Importance: Occupational therapy use in the neurological critical care unit (NCCU) may relate to patient factors, but data about these relationships remain unpublished. Objective: To examine how patient factors predict NCCU occupational therapy use and intervention types. Design: Retrospective cohort study of electronic health records data from adults admitted to the NCCU between May 2013 and September 2015. Setting: NCCU in a large, urban academic hospital. Participants: Adults (age ≥18 yr; N = 1,134) admitted to the NCCU. Measures: Using length of stay (LOS), number of comorbidities, Glasgow Coma Scale (GCS) score, gender, age, and racial–ethnic minority status as independent variables, separate regression models identified predictors for each dependent variable: receipt of NCCU occupational therapy, occupational therapy onset (days after admission), and receipt of self-care or home management (ADL–Home); functional activities or cognitive training (Func–Cog); and therapeutic exercise (Ther-Ex). Results: Four hundred twenty patients (37.0%) received occupational therapy in the NCCU. Receipt of occupational therapy was positively associated with LOS, number of comorbidities, GCS score, and age. Earlier occupational therapy onset was associated with higher GCS score and shorter LOS. Receipt of ADL–Home or Func–Cog interventions was significantly predicted by number of occupational therapy sessions, but patients with longer LOS were less likely to receive ADL–Home interventions. Receipt of Ther-Ex interventions became less likely as GCS score increased. Conclusions and Relevance: Patients are more likely to receive occupational therapy services if they are older and have a longer NCCU LOS, more comorbidities, and a higher level of consciousness. What This Article Adds: A patient’s level of consciousness is clearly associated with occupational therapy utilization and hospital outcomes, but it should not be the only factor considered when prioritizing patients for NCCU occupational therapy services. Compared with patients who were more awake and alert, patients with a lower level of consciousness had a later onset of occupational therapy, which suggests an opportunity for NCCU occupational therapists to collaborate with physicians in the modification of sedation protocols to enable early rehabilitation.

Importance: Care partners report that they are unprepared to manage the care of their loved one during the predischarge rehabilitation process and at the time of transition from hospital to home. Objective: To link, classify, and describe care partner–reported problems using the International Classification of Functioning, Disability and Health (ICF) to explore care partner experiences during the predischarge rehabilitation process. Design: We linked meaningful concepts collected during problem-solving training implemented with care partners of patients with sudden-onset conditions to the ICF using a standardized linking technique. Setting: Health care institution. Results: Care partner–reported problems were linked to 13 of the 30 ICF chapters. Activities and participation was most frequently addressed, followed by body functions. Care partners most commonly reported problems in the areas of emotional function, major life areas, self-care, domestic life, interpersonal relationships, and sleep functions. Conclusions and Relevance: The ICF can be used to examine and describe care partners’ health-related experiences. Care partners experience myriad problems related to activities and participation, body functions, environmental factors, and personal health before the care recipient’s initial discharge from the hospital. What this Article Adds : Care partners’ problems early in the rehabilitation process are complex and interrelated. The ICF can serve as a framework for a systematic approach to identifying care partner needs, as it has for patients with a variety of diagnoses.

Older adults living in skilled nursing facilities (SNFs) and long-term care facilities are particularly susceptible to the coronavirus disease 2019 virus and face unique challenges during their rehabilitation process. This case report highlights the disease and rehabilitation course of an older adult who received all of his medical and rehabilitative treatment while residing in a SNF. The occupational therapy evaluation and intervention processes, as well as the client’s response to intervention, are described. The client’s positive outcomes are linked directly to occupational therapy’s ability to incorporate medical, physical, and psychosocial aspects into part of the interdisciplinary model of care in a SNF.

The coronavirus disease 2019 (COVID-19) pandemic has presented unique challenges for occupational therapy practitioners working in acute and critical care settings. Using the best available evidence, this case report overviews a prototypical COVID-19 disease course and discusses key aspects of clinical reasoning for practitioners working with this novel population. Following a single patient admitted to a tertiary academic medical center, the authors review the occupational profile and medical history, common impairments, the intervention plan, and strategies to align the occupational therapy and medical goals of care.

