Rehabilitation and Therapy Commons^™

The Reliability And Validity Of The Tbi-Careqol System In Four Diverse Caregiver Groups, Noelle E Carlozzi, Sung Won Choi, Zhenke Wu, Srijan Sen, Jonathan Troost, Angela K Lyden, Jennifer A Miner, Christopher Graves, Angelle M Sander

Faculty, Staff and Students Publications

PURPOSE: Establishing the psychometric reliability and validity of new measures is an ongoing process. More work is needed in to confirm the clinical utility of the TBI-CareQOL measurement development system in both an independent cohort of caregivers of traumatic brain injury (TBI), as well as in additional caregiver groups.

METHODS: An independent cohort of caregivers of people with TBI (n = 139), as well as three new diverse caregiver cohorts (n = 19 caregivers of persons with spinal cord injury, n = 21 caregivers for persons with Huntington disease, and n = 30 caregivers for persons with cancer), completed 11 …

Past, Present, And Projected Occupational Impacts Of Adults Who Experienced Parentification In Childhood, Olivia Vanni, Jazminne Orozco-Arteaga

Spring 2023 Virtual OTD Capstone Symposium

Background: Parentification is a functional and/or emotional role reversal where the child sacrifices their own needs for attention, comfort, and guidance in order to accommodate and care for the needs of a parent and/or sibling. OTs need an understanding of how to recognize and support the impact of parentification during childhood, adolescence, and adulthood.

Methods: Mixed methods were used to explore the experience of adults (18-65) that served as caregivers for their sibling(s), and/or their parent(s) during their childhood/adolescence. Quantitative and qualitative data were collected through questionnaires (N=20) and interviews (n=6), allowing for a deeper understanding of the …

Occupation-Based Sexual Health Education For Adolescents With Disabilities, Elizabeth J. Klocke

Occupational Therapy Capstone Presentations

Individuals with intellectual and developmental disabilities experience barriers to learning about sexual health education even though there is documented interest in this subject. Additionally, caregivers of children with disabilities lack experience and knowledge of their children’s sexual developmental needs. My capstone project aimed to provide comprehensive sexual education to adolescents with disabilities and education on childhood sexual development to healthcare professionals, educators, and parents. The literature and needs assessment indicated a need for sexual health education for both students with intellectual and developmental disabilities and caregivers. Due to viewing clients in a holistic manner, occupational therapy is uniquely qualified to …

Occupational Therapists’ Role In Educating Caregivers On Pediatric Sensory Interventions Guided By Neurodiversity Principles, Deanna Bourgeois

Student Capstone Papers

Background: Neurodivergent children often experience differences in sensory processing and self-regulation. Traditional sensory-based interventions are frequently used by occupational therapy practitioners (OTP) and caregivers to address dysregulation. However, sensory-based interventions, while often strengths-based, are not always neurodiversity-affirming.

Problem: There are minimal educational resources available to both OTP and caregivers that promote neurodiversity-affirming sensory interventions to support neurodivergent children.

Methods: The purpose of this project was to create self-paced educational modules to teach neurodiversity-affirming sensory interventions that promote children's self-regulation. To achieve this goal, the student investigator developed virtual educational modules and piloted them with OTP, occupational therapy …

An Occupational Therapy Approach To Play For Pediatric Cancer Patients, Michelle Erika Dytan, Karen Park

Spring 2023 Virtual OTD Capstone Symposium

Play as an occupation has been long identified as a primary aspect of a child’s life (Moore & Lynch, 2017). Play provides children with ways to explore the world while learning skills to improve critical thinking, creativity, and positive self-esteem, and simply to have fun (Guirguis, 2018; Yanof, 2019). Children with cancer face barriers that limit their ability to engage in play, with negative consequences to their social, cognitive, and emotional development (Nijhof et al., 2018). There is an evident gap in a lack of play opportunities in community-based settings, which may limit a child’s personal development, social skills, and …

Educational Modules Promoting Neurodiversity-Affirming Sensory Interventions, Deanna Bourgeois, Mary Smith, Gina Benavente

Spring 2023 Virtual OTD Capstone Symposium

Neurodivergent children often experience differences in sensory processing and self-regulation. Traditional sensory-based interventions are frequently used by occupational therapy practitioners (OTP) and caregivers to address dysregulation. Sensory-based interventions are strengths-based but not always neurodiversity-affirming. There are few educational resources available that promote neurodiversity-affirming sensory interventions.

