Occupational Therapy Commons^™

The Impact Of Patient Characteristics On Dysphagia Therapy Utilization And Feeding Outcomes For Premature Infants In The Neonatal Intensive Care Unit, Tiana Nguyen

Theses and Dissertations

Medical advances have significantly increased the survival rates of preterm infants at lower gestational ages. However, infants born at lower gestational ages have an increased risk for developmental disabilities and oral feeding difficulties. A stay in the neonatal intensive care unit (NICU) is very costly and inadequate oral feeding is the most common barrier to discharge for premature infants. Infants can receive dysphagia therapy services during their NICU stay that focuses on the development of oral feeding and swallowing skills. However, literature to this date has mainly focused on the impact of therapy services for premature infants after NICU discharge. …

The Environment Of Interprofessional Education In Graduate Education: Exploring Professional Programs Of Occupational Therapy, Physician Assistant, And Physical Therapy, Allison R. Kaczmarek

Theses and Dissertations

Interprofessional education (IPE) is an educational approach of increasing popularity in professional schools for the preparation of a collaborative ready healthcare workforce. The accrediting bodies of professional education programs in occupational therapy (OT), physician assistant (PA), and physical therapy (PT) have incorporated standards for outcomes addressing IPE. Although they have endorsed the Health Professions Accreditors Collaborative (HPAC) consensus document on quality IPE, we do not have a contemporary snapshot of the IPE environments in the curriculum of their accredited programs. This dissertation, a collection of three distinct inquiries, has two aims: first, to provide a description of IPE as it …

Nonpharmacological Practices For Reducing Agitation In Persons With Dementia, Meghan L. Farkas

Commonwealth Scholars Program

1 in 11 people aged 45 years and older experience subjective cognitive decline, with nearly a third identifying a decline in the ability to participate in social activities, work, or volunteering. There are twelve modifiable risk factors that can either increase or decrease an individual's possibility of developing Dementia. This can include excessive alcohol consumption, head injury, air pollution, lower education level, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and infrequent social contact. These modifiable risk factors may prevent or delay up to 40% of dementias. Furthermore, many risk factors cluster around inequalities, which occur particularly in Black, …

Tummy Time In Infancy: Real-World Assessments And Associations With Developmental Outcomes In Early Childhood, Ketaki Inamdar

Theses and Dissertations

Tummy time or awake, supervised, prone play is an important developmental play position in infancy. Engaging in more than 15 minutes of tummy time per day is associated with a lower risk of plagiocephaly, lower body mass index, and achievement of higher motor scores in full-term and at-risk preterm infants. However, there are significant gaps in the measurement of tummy time in current literature. Conventionally used subjective parent reports have not been validated against gold standard direct observation, and the feasibility and real-world validity of objective solutions such as wearable sensors has not been examined in full-term and at-risk preterm …

Intentions To Use Telerehabilitation For Communication And Treatment For Vision Impairments, Eric E. Hicks

Theses and Dissertations

BACKGROUND: Approximately 8.1 million people in the United States 18 and older have difficulty performing one or more daily activities because of vision impairment or blindness (Erickson, Lee, & von Schrader, 2020; Taylor, 2018). If the impairments caused by vision loss are not addressed, they can result in financial difficulties, suffering, disability, loss of productivity, and decreased quality of life (National Center for Chronic Disease Prevention and Health Promotion, 2011). Currently, in-person low vision rehabilitation services are the gold standard for teaching people how to adapt to and compensate for these deficits, however, the access and utilization of these services …

Relationship Of Demographic Characteristics Of Occupational And Physical Therapists Towards Their Knowledge And Attitude On Person-Centered Care In Skilled Nursing Facilities, Sadashiv R. Aggarwal

Theses and Dissertations

The study aimed to assess the relationship of specific demographic characteristics of occupational (OTs) and physical therapists (PTs) with their knowledge and attitudes towards principles of Person-Centered Care (PCC) in skilled nursing facilities (SNFs). The study further examined if knowledge and/or attitudinal differences exist between OTs and PTs towards PCC. The proposed descriptive study used the Person-Centered Care theory, which is a holistic (bio-psychosocial-spiritual) health care delivery approach. PCC delivers services that are respectful and individualized, allowing negotiation of care, and offering choice through a therapeutic relationship where persons receiving care are empowered to be involved in health decisions at …

The Impact Of Occupational Therapy Acute Care Services On Readmission Rates For Patients In Medicare’S Hospital Readmission Reduction Program, Jessica M. Edelstein

