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Articles 481 - 510 of 762
Full-Text Articles in Occupational Therapy
Related Service Providers’ Perspectives On Everyday Life Participation Of Children And Youth With Disabilities, Kathleen Flecky, Alyssa Bornman, Danielle Boyer, Andrea Huckabee
Related Service Providers’ Perspectives On Everyday Life Participation Of Children And Youth With Disabilities, Kathleen Flecky, Alyssa Bornman, Danielle Boyer, Andrea Huckabee
The Open Journal of Occupational Therapy
Background: The purpose of this qualitative study was to investigate the perspectives of related service providers on everyday life participation of children and youth with disabilities that they serve.
Method: A qualitative design was used to guide interviews that elicited the participants’ perspectives working with children and youth with disabilities.
Results: Five themes emerged from the qualitative analysis: (a) each child’s individual experiences and quality of life; (b) linked to home, school, and community life; (c) child or youth driven; (d) provider collaboration and carryover; and (e) distinct professional provider views.
Conclusion: Insights into related service …
A Scoping Review Of Self-Awareness Instruments For Acquired Brain Injury, Danielle Mahoney, Sharon A. Gutman, Glen Gillen
A Scoping Review Of Self-Awareness Instruments For Acquired Brain Injury, Danielle Mahoney, Sharon A. Gutman, Glen Gillen
The Open Journal of Occupational Therapy
Background: Self-awareness and insight are critical functions required to maintain safe and optimal participation in all daily life activities in a variety of environmental contexts. In the past two decades, occupational therapists have developed several psychometrically sound assessments designed to identify self-awareness and insight deficits in patients with neurological disorders. This scoping review identifies and evaluates key properties of such assessments to inform clinical practice.
Method: Multiple electronic databases were searched using the key search terms of “self-awareness” and “self-awareness assessment,” and “insight” and “insight assessment.” Included studies were original primary sources from the peer-reviewed journals.
Results: …
An Occupational Therapy-Based Supported Education Program For University Students With Various Dsm-5 Diagnoses: Program Description And Academic Outcomes, Victoria Schindler
An Occupational Therapy-Based Supported Education Program For University Students With Various Dsm-5 Diagnoses: Program Description And Academic Outcomes, Victoria Schindler
The Open Journal of Occupational Therapy
Background: This article describes and provides academic outcomes for an occupational therapy-based supported education program developed to assist undergraduate students with various DSM-5 diagnoses with the academic, social, and psychological skills important for college.
Method: A detailed program description and illustrative example of the intervention is provided. Quantitative designs were used to report retention, graduation, and GPA and to calculate changes in mean cumulative GPA.
Results: Of 83 students who started the program, 80 completed at least one semester (96%). Of these 80, 62 (77.5%) continued at the university for a retention rate of 77.5%, and 43 …
Disability Services For Students In Postsecondary Education: Opportunities For Occupational Therapy, Diane Powers Dirette
Disability Services For Students In Postsecondary Education: Opportunities For Occupational Therapy, Diane Powers Dirette
The Open Journal of Occupational Therapy
No abstract provided.
The Road To Resilience: Traveling The Path Less Followed To Realize What Is Possible, Jennifer Fortuna
The Road To Resilience: Traveling The Path Less Followed To Realize What Is Possible, Jennifer Fortuna
The Open Journal of Occupational Therapy
Dr. Bernadette Mineo, PhD, OTR/L, an occupational therapist and mixed media artist based in Portland, Oregon, provided the cover art for the Winter 2019 issue of The Open Journal of Occupational Therapy (OJOT). The piece, titled “Paper Dolls” (2009), consists of 37 individual paper doll sculptures made from mixed media. Dr. Mineo believes that being an artist is about connecting with one’s creative heart. Her art is about being playful, challenging oneself, and setting up experiments. Engaging in a daily creative art practice has brought joy to Dr. Mineo’s life. Art has empowered her to take risks, build resilience, and …
Increasing Functional Abilities Of People With Postural Orthostatic Tachycardia Syndrome Through Occupational Therapy, Jennifer R. Dochod, Cynthia A. Grapczynski
Increasing Functional Abilities Of People With Postural Orthostatic Tachycardia Syndrome Through Occupational Therapy, Jennifer R. Dochod, Cynthia A. Grapczynski
The Open Journal of Occupational Therapy
The level of functional impairment that people with Postural Orthostatic Tachycardia Syndrome (POTS) experience is life changing. Reduced engagement in purposeful and meaning activities because of functional impairments increases the emotional impact of POTS and decreases quality of life. By including occupational therapy early on in treatment, people with POTS can learn ways to adapt, cope, and incorporate changes into their lifestyles. Increasing participation in purposeful and meaningful occupations that are of value to the individual leads to increased quality of life, increased participation in desired roles, increased sense of well-being, and increased perception of health.
