The Indian Journal of Occupational Therapy

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Background: Attention-deficit hyperactivity disorder (ADHD) is characterized by diminished sustained attention, hyperactive and impulsive behavior and is known to have an impact on the daily routine and self-regulation of children. There is a dearth of evidence for understanding the routine of the children with ADHD and their parents, which is necessary for organizing and scheduling the routine for the better management of daily occupations. Objectives: This study aimed to understand the daily routine and schedule of children with ADHD in Goa. Study Design: A qualitative, descriptive study design was conducted. Methods: This pilot study was conducted in resource rooms and schools in Goa, India. The recruitment of 10 parents of children with ADHD was done by the convenient sampling method and parents were administered a semi-structured questionnaire and in-depth interview was undertaken to understand the children's daily routine. Results: Ten parents (mean ± standard deviation [SD] age 45.4 ± 7.97 years) of children with ADHD (mean ± SD age 9.5 ± 1.85 years) participated in this study. The study understood and described in depth the extent of the organized schedule and routine present, child's home and school routine and schedule, how the routine of the child affects the child and the family in terms of their socialization and how important is a routine for the family. Conclusion: The study inferred that the parents of children with ADHD have difficulty in managing the daily routine of their child at home as well as in school, including the self-care routine, meal-time, bed-time routine, and study schedule. The study helped understand the importance of an organized routine with a well-defined structure in the daily life to carry out timely meaningful occupations.

Background: Occupational therapy (OT) enhances functional independence in the daily activities of people with disabilities and subsequently their quality of life. Research in OT generates evidence to provide safe and effective services to the disabled. However, OT research in India has been shown to have various methodological limitations. These methodological limitations are expected to impact the quality of OT research as well as the evidence derived from this research to inform decision-making in rehabilitation. The majority of the OT research is disseminated and promoted through the All India Occupational Therapists' Association's (AIOTA) annual national conference (ANC). Analyzing the abstracts, selected for the presentation at the ANC could help understand and strategically improve the quality of OT research in India. Objectives: To explore and describe the quality of OT research in India. Study Design: Descriptive analysis. Methods: Descriptive, nonsystematic review and analysis of the key methodological aspects of the conference abstracts submitted for the AIOTA ANC published in the Indian Journal of OT (IJOT) from 2017 to 2021 was carried out. Information related to the methodological aspects of the research abstracts was extracted using a data extraction form and the data were synthesized and reported descriptively. Results: About 218 abstracts had been selected for either poster or oral presentations in the AIOTA ANC. All the abstracts were included for the review. A total of 8055 participants were recruited for the studies conducted from 2017 to 2021. About 5757 (72%) of the participants were recruited for cross-sectional studies. Nearly 72 (33%) of the abstracts presented were related to cross-sectional studies, 52 (24%) were case studies and 66 (30%) were experimental studies. However, research designs implying highest level of evidence such as systematic reviews were only 4 (2%) and randomized controlled trials were only 9 (4%) with 297 participants. Notably, 203 (98%) of the all the studies evaluating effectiveness of interventions or aiming to investigate associations reported positive results with statistically significant improvements and associations. Conclusion: The review provides invaluable information related to the quality of OT research in India. It implies the need to improve the scientific rigor of the evidence generated in relation to OT research in India. This review also implies the need for a radical change and strengthening of OT research within OT education and professional practice in India. National and global OT associations need to prioritize good quality OT research by enhancing the research skills and competencies of OTs in India. This could help promote evidence-based OT science and develop the OT profession in the world's second-most populous country. In addition, it is also expected to encourage those OT researchers who have been striving to build OT research standards in India.