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. A pilot study was completed to examine the effectiveness of OT in helping individuals regain independence in activities of daily living after COVID-19. In a retrospective chart review, statistically significant results (p < .05) on the Inpatient Rehabilitation Facility Patient Assessment Instrument and the Modified Barthel Index demonstrated that OT is effective in the rehabilitation setting to increase individuals' independence following a COVID-19 diagnosis. Primary Author and Speaker: Nelle Hannah Ouellette Additional Authors and Speakers: Leah Bellinger, Julie Leonard Contributing Authors: Leah Bellinger, Julie Leonard

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. We examined similarities and differences in cultural values, beliefs, and experiences between OTs in Taiwan and the United States with respect to the delivery of a strategy-training intervention approach to stroke survivors. Findings of this study increase understanding of the distinctions between strategy training and traditional rehabilitation practice and highlight the potential factors that may affect the delivery of strategy training to stroke survivors in different cultural contexts. Primary Author and Speaker: Feng-Hang Chang Contributing Authors: Jessica Kersey, Chao-Yi Wu, Minmei Shih, Beth Fields, and Elizabeth Skidmore

Date Presented 04/200/21 The study examined Medicare claims data to determine the amount of rehabilitation services needed (e.g., therapy intensity and length of stay) to maximize the improvement in self-care skills for older adults with an orthopedic hip condition in skilled-nursing facilities. Findings of the study provide reference data for OTs to plan intervention and justify resources necessary to increase clients' independence. Primary Author and Speaker: Chiung-Ju Liu Additional Authors and Speakers: Loriana Harkey, Sadie Jung, and Elizabeth Newton

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This descriptive, qualitative study describes the OT process used by expert practitioners for adults with persistent mild traumatic brain injury symptoms in outpatient concussion clinics. OTs are uniquely trained to return persons to their everyday activities, without requiring a military or sport background. This evidence empowers practitioners to advocate for the client and for the professional to be part of the rehabilitation team and raise the perceived value of the profession. Primary Author and Speaker: Mary Ann B. Roelke Contributing Authors: Vanessa Jewell

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. More than half of all surgical patients are age 65 and older, and research suggests that a majority of these patients will require postacute-care (PAC) rehabilitation services. Despite the growing costs, characteristics related to requiring PAC in the elderly abdominal surgery population are not well studied. This project aims to describe discharge trends, as well as factors related to requiring placement at a skilled-nursing facility in the elderly abdominal surgery population. Primary Author and Speaker: Erika Dobson Contributing Authors: Rebecca Julian, Hailey Zanette

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Incarceration exposes individuals to a negative combination of sensory deprivation and sensory overstimulation, which has serious health consequences. The Sensory Profile (SP) was administered to 345 men and women residing in a corrections facility and who participated in OT programming. This presentation will illustrate how the SP data discriminate and then discuss the implications for using the SP in justice settings and designing appropriate intervention based on SP data. Primary Author and Speaker: Sandra Rogers Additional Authors and Speakers: John White

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Hospital discharge readiness is an important yet often elusive matter for pediatric patients, families, and health care providers. Caregiver readiness for discharge should be assessed both at admission and before discharge to allow for timely education and training. The Pediatric Readiness for Hospital Discharge Scale is recommended for use by OTs in an acute rehabilitation setting because they harness the unique ability to address both physical and psychosocial aspects of the child and family encompassed by the measure. Primary Author and Speaker: Lori B. Ragni Additional Authors and Speakers: Camille Velasco, Teresa Fitzsimons, and Katie Shniderman

Date Presented 04/21/21 This systematic review analyzes patient satisfaction with telehealth rehabilitation (OT, physical therapy, speech-language pathology) in global rural communities. Telehealth services should be used to deliver therapy to patients in rural settings for greater outreach. Patients report high satisfaction related to ease of travel, quality of care, safety, and reduced costs. This study has implications for telehealth program development within OT practice. Primary Author and Speaker: Angela Patterson Additional Authors and Speakers: Stephanie C. DeLuca, Hoàng Khánh Chi Contributing Authors: Lê Tường Giao Lê Tường, Đang Nguyễn Thị, and Thi Bich Ngoc Nguyen