The Role Of Occupational Therapy In Functional Literacy, Lenin C. Grajo, Sharon A. Gutman
The Role Of Occupational Therapy In Functional Literacy, Lenin C. Grajo, Sharon A. Gutman
The Open Journal of Occupational Therapy
In this Opinions in the Profession article we aim to uniquely articulate the distinct value of and need for functional literacy development in the clients we serve. Functional literacy, as coined in this article, is the ability to interpret common written materials needed to effectively carry out basic daily life skills and participate in meaningful occupations and social roles. We propose three specific strategies through which occupational therapists, across practice settings, developmental stages, and populations, can assume active roles in literacy support as it is embedded in occupation: literacy (a) as a form of occupational justice promotion; (b) as an …
Role Emerging Placements: Skills Development, Postgraduate Employment, And Career Pathways, Sobiya Syed, Andrea Duncan
Role Emerging Placements: Skills Development, Postgraduate Employment, And Career Pathways, Sobiya Syed, Andrea Duncan
The Open Journal of Occupational Therapy
Occupational therapy educators are increasingly using role emerging placements (REPs) as a forum for students to develop skills required to work in emerging areas of practice. This study explores the impact of REPs on skill development, postgraduate employment, and career pathways for occupational therapists. An online survey was sent to occupational therapists across Canada (n = 1,763). Occupational therapists who had completed a REP responded to the online survey (n = 88). Descriptive analysis was used to examine trends in the quantitative data, and content analysis was used to code categories derived from qualitative survey data. Results indicated five skills …
Collaborative Care Best Practices Model (Ccbpm) Development For Nursing And Occupational Therapy Assistant Interprofessional Simulation, Carrie M. O'Reilly, Lisa P. Simmons, Mary L. Romanello
Collaborative Care Best Practices Model (Ccbpm) Development For Nursing And Occupational Therapy Assistant Interprofessional Simulation, Carrie M. O'Reilly, Lisa P. Simmons, Mary L. Romanello
The Open Journal of Occupational Therapy
The use of simulation as a teaching and learning stratagem is well supported in the professional literature. The development of a collaborative care best practices model (CCBPM) was undertaken to help the creation and implementation of an interprofessional education (IPE) learning strategy between occupational therapy assistant (OTA) and pre-licensure nursing students at a private liberal arts college. The project goals and outcomes involved faculty development, CCBPM development, and OTA and nursing novice student competency acquisition in their respective professions. Twenty-three students (10 OTA and 13 nursing) completed the IPE learning simulation exercise. A mixed-method approach to data analysis was used …
Enhancing Collaborative Practices With Preprofessional Occupational Therapists And Early Childhood Special Education Student Teachers: A Pilot Study, Kathleen M. Farrand, Megan Troxel Deeg, Oaklee Rogers, Allison M. Mullady, Stephanie S. Williams, Bjorg T. Lesueur
Enhancing Collaborative Practices With Preprofessional Occupational Therapists And Early Childhood Special Education Student Teachers: A Pilot Study, Kathleen M. Farrand, Megan Troxel Deeg, Oaklee Rogers, Allison M. Mullady, Stephanie S. Williams, Bjorg T. Lesueur
The Open Journal of Occupational Therapy
This article presents the Collaborative Design Model as a tool for developing collaboration and self-efficacy for preprofessional educators and service providers. As student populations continue to become more diverse, preprofessionals entering the classroom must be prepared to collaborate with colleagues effectively and efficiently to address the variety of needs presented in the classroom. Little research exists on the collaboration among preprofessional teachers and preprofessional occupational therapists. The proposed model provides a method for supporting preprofessionals in collaborating to meet the needs of students at risk for or with disabilities. Initial pilot findings suggest the Collaborative Design Model could potentially increase …
Occupational Therapist Licensure Revocation By State Licensing Boards, Regina Drummond, Myrel Agbayani, Christine Chong, Chris Josko, Shelby Murley, Brenda M. Coppard
Occupational Therapist Licensure Revocation By State Licensing Boards, Regina Drummond, Myrel Agbayani, Christine Chong, Chris Josko, Shelby Murley, Brenda M. Coppard
