods: Two physiotherapists completed the observational form of the DIDTAS while watching 20 video-films of sit-to-stand-transfers or bedside transfers (i.e., caregiver-assisted transfers), videotaped in a dementia special care unit. Two-way analyses of variance (ANOVAs) were used for calculating ICC values of each item.

Results: The results supported the overall reliability of the DIDTAS items with variations in inter- and intra-rater reliability, with ICC values from 0.35 to 0.92.

Conclusion: On the basis of the transfer-related actions of dementia care dyads, the DIDTAS was shown to be sufficiently reliable. This in turn can provide healthcare professionals seeing and treating individuals suffering from dementia with a new method for assessing actions related to person transfer situations in dementia care facilities.

Primary objective: To describe Swedish occupational therapist practice patterns for clients with cognitive impairment following acquired brain injury.

Research design: A cross-sectional stratified random sample of 462 occupational therapists.

Methods: An online questionnaire was used to collect data.

Main results: The predominant practice pattern was the use of ADL-activities for assessment and therapy regardless of whether limitations in occupational performance or cognitive function were assessed or whether the approach was remedial or compensatory. For assessment, general ADL-instruments were used more often than instruments that assessed cognitive function. Instruments were used less often within municipal rehabilitation facilities compared to regional, county and primary care facilities. The most common focus of the therapies was in regard to abilities related to executive functioning. Another prominent practice pattern was a collaborative approach involving clients, relatives and other staff. The theories used in practice were, to a large extent, general in nature and did not focus specifically on cognitive functioning.

Conclusions: Swedish occupational therapy practice for clients with cognitive impairments following acquired brain injury focuses highly on occupational performance. Therapies targeting executive functioning seem particularly important in practice and a collaborative approach involving clients, relatives and other staff is a prominent feature in practice.

To add knowledge on how occupations contribute to health and wellbeing and to explicit describe thetherapeutic potential in occupations deeper knowledge is needed. One way is to ground the knowledgeon narratives from people’s experiences. In consequence a questionnaire was constructed based onnarratives from persons with mental disorders who have taken part in occupational therapy. A new version of the questionnaire was developed and as the items have been reformed a new underlying structure was expected.

The aim of the present study was to investigate the construct validity and the internal consistency of the questionnarie in a new sample of individuals with severe mental disorders. Persons (n=106) with mental disorders participated in the study by answering the questionnarie after performing an occupation in therapy. The correlation between each of the 35 items was analyzed and items with high correlation were excluded from further analysis. Twenty-five items were left to explorethe underlying factor structure of the questionnarie.

A principal component analysis with varimaxrotation resulted in the five factors, “Ability to perform occupation”, “Feeling of belongingness”, “Engaging in occupation”, “Influencing on occupation” and “Insight into ability”. A second order factoranalysis resulted in a three component structure explaining 79 % of the variance. In summery, a pattern of occupation as a therapeutic medium was found and gave a ground for the construction of the questionnaire Self Assessment of Occupational Ability (SAO).

The pattern found is constructed by the three components, “Sense of competence, “Feeling of belongingness” and “Insight into ability”including the five factors and 25 items. The SAO will be presented the first time in the WFOT 2014, a tool to bee used by occupational therapist in their cooperation with persons with mental disability to find out how occupation can be of help in their recovery.

Occupation as a mean in therapy contributes to personal development, stimulates people’s senses, and generates positive energy, happiness and satisfaction. Creative activities might be one form of occupation that mediates these outcomes. The aim of this study was to describe the prevalence of creative activities in occupational therapy in Sweden and how often occupational therapists use creative activities as a means of intervention. A web-mail survey was sent to 2975 occupational therapists working in health care and 63 % answered the questionnaire, of these 44 % did use creative activities. The extent to which the respondents used creative activities varied; 48 % used creative activities once a week or more, 36 % once a month or more, and 14 % at some point every six months. There was a significant relationship between the level of health care the respondent worked at and use of creative activities. Creative activities were more often used by respondents working at county council, regional and “other” health care levels than by those working in primary health care or with vocational rehabilitation. Respondents who worked with patients in psychiatric rehabilitation used creative activities significantly more often than those working with patients in somatic rehabilitation, stressed patients/patients with chronic pain or other patients. Occupational therapists working in psychiatric rehabilitation reported using creative activities more frequently compared to the other areas of health care. No relationships were found between the use of creative activities and the variables gender or years of experience as occupational therapists. Further research should focus on more in-depth inquiries about how occupational therapists and their patients perceive the use of creative activities as a means of intervention in occupational therapy

BACKGROUND/AIM: The concept therapeutic use of self has mainly been described theoretically. Empirical descriptions are few and empirical validation is needed to make the concept more useful for informing practice and explaining what occupational therapists do in the interaction with their clients to facilitate successful outcomes. The aim of this study was to empirically define the aspects that occupational therapists working with clients with cognitive impairments following acquired brain injury find are consistent with the concept of therapeutic use of self.

METHOD: Thirteen expert occupational therapists participated. Reactive Delphi technique in three rounds was used where each round built on the results of the previous one. A questionnaire based on current literature was developed for the first round.

RESULTS: Twenty of 33 statements reached a consensus level of 75% or more. These statements reflected the therapists' consciousness, self-awareness and use of personal characteristics. The statements also concerned the intentions of therapeutic use of self, including client group-specific intentions such as enhancing self-awareness. The results indicate that the content of the concept may be defined differently depending on the client group.

CONCLUSIONS: The empirical descriptions generated from this study may help occupational therapists working with clients with cognitive impairments following acquired brain injury to describe how and with what intention they use themselves therapeutically in the rehabilitation process. In occupational therapy education, the results may be used to highlight how the concept may be understood in practice and to discuss it in relation to different client groups.