Occupational Therapy and Arts Therapies
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Item Chapter 22: Applying the Model of Human Occupation to Individuals With Mental Health Conditions(Wolters Kluwer, 2024) Melton, Jane C.; Harding, Becky; Cooper, John R.; Allen, Susan; Reed, Melissa; Forsyth, Kirsty; Prior, Susan; Maciver, Donald; Harrison, Michele; Raber, Christine; Quick, LauraItem Establishing the measurement properties of the Residential Environment Impact Scale (Version 4.0)(Taylor & Francis, 2022-12-09) Harrison, Michele; Forsyth, Kirsty; Murray, Aja Louise; Angarola, Rocco; Henderson, Shona; Fitzpatrick, Linda Irvine; Fisher, GailBackground Developed as an environment assessment informed by the Model of Human Occupation, the Residential Environment Impact Survey considered the physical, social and activity features of the environment, evaluating the impact of the environment on resident’s quality of life. Clinicians reported that the Residential Environment Impact Survey was a useful tool; however, it had not been structured to be a measurement tool and did not have established psychometric properties. Aims/objectives This study examines the psychometric properties of the restructured Residential Environment Impact Scale Version 4.0 (REIS), which measures the level of environment support provided to residents. Material and methods The REIS was completed across residential sites for people with complex mental health needs. A many facets Rasch analysis was conducted to establish the reliability and validity of the REIS. Results The REIS demonstrated reasonable psychometric properties, with items demonstrating internal scale validity and scale items following an expected pattern of increasingly challenging environment support. Conclusions and significance Initial evidence suggests that the REIS provides a valid and reliable measure of environment support, providing a detailed assessment of how physical, social and activity elements of the environment support or inhibit participation and can be applied across a range of living environments.Item Participation‐related constructs and participation of children with additional support needs in schools(Wiley, 2022-09-25) Maciver, Donald; Roy, Anusua Singh; Johnston, Lorna; Tyagi, Vaibhav; Arakelyan, Stella; Kramer, Jessica M.; Richmond, Janet; Romero‐Ayuso, Dulce; Nakamura‐Thomas, Hiromi; Todorova, Liliya; van Hartingsveldt, Margo; Forsyth, KirstyMaciver, D., Roy, A.S., Johnston, L., Tyagi, V., Arakelyan, S., Kramer, J.M., Richmond, J., Romero‐Ayuso, D., Nakamura‐Thomas, H., SPQ Study Group, Todorova, L., van Hartingsveldt, M. and Forsyth, K. (2022) ‘Participation‐related constructs and participation of children with additional support needs in schools’, Developmental Medicine & Child Neurology, p. dmcn.15390. Available at: https://doi.org/10.1111/dmcn.15390. To investigate associations between participation-related constructs and participation frequency and involvement in inclusive schools. In this cross-sectional study, teachers of children with additional support needs, including intellectual disability, autism, and learning difficulties, completed measures. Participation-related constructs were measured using the School Participation Questionnaire; participation frequency and involvement were measured using the Participation and Environment Measure for Children and Youth. A series of multilevel linear mixed-effects regression models with maximum likelihood estimates and bootstrap confidence intervals with p-values were obtained. Final models included participation-related constructs and participation, controlling for demographic and diagnostic confounders (including age, sex, language, level of school support, and autism). Six hundred and eighty-eight children (448 [65.1%] males; mean age 8 years 7 months [range 4 years 10 months-12 years 13 months, standard deviation 2 years 1 months]) were assessed by 252 teachers. Across a series of models, participation-related constructs were consistently associated with more intensive participation (competence, environment, identity p < 0.001; symptoms p = 0.007), independent of confounders. More frequent participation remained associated with three of four participation-related constructs (competence, identity p < 0.001; environment p = 0.021). Age (p = 0.046), language (p = 0.002), and level of school support (p = 0.039) also remained significantly associated with frequency of participation. Children with additional support needs in inclusive schools may have several participation barriers. Policies and interventions to improve participation are needed. [Abstract copyright: © 2022 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.]Item Neurodevelopmental disorders and neurodiversity: Definition of terms from Scotland's National Autism Implementation Team [Editorial](2022-03-28) Shah, Premal