The Open Journal of Occupational Therapy
Occupational therapists must abide by certain standards to maintain a license to practice. Despite the existence of various studies on licensure revocation in other health care professions, no prior research has been conducted regarding occupational therapist licensure revocations. The purpose of this study was to examine reasons for occupational therapy licensure revocations in the United States from 2005 to 2015. A retrospective descriptive study design was completed. Data were collected from public databases on state websites or through communication with state licensure board representatives. From 2005 to 2015, 65 occupational therapists had their licenses revoked in 40 states and the …
A Scoping Review Of Challenges And The Adaptation Process In Academia: Implications For Occupational Therapy Educators, Maria Concepcion C. Cabatan, Lenin C. Grajo, Erlyn A. Sana
A Scoping Review Of Challenges And The Adaptation Process In Academia: Implications For Occupational Therapy Educators, Maria Concepcion C. Cabatan, Lenin C. Grajo, Erlyn A. Sana
The Open Journal of Occupational Therapy
The fulfillment of role expectations and responsibilities as one builds an academic career can be challenging. Increased demand for occupational therapy faculty merits examination of academic experiences from the literature. This study describes the experiences of educators using adaptation models (Savickas & Porfeli, 2012; Schkade & Schultz, 2003) as a theoretical lens. Arksey and O’Malley’s Scoping Study Framework (2005) was used in the study. Researchers reviewed literature from 2005-2017 from four databases. Researchers analyzed 28 articles from higher education and the health professions using quantitative and qualitative methods. Twenty-two of the 28 articles were published from 2010-2017. The studies analyzed …
The Effects Of The Leisure Activity Of Coloring On Post-Test Anxiety In Graduate Level Occupational Therapy Students, Brittney N. Burton, Mary F. Baxter
The Effects Of The Leisure Activity Of Coloring On Post-Test Anxiety In Graduate Level Occupational Therapy Students, Brittney N. Burton, Mary F. Baxter
The Open Journal of Occupational Therapy
Background: This study examined the effects of the leisure activity of coloring on the anxiety levels of graduate level occupational therapy students after taking a high stress exam. This study also examined the effects of the leisure activity of coloring on the students’ perceptions of preparedness for and performance on the exam.
Method: The participants were recruited for this quantitative, pre/posttest study through a purposive convenience sample and randomly assigned to either the leisure activity or the control. A self-report assessment was used for data collection. The changes in anxiety levels were examined using a repeated measures analysis …
The Feasibility Of Conducting Task-Oriented Training At Home For Patients With Stroke, Veronica T. Rowe, Marsha Neville
The Feasibility Of Conducting Task-Oriented Training At Home For Patients With Stroke, Veronica T. Rowe, Marsha Neville
The Open Journal of Occupational Therapy
Background: Task-oriented training for upper extremity hemiparesis following a stroke is an effective intervention with evidence of its application in the clinic setting. However, the home provides an enriched and practical environment to implement this intervention. This report presents the feasibility of implementing task-oriented training at home.
Method: Stroke survivors with limitations in upper extremity movement and function were assessed before and after a Task-Oriented Training and Evaluation at Home (TOTE Home) program, and 1 month later. Areas of process, resources, management, and scientific value were analyzed for the feasibility of a larger randomized clinical trial (RCT).
Results …
Older Adults And Photo-Elicited Perspectives On Shopping For Groceries In A Changing Community, Lori E. Breeden, Alessandra Planera, Lauren Kirchner, Samantha Asencio, Matthew Branden, Evan Dunlap, Alex Robinson, Samantha Stevens, Sally Wasmuth
Older Adults And Photo-Elicited Perspectives On Shopping For Groceries In A Changing Community, Lori E. Breeden, Alessandra Planera, Lauren Kirchner, Samantha Asencio, Matthew Branden, Evan Dunlap, Alex Robinson, Samantha Stevens, Sally Wasmuth
The Open Journal of Occupational Therapy
Background: A community experiencing gentrification created challenges for older adults and their ability to access food. The purpose of this qualitative study was to examine barriers and facilitators perceived by three urban-dwelling older adults during their grocery shopping experiences.
