Post-Professional Occupational Therapy Doctorate Occupational Therapy Doctorate Scholarship Symposium

Maude Hudson, OTD, OTR/L

Mentor: Norene Carlson, OTD, OTR/L

This study explored healthcare providers experiences and perspectives as they transitioned to the role of informal caregiver for a loved one. A qualitative research approach with in-depth interviews conducted with healthcare providers was utilized and data was collected from 6 participants. 

Three themes were identified with subthemes. These themes were obligation, role conflict and burnout. Obligation yielded the subthemes of pride in knowledge and skills, ability to access resources and enhanced communication. Role conflict identified subthemes of prioritizing the healthcare provider role over caregiver role, neglect of other roles and difficulty in the use of compartmentalization as a coping strategy. Burnout subthemes included lack of self-care, inability to detach and inability to disconnect from either role.

Further study of the perspectives of healthcare providers transitioning to the caregiver role of a loved one is important to identify the transition’s hurdles, coping techniques used and the consequences of caring on their general well-being as healthcare providers.

Kerlange Alexandre, OTD, OTR/L

Mentor: Barbara Nadeau, PhD, OTR/L

Haitian diaspora has described cultural preferences for traditional medicine over pharmaceuticals for disease management and mistrust of Western medicine. The aim of this study was to qualitatively explore the perceptions of Haitian immigrants toward rehabilitation services.

The data in this study was collected through a qualitative phenomenological research design utilizing individual semi-structured in-person and follow-up interviews. Participants for this study were recruited through convenience and snowball sampling via social media platforms and community organizations, such as churches and community centers.

The themes of the study indicate (1) family and friends support participation in rehab, (2) there was motivation to perform therapy to return to normal lives, (3) participants trusted their therapist with care and (4) many participants believed they would not receive rehab services if they lived in Haiti.  

These findings contradict earlier research regarding Haitian views of medical services revealing an increase in trust and comfortability in the receival of rehabilitation service.

Darlene Piraino, OTD, OTR/L

Mentor:  Norene Carlson, OTD, OTR/L

Despite the prevalence of opposite-gender informal caregiving at end-of-life there is a paucity of research into this topic. The purpose of this study is to understand the experience of these caregivers, advance knowledge, and help inform future occupational therapy practice.

This qualitative phenomenological study utilized semi-structured interviewing techniques to explore informal end-of-life opposite-gender care experiences of eight caregivers. The interview transcripts were analyzed using the In Vivo, emotional, and thematic coding.

The study revealed that EOL caregiving tasks, especially those crossing gender boundaries, posed unique challenges in maintaining dignity and modesty, impacting caregivers and care recipients. The caregiver's gender was shown to significantly influence caregiving roles, routines, and experiences. Four main themes and six subthemes were identified.  These themes were role conflict, with subthemes gender expectations, impact on other roles, and impact on communication; routine, with subthemes time demands, gender demands, and establishing routines; dignity; and modesty.

Findings demonstrate the intricate dynamics of opposite-gender caregiving at the EOL, highlighting the need for a nuanced understanding and approach in caregiving support. Occupational therapists can use their unique knowledge and expertise to play a pivotal role in addressing the needs of these caregivers.

Mary Casey, OTD, OTR/L

Mentor:  Karen Majeski, OTD, OTR/L

Flexible seating tools have grown in popularity in recent years and are frequently used to meet the sensory processing needs of the neurodivergent population. Universal Design for Learning (UDL) is an evidenced-based model of practice in the educational system to ensure that inclusive supports, including flexible seating options, are used to best meet the learning needs of all students. However, there is a lack of evidence-based resources available for school professionals to access regarding flexible seating options in elementary schools. Occupational therapists can use their expertise in sensory processing and seating and positioning to add to the evidence based UDL resources available. 

This study utilized the Delphi Method approach to gain feedback from clinicians and educators in the field. Three rounds of data were collected ranging from 70-109 participants per round via SurveyMonkey. The survey was analyzed using descriptive statistics to reach a consensus on the opinions of experts on the subject matter.  

Findings suggest this handbook could be used as an informative tool when considering the implementation of flexible seating using a UDL approach in elementary schools. Further study is required to determine if the flexible seating options offered in the handbook enhance the learning needs of neurodivergent students. 