Theses and Dissertations

The United States (US) health care system is faced with the daunting challenge to make healthcare payments commensurate with quality of care provided. To assess quality, metrics for reimbursement have been established by Medicare. One such quality metric is hospital readmissions (readmissions). Readmissions are associated with poor patient outcomes and costly. Associated poor patient outcomes include higher risk for mortality, deconditioning, nutritional issues and cognitive impairments. As a result, readmissions cost Medicare $26 billion annually. Current strategies for reducing readmissions in the US are fragmented and hospital-specific. While specific strategies may vary, hospitals that have low readmissions rates tend to …

A Review Of Factors, Seating Design, And Shape Capture Methods For Reducing Pressure Injury Risk, John A. Damiao

Theses and Dissertations

This dissertation in the form of three papers ready for submission to peer-reviewed journals is submitted toward the requirements of the PhD in Health Related Sciences program at Virginia Commonwealth University. Chapter One provides an introductory overview of the project, including: (a) an overview of pressure injuries, (b) the impact of seating as an intervention, and (c) aims of the three-paper dissertation in addressing various aspects of pressure injury prevention. Each paper is unique and singular in its focus, yet all share the overlying aim of addressing pressure injury risk associated with wheelchair seating. Paper One describes the unique facilitators …

The Cognitive And Functional Impact Of Open Heart Surgery: A Pilot Study Including Three Common Procedures (Coronary Artery Bypass Graft, Heart Valve Replacement, And Left Ventricular Assist Device), Robert Fix

Theses and Dissertations

This study investigated the impact of open heart surgery (Coronary Artery Bypass Graft, Heart Valve Replacement, or Left Ventricular Assist Device placement) on cognition, functional performance, and mood in the three months following surgery. The Montreal Cognitive Assessment (MoCA), Kettle Test (KT), Physical Self Maintenance Scale (PSMS), and Hospital Anxiety and Depression Scale (HD) measured global cognition, functional cognition, functional performance, and mood states, respectively.

Thirteen male participants (ages 38 – 75) completed assessments at four time points -- when they were scheduled for surgery, within one week prior to surgery, before hospital discharge after surgery, and three months after …

The Impact Of Chemotherapy And Radiotherapy For Breast Cancer On Cognition And Functional Performance: A Comparative Analysis Of Survey Data Taken At Three Time Points Post-Treatment, Ann Marie Potter

Theses and Dissertations

Cognitive impairment related to treatment for breast cancer, affects as many as 75% of patients in study samples (Jansen, Cooper, Dodd & Miaskowski, 2011). Deficits in the cognitive domains of short-term memory, attention, speed of information processing, judgment, reasoning, spatial attention, and verbal memory have been documented. The extent to which these deficits impact functional performance within this population has not yet been quantified. The purpose of this study was to investigate the impact of breast cancer on self-reported cognition and functional performance in the six months post-completion in two groups of breast cancer survivors, a chemotherapy group and chemotherapy …

Successful Management Of Barth Syndrome: A Systematic Review Highlighting The Importance Of A Flexible And Multidisciplinary Approach, Stacey E. Reynolds

Occupational Therapy Publications

This review describes and summarizes the available evidence related to the treatment and management of Barth syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify articles published between December 2004 and January 2015. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach was used to guide the article selection and evaluation process. Of the 128 articles screened, 28 articles matched the systematic review inclusion criteria. The results of this review indicate the need for a flexible and multidisciplinary approach to manage the symptoms most commonly associated with Barth syndrome. It is recommended …

Workplace Discrimination And Visual Impairment: An Analysis Of Eeoc Charges And Resolutions, Jane Mcneil

Theses and Dissertations

Workplace discrimination for individuals with visual impairments in the U.S. is an ongoing issue dating before the founding of the EEOC and the enactment of the ADA. Despite laws enacted to protect against unequal treatment in the workplace, the EEOC continues to receive submissions of formal discrimination charges from individuals with visual impairments.