Methods: The researchers conducted photo-elicitation supported interviews to gather information on grocery shopping from three older adults attending a local senior center. Photo-elicited interviews were conducted, and the thematic analysis examined the participants’ perspectives on their experiences.
Results: Thematic analysis revealed the participants’ experiences in a changing landscape. In the categories of community resources, transportation, and the store, …
The Sensory Processing 3-Dimensions Scale: Initial Studies Of Reliability And Item Analyses, Shelley Mulligan, Sarah A. Schoen, Lucy Jane Miller, Andrea Valdez, Deborah Magalhaes
The Sensory Processing 3-Dimensions Scale: Initial Studies Of Reliability And Item Analyses, Shelley Mulligan, Sarah A. Schoen, Lucy Jane Miller, Andrea Valdez, Deborah Magalhaes
The Open Journal of Occupational Therapy
Background: The Sensory Processing 3-Dimensions Scale (SP-3D) is a performance-based measure for assessing sensory processing abilities and challenges, including sensory modulation, sensory discrimination, and sensory-based motor disorders. Initial studies of reliability were conducted, and item response theory was applied to assist in refining the measure.
Methods: Descriptive and correlational methods were used to examine internal consistency of the scales and inter-rater reliability. Item response theory using Rasch analyses was applied to examine unidimensionality of scales, model fit, and item difficulty.
Results: Internal consistency for most measures was acceptable, demonstrating the subtests, domains, and behavior scales as distinct …
Effects Of Partnerships Between Adolescents With Developmental Disabilities And Service Dogs, Terry K. Crowe, Jean C. Deitz, Melissa Y. Winkle, Rachel A. Nelson, Jennifer Woolf
Effects Of Partnerships Between Adolescents With Developmental Disabilities And Service Dogs, Terry K. Crowe, Jean C. Deitz, Melissa Y. Winkle, Rachel A. Nelson, Jennifer Woolf
The Open Journal of Occupational Therapy
Background: With increasing frequency, service dogs are being placed with children with developmental disabilities (DDs). Occupational therapists and other professionals have advocated for the therapeutic use of service dog partnerships to facilitate greater independence and quality of life. There are no studies that examine service dog intervention with adolescents.
Method: This study focused on the effects of partnerships between service dogs and three participant dyads, each including an adolescent with DDs and a parent. A single-subject, alternating treatment design was used to compare the effects of two conditions (service dog present or not present). The effects were examined …
The Lived Experiences Of Occupational Therapists In Transitioning To Leadership Roles, Shawn Sasha Shams, Ravneet Batth, Andrea Duncan
The Lived Experiences Of Occupational Therapists In Transitioning To Leadership Roles, Shawn Sasha Shams, Ravneet Batth, Andrea Duncan
The Open Journal of Occupational Therapy
Background: Several studies on leadership in occupational therapy have discussed the key qualities of leadership and its importance, even though little is known about the transition process into leadership roles. This research examined the lived experiences of occupational therapists who have transitioned from a clinical to a leadership role and identified the supports and challenges that were found to be important.
Methods: Semi-structured interviews were used to gain insight into the transition process of five occupational therapy professional practice leaders. NVivo software was used to organize and analyze the qualitative data.
Results: Three common themes were identified as “supports” for …
State Of The Journal: Moving Forward, Diane Powers Dirette
State Of The Journal: Moving Forward, Diane Powers Dirette
The Open Journal of Occupational Therapy
No abstract provided.
Integrating Art And Narrative To Enhance Quality Of Life In Palliative Care, Jennifer Fortuna
Integrating Art And Narrative To Enhance Quality Of Life In Palliative Care, Jennifer Fortuna
The Open Journal of Occupational Therapy
Lacie Lee Wallace, a mixed-media artist from Wheeling, West Virginia, is featured on the cover of the Fall 2018 issue of The Open Journal of Occupational Therapy (OJOT). The photograph depicts Lacie holding a self-portrait painted by artist CeCey Rose. Lacie’s physical appearance in the photograph is strikingly different from the physical appearance of the woman featured in the painting. The portrait was created 4 years before Lacie was diagnosed with advanced stage colon cancer. In the year following the diagnosis, Lacie lost nearly 100 lbs. as a result of an aggressive treatment regimen. When the palliative care team at …
Critical Reflections On Self-Management Support In Chronic Disease: The Value Of Occupational Therapy In Health Promotion, Brocha Z. Stern
Critical Reflections On Self-Management Support In Chronic Disease: The Value Of Occupational Therapy In Health Promotion, Brocha Z. Stern
The Open Journal of Occupational Therapy
No abstract provided.