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This qualitative, observational research study explored treatment encounters between patients with disorders of consciousness, rehabilitation practitioners, and family to understand how treatment decisions occurred. The data showed shared decision making (SDM) occurring as a process, meaning that not all five principles of SDM occur in one clinical encounter but rather unfold across multiple clinical encounters. We delineate differences in SDM between rehabilitation and the medical model. Primary Author and Speaker: Jennifer Weaver Contributing Authors: Trudy Mallinson, Leslie Davidson, Christina Papadimitriou, Ann Guernon, and Philip van der Wees

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This poster will discuss the use of commercially available accelerometers to monitor poststroke home rehabilitation of the upper extremity during repetitive, occupation-based exercises. Secondary data analysis of outputs includes (1) comparison of self-reported practice sessions with sessions captured via the accelerometer, (2) comparison of self-reported practice time versus time captured via accelerometer, and (3) patterns in angular velocity based on data processing. Primary Author and Speaker: Kate De Castro Additional Authors and Speakers: Elena Donoso Brown Contributing Authors: Sarah Wallace, Rachael Neilan

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Rehabilitation practitioners (N = 98) indicate it is very important to have specialized therapists and programs for pediatric cancer rehabilitation, yet only 39% of hospitals have a specialized program. Therapists rarely receive education during academic or clinical training on working with children with cancer, resulting in a lack of consistency in services provided across institutions. A pediatric cancer rehabilitation certification program can help promote an evidence-based standard of care. Primary Author and Speaker: Molly Houdeshell Additional Authors and Speakers: Natalie Haffner Contributing Authors: Taniya Easow Varughese, Allison King, and Allison J L'Hotta

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The study objective was to examine the implementation barriers and facilitators after a year of training and use of a task-specific training manual in inpatient rehabilitation. The Consolidated Framework for Implementation Research provided structure for the survey of OTs. Stakeholders reported confidence in evidence incorporation, and the barriers related to ease of selection and use of this intervention need to be addressed. Primary Author and Speaker: Eron Bozec Additional Authors and Speakers: Namrata Grampurohit Contributing Authors: Namrata Grampurohit, Jaime Gorska

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Our study is based on the occupation of medication management in the acute inpatient rehab setting. We examined the use of a tool (the ManageMed Screen, or MMS), primarily based on OT documentation on 100 stroke patients, to determine the correlates of MMS scores. MMS scores were moderately correlated to scores on the Montreal Cognitive Assessment, the discharge portion of the cognitive FIM®, and education level. Primary Author and Speaker: Sharon Hartl Additional Authors and Speakers: Additional Speaker Contributing Authors: Lauren A. Hallberg

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Time management is a key OT intervention component. Valid and reliable instruments are essential for evaluating rehabilitation and OT interventions. The results of this study show that the Assessment of Time Management Skills has good measurement properties and consistent and replicable items and is useful in English-speaking countries. It can provide valid measures of time management skills, organization and planning skills, and regulation of emotion in a general population and presumably also a population with cognitive impairment. Primary Author and Speaker: Afsaneh Roshanai Contributing Authors: Gunnel Janeslätt, Suzanne Marie White, Kajsa Lidstroem Holmqvist, Marie Holmefur

Date Presented 04/13/21 Results of a qualitative phenomenological study of the influence of spirituality on the lived experience of Christians during the rehabilitation process are shared. Findings show the pervasive impact of spirituality on occupational participation, performance, and engagement and align with the concepts of Humbert’s conceptual model of spirituality. This study of spirituality as expressed from a specific worldview perspective advances the provision of holistic, culturally relevant OT services. Primary Author and Speaker: Debra Hanson Contributing Authors: Heather Roberts, Angela Shierk

Date Presented 04/8/21 Vietnamese therapists developed constraint-induced movement therapy (CIMT) models and completed a prospective nonrandomized study at two hospitals in Vietnam. Therapists at Hanoi Rehab Hospital delivered a low-dose (30-hour) CIMT protocol, and therapists in Ho Chi Minh City Children's Hospital delivered a high-dose (72-hour) CIMT protocol. Children in both low- and high-dose CIMT groups showed improvements in everyday activities and individual therapy goals. This study advances the delivery of evidence-based practice in Vietnam. Primary Author and Speaker: Patricia Coker-Bolt Additional Authors and Speakers: Katherine Breithaupt Contributing Authors: Lauren Williams