While occupation began as the central concept of occupational therapy at the dawn of the profession, the use of occupation throughout the therapy process, including assessment, has wavered in recent decades. Occupation is defined as meaningful and purposeful activities that individuals do to occupy their time and attention. The use of occupation-based assessments is vital to establishing care with an occupational focus. The purpose of this paper is to review the outcome assessment tools commonly used in the burn literature to evaluate hand function and critique the presence of occupation in each assessment using the Occupation-Based Practice Assessment (OBPA). Knowledge of the occupational nature of assessments is important to the delivery of an occupational therapy evaluation comprised of a battery of assessments inclusive of discrete measures of movement as well as performance-based tools to represent the person from an occupational perspective. Many outcome measures used in upper extremity burn rehabilitation are discrete in nature and do not measure occupations of clients. The Suitcase Packing Activity (SPA) may be a viable addition to an assessment battery to address this essential need.

UNASSIGNED: Using meaningful activities as a treatment modality is characteristic of occupation-based intervention (OBI). The benefits of OBI have been described, but not the effectiveness thereof. The aim of this review was to assess the effectiveness of OBI in relation to the type, commencement, duration and outcomes as reported in literature.
UNASSIGNED: A comprehensive search of electronic databases was conducted, including EBSCOHost, PubMed, Cochrane Register for Controlled Trials, Web of Science, OTSeeker, PEDro and Google Scholar. Search terms included \'occupation-based\', \'occupation-centered\', \'intervention\', \'upper limb\' and \'outcome measures\'. Studies including OBI for neurological or paediatric cases were excluded.
UNASSIGNED: Twelve studies met the inclusion criteria. Using the PEDro scale, three of the studies, all randomised controlled trials (RCTs), were viewed as high quality, one of fair and one of poor quality. Due to the heterogeneity of the studies, a meta-analysis was not possible, and a narrative synthesis is presented. Five studies used interviewing together with the Canadian Occupational Performance Measure (COPM) to determine the client\'s occupational profile when choosing meaningful activities. The commencement and duration of OBI varied amongst the studies, and a variety of outcome measures were used to determine the effectiveness of OBI.
UNASSIGNED: OBI used together with biomechanical approaches shows promising effectiveness. Outcome measures such as the COPM and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) that measure activity and participation, should be employed in client-centered practice. More robust scientific evidence regarding the effectiveness of OBI is needed.

The aim of this scoping review was to review and assess recent studies on the efficacy of home-based occupational therapy interventions for adults post-stroke. The number of efficacy studies is limited. The few studies available suggest that occupational therapy delivered in home settings may improve outcomes for stroke patients. There is also limited use of occupation-based assessments, interventions, and outcome measures in studies addressing home-based occupational therapy. Methodologies should be improved to include contexts, caregiver training, and self-efficacy. Further high-quality studies are needed on the efficacy home-based occupational therapy services.

Background. Many caregivers of autistic children experience increased stress, and diminished health often due to the caregiving demands. Purpose. The project aim was to design a feasible and sustainable wellness program tailored to these caregivers\' lives. Methods. In this collaborative research-informed project, participants (N = 28) were mostly female, white, and well-educated. In focus groups, we delineated lifestyle issues, then designed, delivered and assessed an initial program with one cohort; and repeated this process with a second group. Findings. Focus group data were transcribed then coded qualitatively to inform following steps. Data analysis identified lifestyle issues key to program design, desired program elements, and after program delivery, affirmed elements and recommended changes. The team used meta-inferences to guide program revisions after each cohort. Implications. Caregivers viewed resulting 5Minutes4Myself program as filling a significant service gap; its hybrid design used in-person coaching and a habit-building app with mindfulness content to support lifestyle change.

Background. Threshold concepts are key to professional identity development, transforming the way individuals think, act, and perceive the world. Purpose. To understand how occupational therapy students describe their professional identity, its importance, and how threshold concepts contribute to identity. Method. Mixed-method survey of final-year occupational therapy students (n = 58) at an Australian University. Findings. (i) High agreement on most identity and threshold questions; but up to 24% uncertain about confidence/competence in understanding specific concepts; (ii) occupation-focus is unique to our professional identity; (ii) identity develops over time; (iii) occupation-based, client-centered, and evidence-based practices are central to thinking like and becoming an occupational therapist; and (iv) practice education provides context for threshold concepts to be transformative. Implications. Identity is defined by a focus on occupation and its relationship to health. Traversing threshold concepts through academic and practice education is essential to developing professional identity.