The Biopsychosocial Model: Application To Occupational Therapy Practice, Keith Gentry, Karen Snyder, Beth Barstow, Jordan Hamson-Utley
The Biopsychosocial Model: Application To Occupational Therapy Practice, Keith Gentry, Karen Snyder, Beth Barstow, Jordan Hamson-Utley
The Open Journal of Occupational Therapy
Despite the call for the profession to embrace a more integrated and holistic approach to practice, therapists may be faced with practical challenges, including issues relating to client caseloads, productivity demands, scheduling, entrenched practices, limitations on service imposed by payer sources, and staffing and budgetary restraints, to name but a few. Due to these limitations, current occupational therapy practice may be predisposed to adopt a more reductive approach to the evaluation and treatment of symptoms, underlying biological pathologies, and resulting impairments and disabilities. Therefore, psychological and social factors may be neglected, resulting in an unbalanced, fragmented, and incomplete approach to …
Use Of A Journal Club During Level Ii Fieldwork To Facilitate Confidence And Skills For Evidence-Based Practice, Kelly A. Lavin
Use Of A Journal Club During Level Ii Fieldwork To Facilitate Confidence And Skills For Evidence-Based Practice, Kelly A. Lavin
The Open Journal of Occupational Therapy
Level II fieldwork students should have an opportunity to engage in the process of evidence-based practice (EBP) firsthand; however, ensuring that EBP is visible to students is often a challenge for fieldwork educators. This study investigated if the use of a journal club during a Level II, psychosocial fieldwork placement would increase the students’ confidence and perceived abilities in using skills required for EBP. A descriptive study via survey design was used for the study. The participants consisted of two cohorts (n = 10) of occupational therapy graduate students. The results indicate that the students perceived an increase in their …
Hearing Voices Simulation: Impact On Occupational Therapy Students, Rebecca Ozelie, Paige Panfil, Nicole Swiderski, Elizabeth Walz
Hearing Voices Simulation: Impact On Occupational Therapy Students, Rebecca Ozelie, Paige Panfil, Nicole Swiderski, Elizabeth Walz
The Open Journal of Occupational Therapy
Auditory hallucinations, which are symptoms of schizophrenia, can significantly disrupt individuals’ daily lives. Occupational therapists (OTs) can address both the daily needs of people with schizophrenia and address cultural stigmas against mental illness. To combat stigma and increase empathy for patients with mental illnesses, auditory hallucinations simulations were developed. The purpose of this study was to determine if the Hearing Voices That Are Distressing (HVTAD) Simulation impacts OT students’ attitudes toward patients with auditory hallucinations and to explore the students’ perceptions of the simulation’s effectiveness as a teaching method. The participants completed a pretest Attitudes to Mental Illness Questionnaire (AMIQ) …
International Occupational Therapy Faculty Perceptions Regarding Doctoral Level Education, Bernadette Mineo, Beth Hathaway, Monali Kadkade
International Occupational Therapy Faculty Perceptions Regarding Doctoral Level Education, Bernadette Mineo, Beth Hathaway, Monali Kadkade
The Open Journal of Occupational Therapy
Over the past decade a debate has ensued in the US regarding the clinical doctorate in occupational therapy (OT) and whether to require a doctorate to become an occupational therapist. Little discussion has occurred regarding the potential implications on the global community of occupational therapists, and there have been no attempts to ascertain the views of international OT faculty and practitioners. This study surveyed international OT faculty regarding their perceived need for and value of graduate education, particularly at the doctoral level, for OT faculty and practitioners in their countries. Fifty-three OT faculty from WFOT approved programs in eight countries …
Cross-Cultural Service Learning As Pedagogy For Character Development In Occupational Therapy Doctoral Students, Heather Y.Z. St. Peters, Nathan Short
Cross-Cultural Service Learning As Pedagogy For Character Development In Occupational Therapy Doctoral Students, Heather Y.Z. St. Peters, Nathan Short
The Open Journal of Occupational Therapy
Occupational therapists must demonstrate a broad spectrum of knowledge, clinical reasoning skills, and professionalism to be effective practitioners. Development of ethical practice must begin with the educational process to shape character traits as building blocks of moral reasoning. This article puts forth a cross-cultural service learning curricular module as lived experience for development of character traits in occupational therapy students. This mixed methods study investigated lived experience in the form of cross-cultural service learning as a pedagogy for development of character traits, as measured by the CIVIC, necessary to navigate professional ethical standards. Findings suggest a cross-cultural lived experience for …
Burnout Among Filipino Occupational Therapists: A Mixed Methods Analysis, Rod Charlie Delos Reyes
Burnout Among Filipino Occupational Therapists: A Mixed Methods Analysis, Rod Charlie Delos Reyes
The Open Journal of Occupational Therapy
Background: There is a shortage of practicing occupational therapists in the Philippines, with approximately one Filipino occupational therapist per 30,000 stakeholders. One of the possible consequences is the experience of burnout among therapists.