The purpose of this project was to create self-paced educational modules to teach neurodiversity-affirming sensory interventions promoting children's self-regulation. The student investigator developed virtual educational modules and piloted them with OTP, occupational therapy students, and caregivers during the capstone experience. The participants engaged with the modules and also submitted responses to pre-and post-surveys. Based on …

Initial Evidence For Reliable And Valid Use Of Scores On The 8-Item Econ-Qol Short Form To Measure Economic Quality Of Life In Caregivers Of Persons With Traumatic Brain Injury, Noelle E Carlozzi, Christopher Graves, Jonathan P Troost, Michael A Kallen, David S Tulsky, Robin A Hanks, Phillip A Ianni, Jennifer A Miner, Angelle M Sander

Faculty, Staff and Students Publications

OBJECTIVE: To provide reliability and validity data to support the clinical utility of Economic Quality of Life Measure (Econ-QOL) scores in caregivers of civilians and service members/veterans with traumatic brain injury (TBI).

DESIGN: Cross-sectional survey study.

SETTING: Three academic medical centers and a Veterans Affairs treatment facility.

PARTICIPANTS: 376 caregivers of civilians (n=213) and service members/veterans (n=163) with TBI (N=376).

INTERVENTIONS: N/A.

MAIN OUTCOME MEASURES: Econ-QOL and several patient-reported outcome measures (Traumatic Brain Injury Caregiver Quality of Life Caregiver-Specific Anxiety and Caregiver Strain, Patient-Reported Outcomes Measurement Information System sleep-related impairment, Neurological Quality of Life Measurement System positive affect and well-being) …

A Swimming Program For Children With Autism Spectrum Disorders: Assessing Critical Parameters From Caregivers’ Perspectives, Abir K. Bekhet, Norah Johnson, Tana Karenke, Amy Van Hecke

International Journal of Aquatic Research and Education

One in 54 individuals is diagnosed with autism spectrum disorders (ASD). Swimming can impact the physical and mental well-being of persons with ASD, which in turn may improve their caregivers’ well-being. The purpose of this qualitative evaluation study is to assess the necessity, acceptability, feasibility, fidelity, and beginning effectiveness of a 12-session swimming training program (STP) at an indoor university pool designed to teach persons with ASD how to swim, and to teach caregivers precautions for safety around water. Participants included 7 boys, and 3 girls with ASD [mean age 7.05 years (SD 1.17)] and their caregivers. Results indicated that …

Occupational Transitions Of Family Caregivers Of Loved Ones With Dementia, Katherine L. Groezinger, Cameron J. Honsa, Darcey A. Wilkinson, Emily K. Simpson

Internet Journal of Allied Health Sciences and Practice

Purpose: The primary purpose of this study was to explore how family caregivers of people with dementia experience transitions in occupations as they assume the caregiver role. Because unpaid family caregivers play a vital part in the scheme of health care, it is important to understand their supports, their perceptions of themselves as caregivers, and the impact of caregiving on relationships, identity, and physical and mental health. Many researchers have studied the effects of caregiver burden, yet minimal attention has been given to the lived experiences of caregiving on their daily roles and routines. Methods: A qualitative descriptive design was …

Perceived Care Partner Burden At 1-Year Post-Injury And Associations With Emotional Awareness, Functioning, And Empathy After Tbi: A Tbi Model Systems Study, Daniel W Klyce, Kritzianel Merced, Alexander Erickson, Dawn M Neumann, Flora M Hammond, Angelle M Sander, Jennifer A Bogner, Tamara Bushnik, Joyce S Chung, Jacob A Finn

Faculty, Staff and Students Publications

BACKGROUND: People with traumatic brain injury (TBI) can lack awareness of their own emotions and often have problems with emotion dysregulation, affective disorders, and empathy deficits. These impairments are known to impact psychosocial behaviors and may contribute to the burden experienced by care partners of individuals with TBI.

OBJECTIVE: To examine the associations of emotional awareness, emotional functioning, and empathy among participants with TBI with care partner burden.

METHOD: This multisite, cross-sectional, observational study used data from 90 dyads (participants with TBI and their care partner) 1-year post-injury. Participants with TBI completed the Difficulty with Emotional Regulation Scale (DERS; Awareness, …

The Experiences Of Children With Neurological Conditions And Families, Charmaine Alexis Pasion, Jazminne Orozco Arteaga

Fall 2022 Virtual OTD Capstone Symposium

Children with chronic neurological conditions and their families experience various challenges that impact their quality of life and occupational participation as they reintegrate back into their communities (Dumas & Grajo, 2021; Taib et al., 2021). However, rehabilitation for children with chronic neurological conditions focuses on addressing functional impairments and self-care activities rather than transitioning home (Diener et al., 2021). Therefore, children and their families are in need of resources and interventions to address their occupational impact as they return to their occupations (Diener et al., 2021). This capstone research study explored the lived experiences of children with chronic neurological conditions …

Development Of The International Spinal Cord Injury Basic Data Set For Informal Caregivers, Carol Haywood, Rebecca Martin, Kathryn Dent, M J Mulcahey

Faculty, Staff and Student Publications

STUDY DESIGN: Mixed-methods, including expert consensus for initial development and a multi-center repeated measures design for field testing.