The workplace is experiencing changes with increasing amounts of older adults, women, minorities, and the use of technology and the Internet. By examining characteristics of the discrimination charges and the resulting outcomes, the knowledge gained can describe the current situation and the historical progression of workplace discrimination …

Relieving Post-Stroke Fatigue Using A Group-Based Educational Training Approach, Catherine E. Emery

Theses and Dissertations

Post-stroke fatigue is a common problem that may limit participation in everyday activities. Emerging evidence suggests that group-based training in fatigue management may be an efficient means of reducing the effects of post-stroke fatigue. This mixed methods, quasi-experimental study proposed to determine whether a group-based educational program could be successful in relieving post-stroke fatigue and improving participation in daily activities. A convenience sample of stroke survivors (n=20) from retirement communities in southeastern PA were invited to participate in the research. Participants were screened for depression, motor and cognitive recovery, and sleep quality. Fatigue was measured using the Fatigue Severity Scale …

Individuals With Fetal Alcohol Spectrum Disorder: Predictive Factors For Successful Occupational Performance, Mary Culshaw

Theses and Dissertations

As awareness and diagnoses of FASD grow in Canada, there is increased need to support these individuals across their lifespan. One study suggested the prevalence of FASD may be as high as 10 per 1000 births (May & Gossage, 2001). The impact to society is growing as well, since this population requires support across their lifespan due to cognitive and sometimes physical impairments. It was estimated that the annual cost to Canadians was $53 billion (in 2007 dollar value) to support individuals aged 0-53 years (Stade et al., 2009). There is mounting evidence identifying the cognitive and physical impairments that …

Growing Up In Ireland: Factors Impacting Sleep Patterns Of Preterm Infants, Joanne Fallon

Theses and Dissertations

GROWING UP IN IRELAND: FACTORS IMPACTING SLEEP PATTERNS OF PRETERM INFANTS

By Joanne Fallon MS, OT, PhD

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2015.

Major Director: Shelly J. Lane, PhD, Professor, Department of Occupational Therapy

Preterm infants represent the largest child patient group in the European Union (EU), accounting for 5.5-11.4% of all births (European Foundation for the Care of Newborn Infants, 2011b). Preterm birth is defined as birth prior to 37 weeks gestation. Infants born late preterm (34-36 weeks) are considered more …

Test Of Ideational Praxis (Tip): Preliminary Findings And Interrater And Test–Retest Reliability With Preschoolers, Shelly J. Lane, Carol K. Ivey, Teresa A. May-Benson

Occupational Therapy Publications

Praxis is the ability of the brain to develop an idea for action and plan, organize, and execute unfamiliar motor actions. It enables purposeful interaction with people and things in the environment. Ideation is central to praxis but has been little researched. This study investigated the reliability of the Test of Ideational Praxis (TIP) and examined ideational praxis in typical preschoolers. TIP performance for 78 preschoolers ages 3, 4, and 5 yr was videotaped and scored by two trained raters. The TIP has strong interrater reliability, supporting earlier findings. Further, we documented test–retest stability over 2 wk. As a group, …

Examining The Effects Of Human-Animal Interaction On Individuals With Developmental Disabilities, Jennie Feinstein

Theses and Dissertations

Companion animals play a pivotal role in typical human development. It remains unknown how animals affect individuals with developmental disabilities. Based on the knowledge that companion animals help typically developing individuals, this research examined the effects of human-animal interactions on individuals with developmental disabilities.

Human-animal interactions are based on the Biophilia hypothesis, an assertion that an emotional and beneficial relationship exists between humans and nature, in which there is an “innate tendency to focus on life and lifelike processes.” These are the shared, dynamic associations between people and animals, and the effects of those relationships on health and well-being. Sparse …

Examining The Sensory Characteristics Of Preschool Children With Retentive Fecal Incontinence, Isabelle Beaudry-Bellefeuille

Theses and Dissertations

Occupational therapists are concerned with individuals´ abilities to engage in daily occupations. When a daily activity such as bowel management is problematic, participation in key occupations can be limited. Retentive fecal incontinence is a common disorder in children. Behavior seems to be partly responsible for this condition. Occupational therapists have hypothesized that some behaviors could be related to sensory over-responsivity. This study investigated the relationship between retentive fecal incontinence and sensory over-responsivity and examined the Toileting Habit Profile Questionnaire, a tool designed to screen for toileting difficulties. The study showed that a group of children (n=16) with retentive fecal incontinence …

Effectiveness Of Sensory Integration And Behavioral Interventions On Nonengagement In Preschool Aged Children, Tiffany Kuyper