J.; Boilson, Marie; Rutherford, Marion; Prior, Susan; Johnston, Lorna; Maciver, Donald; Forsyth, KirstyAdults with neurodevelopmental disorders frequently present to, but fit uneasily into, adult mental health services. We offer definitions of important terms related to neurodevelopmental disorders through unifying research data, medical and other viewpoints. This may improve understanding, clinical practice and development of neurodevelopmental disorder pathways within adult mental health services.Item Associations between adolescent psychosocial factors and disengagement from education and employment in young adulthood among individuals with common mental health problems(Springer, 2022-03-11) Tayfur, Sumeyra N.; Prior, Susan; Singh Roy, Anusua; Maciver, Donald; Forsyth, Kirsty; Irvine-Fitzpatrick, LindaTransition to adulthood can be a challenging developmental task for adolescents with common mental health problems and is linked to adverse outcomes such as ‘not in education, employment or training’ (NEET). This study investigated longitudinal associations between adolescent psychosocial factors (e.g., self-esteem, aspirations, bullying, physical activity) and later NEET status among individuals with common mental health problems (i.e., depression and anxiety). A secondary data analysis of the Next Steps cohort study was completed using waves 2 and 8. Psychosocial factors, mental health, and background characteristics were captured when participants were aged 15–16 years (wave 2) while still in compulsory education. The 12-item General Health Questionnaire was used to identify adolescents with common mental health problems. The study population consisted of 2224 participants (females 66.8%) of which 1473 (66.2%) were aged 15 years and 751 (33.8%) were aged 16 years in wave 2. The outcome was NEET status at ages 25–26 years (wave 8). The results showed that after adjusting for background characteristics, adolescent self-esteem, locus of control, bullying, physical activity, job aspirations, and attitudes to school predicted NEET status. Educational aspirations, substance use, and behavioural problems were not significantly associated with NEET status. These findings provide new insights into the role of adolescent psychosocial factors in the context of education and employment outcomes for youth at risk and highlight the necessity of targeted mental health support to improve life chances.Item Psychometric properties of the School Participation Questionnaire: Testing a measure of participation-related constructs(Wiley, 2022-01-31) Maciver, Donald; Tyagi, Vaibhav; Johnston, Lorna; Kramer, Jessica M.; Richmond, Janet; Todorova, Liliya; Romero-Ayuso, Dulce; Nakamura-Thomas, Hiromi; Van Hartingsveldt, Margo; O’Hare, Anne; Forsyth, KirstyAIM To explore concurrent validity, convergent validity, interrater reliability, test–retest reliability, and Rasch model analysis of the School Participation Questionnaire (SPQ), a tool for teachers to assess personal and environmental determinants of school participation.Item Development of a pathway for multidisciplinary neurodevelopmental assessment and diagnosis in children and young people(MDPI, 2021-11-11) Rutherford, Marion; Maciver, Donald; Johnston, Lorna; Prior, Susan; Forsyth, KirstyThere is a variable standard of access to quality neurodevelopmental assessment and diagnosis. People may have negative experiences, encountering lengthy waiting times, and inconsistent practices. Practitioners need guidance on standards and practices for assessment and diagnosis matched to new ways of working. In this paper, we present a new pathway and recommendations for multidisciplinary neurodevelopmental assessment and diagnosis for children and young people (<19 years), developed by the Scottish Government funded National Autism Implementation Team (NAIT). Our research used the Medical Research Council guidance for the development of complex interventions and included several iterative stages. Stage 1: n = 44 stakeholders attended an event on developing new practices for diagnosis and assessment. Stage 2: a literature synthesis was completed by the research team of clinical guidelines and diagnosis and assessment tools. Stage 3: an event with n = 127 stakeholders included discussion and debate of the data from stages 1 and 2. Recommendations and a draft pathway were written. Stage 4: successive drafts of recommendations and the pathway documentation were circulated among an advisory group, including multidisciplinary clinical experts and people with lived experience, until the final pathway was agreed upon. The finalised pathway includes guidance on terminology, assessment, diagnosis, triage, time standards and engagement of people with lived experience. The new pathway has been adopted by the Scottish Government. The pathway and associated documentation are freely available online for use by others.Item Differences