OBJECTIVES: To develop an International Spinal Cord Injury Basic Data Set for caregivers of individuals with spinal cord injury/disorder (SCI/D) for use in research and clinical care settings.

SETTING: International, multi-disciplinary working group with field testing in five North American pediatric rehabilitation hospitals.

METHODS: The data set was developed iteratively through meetings and online surveys with a working group of experts in pediatric and adult SCI/D rehabilitation and caregivers of individuals with SCI/D. Initial reliability was examined through repeat administration of a …

Meeting Mental Health Needs Of Parents Caring For Children With Disabilities By Facilitating Occupational Balance And Well-Being, Emily J. Heumiller

Occupational Therapy Capstone Presentations

Parents caring for children with disabilities experience unique challenges which affects their well-being and occupational balance. The affects can contribute to further limitations within their family systems. The purpose of this capstone project is to explore the need and effectiveness of an occupation therapy-based program to address parents’ mental health needs. Needs assessment results and literary evidence supported the need for the proposed program, titled the Well Parent Program. Program development was guided by occupational therapy models and frames of reference. Three assessments were used to evaluate the effect of program interventions on parents’ perceived stress, perceived well-being, and goal …

Fostering Community Participation For Youth With Intellectual And Developmental Disabilities: An Occupation-Based Program For Caregivers, Mindy Goltiao, Kristin Domville, Pam Kasyan-Howe, Lisa Schubert

Spring 2022 Virtual OTD Capstone Symposium

Caregiver expectations influence outcomes of youth with intellectual and developmental disabilities (IDD) as they seek more independence transitioning from adolescence to adulthood. The purpose of this program development capstone project is to promote realistic expectations of caregivers of youth by improving caregiver youth relationships and facilitating activities. Strategies of current and evidence-based programs that support caregivers of youth with IDD, such as Maximizing Adolescent Post-Secondary Success and TrASDition training. The American Occupational Therapy Association Vision 2025 aligns with the program as it aims to provide caregivers equal opportunity, access to care, and expands an individual’s capacity to advocate for caregivers. …

Improving Occupational Engagement: An Occupation-Based Virtual Program For Caregivers Of Individuals With Dementia, Betsabel Garcia, Pam Kasyan-Howe, Kristin Domville, Lisa Schubert

Spring 2022 Virtual OTD Capstone Symposium

Dementia is a progressive disorder that affects many people worldwide including informal caregivers of individuals with dementia (Harrison et al., 2019). Every year, more than 16 million Americans provide more than 17 billion hours of unpaid care for family and friends with Alzheimer’s disease or other related dementias (CDC, 2019). As a result, many informal caregivers experience higher levels of caregiver burden, depression, and anxiety (Amato et al., 2021; Raj et al., 2021; Walter & Pinquart, 2020). This causes an occupational imbalance in caregivers' ability to meet their needs and those of their loved one. Leisure is within occupational therapy's …

Psycho-Emotional Education For Occupational Therapists Supporting Individuals Assuming The Role Of Family-Caregiver For People With A Traumatic Brain Injury (Tbi), Laura Dawn Lippman, Caitlyn E. Baird, Natalie L. Billharz

2022 Celebration of Scholarly Works

The purpose of this research was to identify the psycho-emotional needs of family-caregivers of individuals who sustained a traumatic brain injury (TBI), and measure if there was a change in knowledge among occupational therapists, and occupational therapy students following a two-hour seminar covering topics identified in the literature. The topics covered in the seminar included the concept of ambiguous loss, the importance of validating emotions, the caregiver grieving process, and the importance of providing caregiver resources. To measure the change in knowledge, researchers utilized primarily a quantitative research design using pre- and post-test questionnaires with Likert- scale questions. The questionnaire …

Impact Of Coping Strategies For Caregivers Of Those With Dementia Or Alzheimer's Disease, Amanda W. Tilley

MOT Student Capstones

Caregivers of those who have Alzheimer's disease (AD) or dementia are challenged by the burdens placed on them in their role including not knowing how to use coping strategies to decrease the burden of care. There has already been research completed on how occupational therapy (OT) can help the client who has dementia or AD and how the caregiver can improve communication with person who has dementia or AD. There is a gap in the research showing how OT can help the caregivers cope with their role. OT can help with the difficulties caregivers have by teaching them coping strategies …