Theses and Dissertations

Abstract EFFECTIVENESS OF SENSORY INTEGRATION AND BEHAVIORAL INTERVENTIONS ON NONENGAGEMENT IN PRESCHOOL AGED CHILDREN By Tiffany Ann Kuyper, OTR/L A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Occupational Therapy at Virginia Commonwealth University Virginia Commonwealth University, 2012 Director: Marie Anzalone ScD, OTR, FAOTA This single subject pilot study explored a combination of sensory-based interventions and behavioral interventions in a preschool aged child identified with Sensory Over-Responsivity (SOR). Children often display nonengagement associated with escaping and avoiding tactile and/or vestibular information because they perceive sensory input as negative or aversive. The subject …

A Study On The Effects Of Therapeutic Listening On The Social And Functional Behavior Of Preschool Children With Autism Spectrum Disorder, Robin Abbott

Theses and Dissertations

Auditory sensory differences and sensitivities are often mentioned by parents of children with Autism Spectrum Disorder (ASD), and in research involving children with ASD. Addressing these auditory processing differences is the goal of various auditory treatment techniques, but current research does not yield a body of evidence in support of auditory therapy as a treatment for children with ASD. This study is a single-subject study, repeated across two subjects, to investigate the effect of the Therapeutic Listening program on the social engagement and self-care skills of preschool-aged children with ASD. Both social engagement and self-care skills increased with for both …

Stress And Anxiety In Adhd: Links To Sensory Over-Responsivity, Stacey E. Reynolds

Theses and Dissertations

Sensory Modulation Dysfunction (SMD) is characterized by an inability to consistently and accurately grade responses to sensory information. SMD, and specifically sensory over-responsivity (SOR), has been correlated with stress and anxiety in some developmentally delayed populations and has been associated with structures and functions of the hypothalamic-pituitary adrenal (HPA) axis. Recent attention has been given to HPA functioning in children with Attention Deficit Hyperactivity Disorder (ADHD), with a majority of studies identifying blunted or diminished cortisol patterns. In contrast, elevated cortisol has been associated with anxiety and anxious behaviors in both animal and human studies. The purpose of this study …

Parent And Therapist Perceptions Of Sensory Based Strategies Used By Occupational Therapists In Family-Centered Early Intervention Practice, Juliet Bertaut Copeland

Theses and Dissertations

A qualitative approach was used to explore the perceptions of parents and therapists in early intervention regarding sensory diets and their efficacy, particularly their goodness of fit within family routines and occupations. Open-ended interviews were conducted with therapist and parent participants and analysis of the data resulted in a model depicting how sensory diets became a "way of life" for families. The Sensory Diet "Way of Life" Model revealed seven themes that illustrated how occupational therapists in early intervention enter the homes of the families they serve and establish a "partnership" with parents to address a child's needs. Once this …

An Exploration Of How And Why Primary Care Providers Educate Infant Caregivers About Positioning, Amy Greenspon Choffin

Theses and Dissertations

A review of the literature indicates that how infants are positioned is related to the risk of SIDS, the incidence and severity of plagiocephaly, torticollis, and developmental delays. A quantitative approach with survey methodology was used with 66 pediatric primary care providers responding to 26 questions. Overall, PCPs are educating caregivers about sleep positioning with a high frequency. There was a relationship between practice site, and the frequency of sleep positioning education is provided. While the participants provide education about awake positioning, and the use of positioning devices, it was with less frequency than they do about sleep positioning; there …

The Effects Of The Handwriting Without Tears Program On The Handwriting Of Students In Inclusion Classrooms, Lisa Owens

Theses and Dissertations

Many handwriting programs are currently used in schools, but little research has been conducted on their effectiveness. A quasi-experimental non-equivalent comparison group pretest posttest design examined effects of the Handwriting Without Tears program with special and general education students enrolled in inclusion classrooms. Two experimental classes received instruction with the HWT method while two comparison classes received instruction using traditional methods. Handwriting performance was measured using the Minnesota Handwriting Assessment. One-way analysis of covariance tested the differences between rates of handwriting improvement for experimental and comparison groups while controlling for pretest scores. Students in the experimental classes showed no statistically …

Parent Perceptions Of Occupational Therapy In Early Childhood Special Education Programs Following Transition From Early Intervention Programs, Anita M. Wyrick

Theses and Dissertations

A qualitative approach was used to explore the perspectives of seven parents of preschool age children with disabilities in Virginia regarding occupational therapy and the transition from early intervention (EI) to early childhood special education (ECSE). Open-ended interviews were used to collect data from each family participant and were presented as individual case reports. A cross-case analysis revealed six common categories and four overarching themes. Results indicated that the transition was viewed positively when parents saw benefits of the change and when they were oriented toward the future. Parents viewed the EI and ECSE systems as not sharing their same …