UNASSIGNED: While occupational therapists value occupation-based practice, they appear to spend less time on this approach and more time on impairment-based practices. Several barriers are reported for the occupation-based approach.
UNASSIGNED: To explore different aspects of occupation-based practice among occupational therapists working in hospitals and rehabilitation institutions, and to examine associations between sociodemographic factors, barriers, and occupation-based practice.
UNASSIGNED: A cross-sectional survey was conducted. Participants were occupational therapists working in hospitals and rehabilitation institutions in Norway. The data were analysed with descriptive statistics and logistic regression.
UNASSIGNED: The therapists (n = 124) valued occupation-based practice and reported using it frequently and to a large extent. Relatively small proportions of their practice (26% assessments and 38% interventions) were classified as occupation-based. Lack of time, space and equipment were reported as large barriers. Lack of time and lack of equipment were associated with low self-reported level of occupation-based practice.
UNASSIGNED: The participants valued occupation-based practice, while the reported assessment and intervention methods were mainly not occupation-based. Several barriers were reported, and some were associated with less use of occupation-based practice.
UNASSIGNED: The results can be used to raise awareness of occupational therapists\' use of occupation-based practice and barriers to this approach.

We aimed to examine the feasibility and impact of a short-term occupation-based telerehabilitation intervention (Managing Participation with Breast Cancer (MaP-BC)) on daily participation, health-related quality-of-life, and breast-cancer-related symptoms and understand women\'s perspectives regarding strategies to manage daily participation and symptoms during COVID-19 pandemic. A mixed-methods study (single-arm pre-post with a qualitative component) included 14 women after their primary medical treatment for breast cancer. Women received six weeks of occupation-based intervention using a video-communication. Sessions focused on identifying functional goals and training strategies to manage daily participation. The primary outcome was perceived performance and satisfaction with meaningful activities by the Canadian Occupational Performance Measure (COPM). Secondary outcomes were participation in the Activity Card Sort (ACS), upper-extremity functioning of Disability Arm Shoulder Hand, self-reported symptom severity, executive-functioning, health-related quality of life, and a question regarding strategies used to manage daily participation. Women significantly improved their daily participation in meaningful activities in the COPM, most ACS activity domains, self-reported executive functioning, and health-related-quality-of-life. Qualitative findings revealed three main themes: (1) daily life under the threats of breast cancer and COVID-19, (2) women\'s own strategies to overcome challenges, and (3) contribution of the MaP-BC. Providing telerehabilitation during the COVID-19 pandemic is feasible and successful in improving women\'s daily participation after breast cancer.

The purpose of this study was to gather information on how hand therapists incorporate occupation-based interventions in their clinical practice and what outcome measures hand therapists use to measure the occupational performance of their clients STUDY DESIGN: Cross-Sectional Survey Design.
The 16-item Survey was distributed to members of the American Society of Hand Therapists on two occasions.
Three hundred eleven hand therapists responded to the survey. Hand therapists use a variety of occupation-based interventions (OBI) in clinical practice and most believe they are important. Findings from this study reveal that incorporating an occupation-based assessment along with or in place of an assessment of body functions and structures is not performed routinely. One hundred twenty-six (41%) respondents indicated that they use occupation-based activities 26-50% of the time with their clients.
The top three OBI interventions used by hand therapists included dressing tasks, cooking and meal preparation, and in hand manipulation of coins and medication. The lack of understanding of the theoretical models regarding occupation-based interventions may be a barrier toward implementation of occupation-based interventions and assessments as many hand therapists may have trained under a medical model.
Most respondents to this survey indicated that they believe OBI should be performed by hand therapists and use them routinely in practice. The most frequently used type of assessment was the DASH (Disabilities of the Shoulder Arm & Hand). The least frequently used assessment was the Short Form 36 and patient specific occupation-based assessment.

This paper describes implementation of a narrative-informed occupation-based service in an outpatient community mental health setting that addressed several gaps, including 1) the need for outcome data on occupational therapy in this setting; 2) an ongoing mental health provider shortage; and 3) a need for innovative approaches to supporting mental health. We found a significant improvement from baseline to post-intervention in occupational participation, and dose of occupational therapy was significantly related to improvements in the areas of roles, habits, values, long-term goals, social environment, and readiness for change. This study suggests future, larger effectiveness studies of narrative-informed occupation-based interventions delivered by occupational therapists in outpatient community mental health are warranted.

UNASSIGNED: Describing how occupation is used in practice can be challenging for occupational therapists. Occupation-centred, occupation-based, and occupation-focussed terminology are frequently used interchangeably and ambiguously to describe practice. However, ambiguous language creates confusion and inadequately demonstrates the value of occupation.
UNASSIGNED: This scoping review aimed to identify how occupation-centred, occupation-based, and occupation-focussed terminology are defined and represented in occupational therapy literature.
UNASSIGNED: A five-step scoping review included papers published between 2014 and 2019 from four databases. Extracted data were summarised to outline how the terms were being used within the literature.
UNASSIGNED: Initial searching yielded 819 articles and 35 papers met inclusion/exclusion criteria. Within current literature, occupation-focussed and occupation-based terminology were inconsistently described. A limited number of articles used occupation-centred and occupation-focussed terminology to describe practice, whilst occupation-based was more prominent. Occupation-based terminology was represented in numerous ways to describe assessments, practice tools, interventions, research, and theory. Discrepancies between the description and implementation of occupation-based practice were most prominent within interventions.
UNASSIGNED: Findings demonstrated that occupation-based and occupation-focussed terminology were used interchangeably and inconsistently in literature. It is timely to consider how this is problematic for our professional identity and perceptions of occupation in practice.