Effects Of The Tailored Activity Program (Tap) On Dementia-Related Symptoms, Health Events And Caregiver Wellbeing: A Randomized Controlled Trial, Laura N Gitlin, Katherine Marx, Catherine V. Piersol, Nancy A Hodgson, Jin Huang, David L Roth, Constantine Lyketsos

Department of Occupational Therapy Faculty Papers

BACKGROUND: People living with dementia (PLWD) and caregivers are adversely impacted by lack of meaningful activity leading to worse symptoms and impaired quality-of-life. There is a critical need to develop effective and well-tolerated treatments that mitigate clinical symptoms, engage PLWD and support caregiver wellbeing. We tested whether, compared to attention control, the Tailored Activity Program (TAP) reduced clinical symptoms and health-related events, and improved caregiver wellbeing, and if TAP activities were well-tolerated.

METHODS: We conducted a single-blind randomized controlled trial among 250 dyads recruited from Baltimore-Washington DC (2012-2016) with a dementia diagnosis and clinically significant agitation/aggression. Dyads were randomized to …

Analysis Of Occupational Therapy’S Role To Promote Healthy Sleep Participation To Support Caregivers Of Children With Autism Spectrum Disorder, Sophia N. Roman

Student Capstone Papers

Children with autism spectrum disorder (ASD) face sleep disturbances. Healthy sleep habits are essential for children with ASD and their caregivers to properly engage in their everyday lives. Occupational therapists are trained to evaluate clients in areas that contribute to sleep dysfunction and to focus on promoting optimal sleep performance. There is limited research on caregivers’ perceptions of their child’s sleep disturbances, these disturbances’ influence on occupational engagement, and whether occupational therapists have collaborated with caregivers of children with ASD to treat this area of occupation. Collecting data from caregivers by using a questionnaire can provide occupational therapy (OT) practitioners …

Perspectives Of Individuals With Acquired Neurogenic Communication Disorders And Co-Survivors On Person-Centered Care Within Speech-Language Therapy, Logan Macrae Ellis

Online Theses and Dissertations

Main Argument: Acquired brain injury impacts 2.8 million individuals each year in the United States (Taylor et al., 2017). Stroke, traumatic brain injury, tumor, infection, and other conditions cause life-altering changes to the way humans interact with each other. Social interaction and communication are important in many aspects of life, including but not limited to work, community, relationships, and mental health, etc. Damage to the brain often changes the ability to communicate drastically, which can impact all of the aforementioned aspects of life (Ardila & Rubilo, 2018). Speech-language pathologists (SLPs) address the acquired neurogenic communication disorders associated with brain injury …

Inclusion In Religion And Spirituality For Children With Special Needs, Mackinzie C. Weiss

Student Capstone Papers

The proposed vision of this capstone project will focus on using occupational therapy interventions to help a local church be more inclusive to children and families with special needs. This capstone project will partner with a pre-existing special needs program to develop evidence based volunteer training, implement a parent respite program, and introduce a movement based program.

Exploring Family-Centered Care From The Perspectives Of Home-Health Physical Therapists, James Mathews

Walden Dissertations and Doctoral Studies

Older adults may need, or desire, caregiver and family involvement to avoid hospitalizations and institutionalizations. The caregivers of these older adults have the highest rates of burnout, injury, and turnover. Family-centered care (FCC) involves collaboration between healthcare practitioners, patients, family members, and caregivers. FCC is both established and effective in pediatric care settings. There is a paucity of evidence on how FCC is applied to older adult populations. Home health physical therapists (HHPTs) work with older adults in their homes and train both family members on how to safely handle and manage the care-dependent older adult. The purpose of this …

Caregiver Perspectives On Telehealth: A Service Delivery For Occupational Therapy, Rebecca Johnston

Student Capstone Papers

Telehealth; also known as telerehabilitation, telecare, telemedicine, teletherapy, and telepractice; is an emerging healthcare service that is utilized in various healthcare facilities with a span of ages, conditions, and locations (World Federation of Occupational Therapy [WFOT], 2014). Telehealth utilizes information and communication technologies to deliver services to a patient when the healthcare provider is not in the same location (WFOT, 2014). Telehealth can provide an online platform for evaluations, consultations, monitoring, supervision, and intervention with patients and other professionals (WFOT, 2014).