Method: A two-phase mixed methods study using a sequential explanatory approach was used. The first phase involved the administration of the Maslach Burnout Inventory – Human Services Survey (MBI-HSS) with a survey questionnaire that supplied demographic and work-related factors through an online platform. The results were analyzed using frequency distribution and measures of central tendency. Relationships were analyzed using Spearman’s Rho and Cramer’s V. The second phase …
Exploring Parents’ Experiences Of Raising A Child With Sensorimotor Impairments And Expectations For Leisure Participation, Emily A. Eicher, Camille Skubik-Peplaski, Shirley P. O'Brien, Anne Fleischer
Exploring Parents’ Experiences Of Raising A Child With Sensorimotor Impairments And Expectations For Leisure Participation, Emily A. Eicher, Camille Skubik-Peplaski, Shirley P. O'Brien, Anne Fleischer
The Open Journal of Occupational Therapy
Background: The objective of this descriptive study was to study parents’ experiences of raising a child with sensorimotor impairments and how leisure pursuits impact their expectations of their children. The development and participation in leisure activities is different for these children and could affect the parents’ hopes and dreams for their child’s future.
Method: Six children between 5 and 8 years of age, with sensorimotor impairments, participated in a movement program that was held for eight sessions at an outpatient pediatric clinic to address praxis and sensory processing impairments. Six parent dyads were interviewed during the fifth, sixth, …
Medication Management In Home Health Care Occupational Therapy Practice, Julie Blum, Jennifer Fogo, Judith Malek-Ismail
Medication Management In Home Health Care Occupational Therapy Practice, Julie Blum, Jennifer Fogo, Judith Malek-Ismail
The Open Journal of Occupational Therapy
Background: Many community-dwelling adults do not adhere to their medication regimen, which results in high rates of emergency department visits and subsequent hospital admissions. Occupational therapists, as members of the home health care team, provide medication management in the occupational therapy scope of practice. There is sparse information in the literature regarding occupational therapists’ involvement in medication management in home health care practice.
Methods: The researchers interviewed nine occupational therapists practicing in home health care. Using a qualitative interpretive phenomenological study, the researchers explored the participants’ experiences addressing medication management.
Results: The researchers identified three themes: professional reasoning, interprofessional involvement, …
Quality Of Life, Stress Perception, And Quality Of Social Networks In Persons Living With Brain Injury: An Exploration Of The Effectiveness Of A Community-Based Program, Barbara P. White, Abigail Brinkman, Barbara P. Kresge, Lisa Couture
Quality Of Life, Stress Perception, And Quality Of Social Networks In Persons Living With Brain Injury: An Exploration Of The Effectiveness Of A Community-Based Program, Barbara P. White, Abigail Brinkman, Barbara P. Kresge, Lisa Couture
The Open Journal of Occupational Therapy
Background: This paper examines specific program elements of a community-based program for individuals living with brain injury. Results from a previous study suggested that members who attended regularly reported lower stress perception, higher quality of life perception, and higher social connectedness than did peers living in the community without such supports. In this study, we sought to understand reasons for their perceptions about how the program may have been helpful in shaping their perspectives of living with the effects of brain injury.
Methods: An explanatory case-study approach was applied, using multiple cases. Nine individuals were randomly selected from a subsample …