in assistive technology installed for people with dementia living at home who have wandering and safety risks(BMC, 2021-10-30) Curnow, Eleanor; Rush, Robert; Górska, Sylwia; Forsyth, KirstyBackground: Assistive Technology for people with dementia living at home is not meeting their care needs. Reasons for this may be due to limited understanding of variation in multiple characteristics of people with dementia including their safety and wandering risks, and how these affect their assistive technology requirements. This study therefore aimed to explore the possibility of grouping people with dementia according to data describing multiple person characteristics. Then to investigate the relationships between these groupings and installed Assistive Technology interventions. Methods: Partitioning Around Medoids cluster analysis was used to determine participant groupings based upon secondary data which described the person characteristics of 451 people with dementia with Assistive Technology needs. Relationships between installed Assistive Technology and participant groupings were then examined. Results: Two robust clustering solutions were identified within the person characteristics data. Relationships between the clustering solutions and installed Assistive Technology data indicate the utility of this method for exploring the impact of multiple characteristics on Assistive technology installations. Living situation and caregiver support influence installation of assistive technology more strongly than level of risk or cognitive impairment. People with dementia living alone received different AT from those living with others. Conclusions: Results suggest that caregiver support and the living situation of the person with dementia influence the type and frequency of installed Assistive Technology. Reasons for this include the needs of the caregiver themselves, the caregiver view of the participants’ needs, caregiver response to alerts, and the caregiver contribution to the assistive technology assessment and selection process. Selection processes should be refined to account for the needs and views of both caregivers and people with dementia. This will require additional assessor training, and the development of validated assessments for people with dementia who have additional impairments. Policies should support the development of services which provide a wider range of AT to facilitate interventions which are focused on the needs of the person with dementia.Item Incite to practice: Development of a realist-informed program theory to support implementation of intersectoral partnerships(SAGE, 2021-08-11) Irvine-Fitzpatrick, Linda; Maciver, Donald; Forsyth, KirstyPolicy internationally is supportive of intersectoral partnerships (ISPs) for promoting positive outcomes among people with complex social, psychological, and physical needs. This realist-informed study describes the development of a program theory to provide insight into enactment of effective ISPs. Interviews were completed with 18 senior staff with leadership roles in six ISPs, including voluntary, statutory, and commercial organizations, supporting people with complex health and social care needs. An iteratively developed and refined program theory, termed the “Incite” model, was developed, with collaboration with participants and an advisory group, including people with lived experience. Important contextual conditions that emerged included organizational culture, historical perspectives, policy, and social determinants of health. Mechanisms included desire for change, creating safe psychological spaces, establishing shared values, and talking about power. Outcomes included transformed world view, increased psychological safety, clarity of purpose, fluidity of relationships, and power shifting. Three phases of partnership development were also identified within the model. This study has led to a clearer, more rigorous, and systematic understanding, with recommendations for how ISPs might be developed or expanded. How the Incite model may be operationalized is discussed, as well as implications for policy, practice, and research.Item Psychometric evaluation of the Making it CLEAR questionnaire, a resilience measure for older adults(Oxford University Press, 2021-09-28) Whitehall, Lucy; Górska, Sylwia; Rush, Robert; Singh Roy, Anusua; Irvine-Fitzpatrick, Linda; Forsyth, KirstyBackground and Objectives: Previous efforts to develop a resilience measure for older adults have largely failed to consider the environmental influences on their resilience, and have primarily concentrated on the resilience of community dwelling older adults. Our objective was to validate a new multidimensional measure of resilience, the Making it CLEAR (MiC) questionnaire, for use with older adults at the point of discharge from hospital.
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