Background: Global health care is moving toward function, quality of life, and occupation. Occupational therapy (OT) has been the only profession using “occupation” as core intervention since inception. With advancements in intervention techniques, occupational therapists (OTs) need to ensure the continued use of “occupation” as core intervention type. Previous surveys were conducted to analyze the use of specific intervention types: occupation-based interventions (OBIs), creative activities, acute-hospital-based rehabilitation, and different interventions used in pediatric OT practice. However, information on OT practices and types of interventions used by Indian OTs versus global OTs is unavailable. Objectives: The objective of this study was to analyze differences, if any, in the OT practices and types of interventions frequently used in daily practice by Indian versus global OTs. Study Design: This was an online, survey-based, cross-sectional study. Methods: The Google Forms questionnaire link was sent to OTs on E-mail with electronic written informed consent from May 2020 to March 2021 using convenient sampling. The questionnaire included participant's demographics, 17 clinical practice areas, and 9 intervention types and factors influencing OT practice. Total 201 (84 Indian OTs and 117 global OTs) fulfilled the selection criteria: OTs with at least bachelor's degree and minimum 3 years of work experience. Results: Indian OT workforce showed significantly more male OTs than global OTs (31 [36.9%] vs. 11 [9.4%]; 95% confidence interval [CI]: [0.0236–0.2964]; P = 0.0001) and OTs with master's degree (56 [66.7%] vs. 41 [35.04%]; 95% CI: [0.1852–0.4480]; P = 0.0001). Global OTs have more OTs with additional qualifications in non-OT fields (58 [49.57%] vs. 27 [32.10%]; 95% CI: [−0.3088–−0.0406]; P = 0.013) and more OTDs (13 [11.11%] vs. 1 [1.23%]; 95% CI: [−0.1641–−0.0335]; P = 0.006) than Indian OTs. Indian OTs practiced significantly more in the private sector: clinic and hospital (52 [61.90%] vs. 40 [35.80%]; 95% CI: [0.1273–0.3947]; P = 0.0001), whereas global OTs practiced significantly more in the government sector (46 [39.31%] vs. 19 [22.61%]; 95% CI: [−0.2930–−0.0410); P = 0.0124). Among the organizational roles, Indian OTs work significantly more as consultants (50 [50.95%] vs. 35 [29.91%]; 95% CI: [0.0751–0.3457]; P = 0.0001) while global OTs work significantly more as managers (36 [30.76%] vs. 12 [14.28%]; 95% CI: [−0.2770–−0.0526]; P = 0.0069). Among patient population treated, Indian OTs majorly (54.76%) treat children (up to 15 years) but significantly more in “all age groups” (35 [41.67%] vs. 18 [15.38%]; 95% CI: [0.1388–0.3870]; P = 0.0001) while global OTs treat significantly more adults (21–65 years) (61 [52.13%] vs. 25 [29.76%]; 95% CI: [−0.3569– −0.0905]; P = 0.0015) and geriatric (>65 years) (50 [42.73%] vs. 17 [20.23%]; 95% CI: [−0.3492–0.1008]; P = 0.0008). Indian OTs practice significantly more in developmental disability rehabilitation (78 [92.85%] vs. 68 [58.11%]; 95% CI: [0.2424–0.4524]; P = 0.0001), ante- and postnatal women's care (15 [17.85%] vs. 3 [2.56%]; 95% CI: [0.0662–0.2396]; P = 0.00018), and hemophiliac rehabilitation (14 [16.67%] vs. 2 [1.70%]; 95% CI: [0.0666–0.2328]; P = 0.00012) areas of practice than global OTs. Indian OTs practice significantly more in clinic outpatient department (OPD) (62 [73.80%] vs. 55 [47%]; 95% CI: [0.1375–03985]; P = 0.0001), hospital OPD (40 [47.61%] vs. 27 [23.07%]; 95% CI: [0.1141–0.3767]; P = 0.0002), and inpatient (37 [44.04%] vs. 30 [25.64%]; 95% CI: [0.0516–0.3164]; P = 0.0006) while global OTs practice significantly more in natural environment settings (53 [45.29%] vs. 24 [28.57%]; 95% CI: [−0.2994–−0.0350]; P = 0.016). Most preferred types of interventions among both groups are relatively the same: client education, counseling, and consultation and interview; therapeutic relationships; and therapeutic use of self. Besides these, Indian OTs prefer performance skills training and adaptive interventions, while global OTs prefer activities as therapeutic media and OBIs over other types. Preventive interventions and advocacy were the least preferred types of intervention among each group. Despite these relative preferences, significant differences were found between groups with regard to number of OTs practicing these 5 types of interventions: client education, counseling, and consultation (46 [54.76%] vs. 47 [40.17%]; 95% CI: [0.0073–0.2845]; P = 0.04]; performance skills training (41 [48.80%] vs. 34 [29.05%]; 95% CI: [0.0626–0.3324]; P = 0.004); preventive intervention and health promotion (29 [34.5%] vs. 24 [20.51%]; 95% CI: [0.0148–0.308]; P = 0.026]; adaptive interventions (39 [46.42%] vs. 23 [19.65%]; 95% CI: [0.1390–0.3964]; P = 0.001]; and preparatory interventions: (35 [41.67%] vs. 28 [23.93%]; 95% CI: [0.0467–0.3081]; P = 0.0075). Conclusion: The study provides the current stand for preferences and practices of therapeutic interventions by OTs in India versus globally, thus aiding in repositioning of OT practice, focusing on core OT domains as well as providing a baseline for monitoring practice trends over time.

Background: In India, the number of occupational therapy practitioners currently working in mental health settings is lower than most other specialties. The attitudes of students influence their interest in any field and their desire for working in it. Objectives: The objective of this study was to examine the attitudes of Indian undergraduate occupational therapy students toward mental health and psychiatry, and to explore the differences in attitudes across different years of study, gender, resulting from personal experiences, and educational coursework, and to examine if the attitudes influence future career choices. Study Design: This was a cross-sectional survey. Methods: Permission was obtained from heads of institutions of 14 occupational therapy colleges and the survey link was sent. In order to obtain a representative sample, the link was also shared on social groups. The purpose of the study, voluntary participation, and confidentiality were explained on the landing page. The subsequent sections consisted of the demographic questionnaire, the Attitudes toward Psychiatry-30 (ATP-30) Questionnaire, and the Career Preference Questionnaire. A total of 402 responses were obtained within the stipulated period. Statistical analysis was performed, and the odds ratio using logistic regression and Pearson's correlation coefficient were determined. Results: Gender and contact with persons with mental illness were significant predictors of positive ATP. Females are 5.387 times more likely to have positive ATP (odds ratio [OR] = 5.387, 95% confidence interval [CI]: 2.101–13.814, P = 0.000). Furthermore, those in contact with persons with mental illness are 2.883 times more likely to have positive ATP (OR = 2.883, 95% CI: 1.076–7.724, P = 0.035). Moderately high positive correlations existed between ATP and career preference in psychiatry. Conclusions: Overall, positive attitudes were found. Significant correlations were seen across the domains of the ATP-30 and career preference in psychiatry. Female students are five times more likely to have positive attitudes than male students. Those in contact with persons with mental illness were almost thrice more likely to have positive attitudes than those without any contact.

Online since 6^th November 2018