Melissa Olson, OTD, OTR/L

Mentor: Karen Majeski, OTD, OTR/L

Federal educational legislation has broadened the role of school-based providers to support learner variability and promote equity through service delivery models targeting health promotion, prevention, and specialized intervention meeting needs at all levels of the school system. Occupational therapy practitioners have largely struggled to broaden their practice beyond services to students with individualized education plans. Barriers to an expanded role have been well documented. This study’s purpose is to discover the factors that contribute to specialized instructional support personnel (SISP)'s ability to adopt an expanded role of service delivery in school-based practice.

This study utilized survey methodology.  Snowball and convenience sampling were utilized. Two hundred sixty-eight school-based practitioners participated in the online survey. Statistical software was utilized to analyze the data. Data analysis included both descriptive and inferential statistics.

Two hundred ten respondents from across 46 states completed the survey. Results found statistically significant correlations among provider familiarity with general education standards, familiarity with educational legislation, a framework for tiered services, and engagement in professional activities with the provision of services in an expanded role.

Practitioners are engaging in an expanded role through participation in tiered activities though they are not identifying this within their role as SISP. School-based providers require enhanced competencies to adopt an expanded role. Entry-level practitioners must be equipped with the foundational knowledge and skills needed for contemporary school-based practice. Further analysis of the data set is important to explore the degree to which participatory factors impacted engagement in tiered activities to further understand contributions to role expansion.

Mezhda Mohammadi, OTD, OTR/L

Mentor: Karen Majeski, OTD, OTR/L

The purpose of this study was to explore the experiences of occupational therapy practitioners (OTPs) as they navigate the discharge planning process for uninsured stroke survivors in the acute care setting. Despite the documented challenges faced by uninsured patients, there is a gap in understanding the experiences of OTPs during the discharge planning phase for uninsured stroke survivors.

This study utilized a qualitative approach. Data was collected from a sample of six OTPs through semi-structured interviews. The interview transcripts were analyzed using thematic analysis to identify recurring patterns and themes in the experiences of OTs during discharge planning.

Themes identified include challenges in OTP service delivery at the acute care level due to limited resources, advocating for necessary protocols to be developed for OTPs working with uninsured patients, and the need for innovative strategies to address financial constraints through interdisciplinary collaboration.

Findings suggest that OTPs should develop targeted protocols and advocate for innovative strategies through interprofessional collaboration that prioritize the unique needs of this vulnerable population.

Vinita Jobes, OTD, OTR/L

Mentor: Barbara Nadeau, PhD, OTR/L

Despite the lack of evidence to support the NDT approach, it continues to be utilized by therapists clinically when working with individuals with stroke.  The purpose of this study was to explore the beliefs and perceptions of occupational therapists (OT) regarding the use of Neurodevelopmental therapy (NDT) to restore upper extremity function in individuals with moderate to severe stroke. 

This study used qualitative phenomenological methodology. Data was collected from 9 participants via semi structured interviews. The interviews were transcribed, then coded and clustered into common themes. Themes identified included:

• NDT is a multifaceted structured approach that necessitates training.
• Belief that knowledge of NDT can inform practice.
• Perception that NDT integrates well with other approaches.
• Perception that using NDT increases client satisfaction with therapy.
• Therapists see value in NDT as a useful approach for treating stroke.

The occupational therapists in this study view NDT as a multifaceted structured approach that has efficacy based on personal experience. Further the participants interviewed for this study perceived NDT as being a useful adjunct to occupation-based practice and want NDT embedded in OT curriculum.

Robert St. Lawrence, OTD, OTR/L

Mentor: Barbara Nadeau, PhD OTR/L

Although there is research regarding the medical aspects of mild traumatic brain injury (concussion) there is little research regarding how these impairments may impact daily function after the initial injury. The purpose of this study was to investigate the impact of mild traumatic brain injury on everyday occupation. The research for this study was: What is the impact of mild traumatic brain injury on daily function?

This study was conducted utilizing a qualitative approach with phenomenological research design to explore the lived experiences of those who have sustained a mild traumatic brain injury. Interviews were conducted with ten participants and transcribed to text for coding and thematic analysis. Themes included:

• Adapting daily life to manage post concussive symptoms;
• Misunderstanding of management of mTBI
• Complex and persistent nature of post concussive symptoms.

Findings suggest that mild traumatic brain injury impacts individuals’ participation in everyday occupational engagement. Further study regarding rehabilitation to manage post concussive symptoms may assist with lessening the impact of mild traumatic brain injury on functioning and may provide a path for improved occupational therapy service delivery to facilitate the transition back into everyday life.