Telehealth is an emerging method of delivering occupational therapy (OT) services to various populations, including: children and youth; productive …

Caregiver Perspectives On Telehealth: A Service Delivery For Occupational Therapy, Rebecca Johnston, Becki Cohill, Susan Macdermott

San Marcos, Fall 2019

Telehealth; also known as telerehabilitation, telecare, telemedicine, teletherapy, and telepractice; is an emerging healthcare service that is utilized in various healthcare facilities with a span of ages, conditions, and locations (World Federation of Occupational Therapy [WFOT], 2014). Telehealth utilizes information and communication technologies to deliver services to a patient when the healthcare provider is not in the same location (WFOT, 2014). Telehealth can provide an online platform for evaluations, consultations, monitoring, supervision, and intervention with patients and other professionals (WFOT, 2014).

Telehealth is an emerging method of delivering occupational therapy (OT) services to various populations, including: children and youth; productive …

Understanding Participation In A Community-Based Art Program, Melody Taban, Otd, Otr, Gabrielle Kains, Otd, Otr/L, Lydia Navarro-Walker, Otd, Otr/L, Namrata Grampurohit, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Objectives

1. To understand the perceived benefits of occupational engagement with art for people with dementia and their informal caregivers
2. To understand the art program’s influence on interpersonal relationships

Caregiver Participation In Leisure And Social Activities While Caring For Individuals With Alzheimer's Disease, Ashley Devoti

MOT Student Capstones

This project focused on caregiver's participation in leisure and social activities while caring for individuals with Alzheimer's Disease or a related dementia. This project had caregivers describe how they view leisure and social activities. reporting the amount of time that they engage in leisure and social activities. The caregivers then participated in an educational training module. With the goal of having the caregivers identify a change in their overall views of leisure and social participation and thus reporting an increase in the amount of time that they engage in leisure and social activities in order to promote improved quality of …

Engaging Caregivers In Family-Centered Pediatric Occupation Therapy, Sidney Carlson, Sarah Schwartz

Occupational Therapy Capstones

Purpose Family-centered care is considered the gold standard when working with children and their families (Darrah, Wiart, Magill-Evans, Ray, & Andersen, 2010). Despite there being a strong push toward family-centered care, there remains a disconnect in outpatient pediatric settings when working with children ages 3-18. The purpose of this scholarly project is to raise awareness of the need for caregiver engagement in pediatric, outpatient occupational therapy and identify best practice principles for caregiver engagement.

Methods An extensive literature review was conducted in order to understand caregiver engagement in pediatric occupational therapy. The information obtained from the literature review was analyzed …

Caregiver Perspectives On Body-Weight Supported Treadmill Training As An Intervention For Young Children With Cerebral Palsy, Megan Flores, Carolyn Da Silva

Physical Therapy Collection

PURPOSE/HYPOTHESIS: Children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels IV and V present with challenges that impact their functional activities and participation in family activities. The purpose of this study was to examine caregivers’ perspectives on body-weight supported treadmill training (BWSTT) as an intervention for their young children with CP.

NUMBER OF SUBJECTS: Participants included 4 caregivers of children with CP in GMFCS levels IV (n = 2) and V (n = 2) who previously participated in 6 weeks of BWSTT.

MATERIALS/METHODS: Three children diagnosed with CP in GMFCS levels IV and V between the …

Caring For Caregivers Of Children With A Traumatic Brain Injury: Support Group, Caroline T. Boyd

MOT Student Capstones

This Capstone project discusses a piloted support group for Eastern North Carolina at Vidant Medical Center for caregivers of children with a traumatic brain injury (TBI). Through collaboration with Vidant Medical Center interprofessionals, my fieldwork supervisor, and literature reviews of scholarly articles I designed outcome objectives and an itinerary for four piloted support group sessions. Support group topics included health maintenance, stress management, leisure exploration, parenting children with a TBI, and learning self-care management skills. Pre-and post-questionnaires were created and provided to participants. These questionnaires included questions concerning level of understanding of TBI, knowledge of community resources, level of stress, …

The Impact Of Interactive Education On Caregivers Caring For Individuals With Dementia, Lisa K. Hong

Occupational Therapy Doctorate Capstone Projects

Background: Alzheimer’s disease and related dementias are becoming more prevalent and individuals with the disease requiring much physically and emotionally from caregivers. As caregivers are often thrust unprepared into their roles, the need for quality education becomes increasingly important.

Purpose: The purpose of this study was to identify changes in caregiver perception after participation in an interactive educational program. The following research questions were used: 1) What is the perception of both professional and family caregivers about their ability to provide care following an interactive education program for dementia care? 2) Does an education program change the caregiver’s general knowledge …