The use of interventions based on the best available evidence in occupational therapy is essential, and evaluation of research is part of an evidence-based practice. The aim of this study was to assess the quality of studies describing and evaluating the effects of occupational therapy interventions on chronic pain. A systematic review of studies with diverse designs was carried out. A quality assessment was conducted, and the level of evidence was defined using the Research Pyramid Model. Of 19 included studies, three received the highest evidence level, and three were considered to be of high quality. The clinical recommendations that can be derived from this study are the following: occupational therapy interventions should start from the identified needs of the person with chronic pain; no support exists for the effectiveness of electromyographic biofeedback training as a supplement, more studies are needed to confirm this result; the efficacy of instructions on body mechanics was significant during work-hardening treatment; and occupational therapists need to perform and present more clinical studies of high quality and high-evidence level to build up a trustworthy arsenal of evidence-based interventions, for example, in persons with chronic pain. Copyright (C) 2015 John Wiley & Sons, Ltd.
The purpose of the study was to investigate the value of computer-assisted activities for four individuals with brain damage. Individuals were trained in cognitive functions in their homes to compensate for cognitive impairment, assisted in work activities and helped in leisure time occupations. The four people received individually adapted computers and peripheral equipment, and the environment was changed to accommodate their needs. Each person received guidance and instruction from an occupational therapist once or twice a week for 12–18 weeks. The goals for each person were achieved according to evaluation with Goal Attainment Scaling.
Focus group interviews were used to examine validity of the Quality of Life Scale, Swedish version (QOLS-S) for use with women with fibromyalgia. Five interviews with 18 women with fibromyalgia were completed. The opening question was “What does quality of life mean to you?” Later, participants were asked to respond to questions about the specific domains and items in the QOLS-S. The transcribed interviews were analysed, and categories were identified. Opinions concerning domains and items in the QOLS-S were linked to domains of the QOLS-S. Four categories emerged from the opening question: finances, to be an active person and participate in society, relations with others, and health. Overall, the women's perceptions of quality of life were congruent with the domains of QOLS-S. However, further attention should be given to the translation of certain items and apparent overlaps in some items indicate that they can be combined. Also, the instrument needs to be scrutinized from a cultural perspective because some items in the “social, community and civic activities” domain were not endorsed by the participants.
Adherence to highly active antiretroviral therapy (HAART) is essential to improving the quality of life of people living with HIV/AIDS; however, it still remains a challenge especially for young African women. The purpose of the study was to explore how young women with HIV/AIDS in Uganda experience the influence of their everyday life occupations on adherence to HAART after more than 1 year on the medication.
Narratives of six participants were elicited using two semistructured interviews within a period of 1 month. Narrative analysis was used to develop themes reflecting the participants' stories of coping with everyday activities.
The participants described their adherence to HAART in relation to everyday life occupations as a “tug of war”, which describes the struggles they had taking medication because they were afraid of being discriminated by peers and the general society. They also expressed fear of not being included in many activities if people knew they have HIV/AIDS because there are many beliefs associated with the illness especially for young women in which they are branded promiscuous. However, in the Ugandan culture, women are considered to be home makers, which restricted their activities mostly around domestic work making it hard for them to prioritize their medication, and when they young women prioritized, it was all about fun activities that seemed to consume much time, hence contributing to the poor adherence. It is therefore important to assess the everyday occupations of young women before they start taking medication, so that HAART is scheduled in accordance with their everyday life occupation to reduce poor adherence.
The implications of the study on practice is that it will enable occupational therapists working with persons with HIV/AIDS develop age-specific activities taking into consideration HAART as an everyday life activity rather than one that needs to be incorporated into their already existing activities, hence improving their adherence and reducing on stigma associated to the medication.