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   2020| October-December  | Volume 52 | Issue 4  
    Online since April 22, 2021

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Impact of Corona Virus Disease-2019 on occupational therapy practice in India: An online national survey
Karthik Mani
October-December 2020, 52(4):117-124
Background: India imposed several consecutive lockdowns to control the spread of coronavirus disease-2019 (COVID-19) beginning March 2020. As a result, many establishments, including outpatient health-care settings and educational institutions, were closed. Consequentially, many health-care professionals experienced disruption in their work lives and faced financial crisis. Objectives: The objective was to assess the impact of COVID-19 on the occupational therapy (OT) community in India. Study Design: This is a cross-sectional study. A ten-item electronic survey was developed based on the research question to gather data. Methods: An online survey form was e-mailed to 760 OTs in India identified through convenience sampling. The survey link, generated through SurveyMonkey, was also shared on four WhatsApp Messenger groups (TNAIOTA Official Group, OTist Group, Clinic OT, and IPOTPDG1) with many Indian OTs (snowball sampling). In addition, the survey link was shared through Facebook Messenger to around 200 OTs in India. Data were collected from May 24, 2020 to June 21, 2020. Results: The number of responses received was 99. Eighty-seven respondents reported experiencing disruption in work, of which 37 reported 81%–100% income loss. The income loss was high among private practitioners and low among academicians. Respondents utilized telehealth to overcome the disruption. Conclusions: COVID-19 has severely impacted the work lives of OTs in India and caused financial strain. This study provides preliminary data and some suggestions for the professional organizations and leaders to consider when advocating for the profession. Further in-depth exploration is recommended.
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Guest editorial: Emotional and psychosocial well-being: Challenges in contemporary occupational therapy in mental health practice
Supat Chupradit, Senthil Vadivel Vadivu
October-December 2020, 52(4):115-116
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Occupational therapy practice in mental health
Lakshmanan Sethuraman, Punita V Solanki, Anil K Srivastava
October-December 2020, 52(4):113-114
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Effect of mindfulness-based stress reduction occupational therapy program in parents of children with autism spectrum disorder: An interventional study
Sushant D Sarang, Arthi G Karnam, Bhakti A Vanmali, Pallavi R Phulpagar
October-December 2020, 52(4):132-138
Background: Raising a child with autism spectrum disorder (ASD) is highly demanding. Parents of children with ASD show increased parenting stress. This may lead to parental mental health problems, such as symptoms of stress, anxiety, and depression. Stress can affect the parents functioning and also hinder the ASD child's progress. Jon Kabbat Zinn defines mindfulness as a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used and helps to increased coping and decreased reactivity to physical and emotional difficulties. Objectives: The current study aimed at finding the effect of a mindfulness-based stress reduction-occupational therapy (MBSR-OT) program on psychological functioning (stress, anxiety, depression, mindfulness, and psychological wellbeing) in parents of children with ASD. Study Design: A one-arm interventional study with subgroup analysis was conducted. Methods: Sixty parents of children diagnosed with ASD were included in the study. Parents diagnosed with schizophrenia, intellectual disability, dementia, or receiving treatment for any mental illness were excluded. All the parents were scored on the following outcome measures: Perceived Stress Scale, Mindful Attention Awareness Scale, Ryff's Psychological Scale, and Hamilton Anxiety and Depression Scale. Data were analyzed using Windows-based R-Programming software. A paired t-test was used to analyze the data. Results: When results were analyzed, it was found that there was a significant improvement in the levels of stress (at baseline: mean ± standard deviation [SD] = 20.54 ± 4.89, 95% confidence interval [CI]:18.8–22.3; postintervention mean ± SD 10.96 ± 2.32, 95% CI: 10.1–11.8, P = 0.00), mindfulness (at baseline: Mean ± SD = 4.37 ± 0.90, 95% CI: 4.05–4.69; postintervention: Mean ± SD = 5.27 ± 0.70, 95% CI: 5.02–5.52, P = 0.00) psychological wellbeing (at baseline: Mean ± SD = 170.46 ± 25.54, 95% CI: 161–180; postintervention: Mean ± SD = 190.77 ± 24.53, P = 0.05, 95% CI: 182–200), anxiety (at baseline: Mean ± SD = 14.15 ± 5.72, 95% CI: 12.1–16.2; postintervention: Mean ± SD = 190.77 ± 24.53,95% CI: 182–200, P = 0.00) and depression (at baseline: Mean ± SD = 7.77 ± 3.90, 95% CI: 6.37–9.17; postintervention: Mean ± SD = 3.35 ± 2.94, 95% CI: 2.3–4.4, P = 0.00). Conclusion: MBSR-OT program can help reduce stress, anxiety, and improve the psychological wellbeing of parents having children with ASD.
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Perception of psychiatrists on occupational therapy practice in mental health: A qualitative study
Sadichha Paresh Kamat, Pooja Vivek Vajaratkar
October-December 2020, 52(4):125-131
Background: In India, there is a significant predominance of mental illnesses in varied age individuals that leaves them incapacitated in various domains of functioning (self-care, occupational and interpersonal functioning, and social participation). Moreover, with the current lifestyle and working conditions, a large majority of the population also face psychological issues hindering their emotional and psychosocial well-being. All of these individuals require a comprehensive interdisciplinary intervention. The psychiatrists serve as a primary source of referral for occupational therapy (OT). It becomes essential to understand the perceptions of the psychiatrists on the role of OT practice in mental health and its relative contribution in the psychosocial rehabilitation and promotion of mental wellness to provide holistic treatment. Objective: This study aimed to explore the perceptions and understanding of OT practice in mental health among psychiatrists based in Goa, India. Study Design: A qualitative descriptive design was used for this study. Methods: A qualitative study was conducted on psychiatrists (n = 10) currently practicing in Goa, having experience of 3 or more years in psychiatric practice. The snowball sampling method was used. A semi-structured questionnaire was used to conduct in-depth interviews to explore the psychiatrists' knowledge and understanding of OT practice in mental health. Results: The psychiatrists have a general understanding of the role of OT in mental health. They stated the importance of OT interventions in vocational rehabilitation and promotion of functioning. They also reported that occupational therapists (OTs) are important stakeholders in the multidisciplinary team. However, it was found that there was limited knowledge about the scope and OT practice in mental health among the psychiatrists. They also lacked clarity over the professional roles of OT and other mental health professionals in a mental health setting. Conclusion: There is a general understanding of OT practice in mental health among psychiatrists. However, there exists a lack of clarity about the roles of OT in mental health.
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Effect of tele-occupational therapy on self-determined routine task performances in a young adult with autism, intellectual disability, and obsessive-compulsive disorder: A case report
Aishwarya Swaminathan, Anuradha Venkatesh Pai
October-December 2020, 52(4):151-154
A 19-year-old male with autism, intellectual disability (ID), and obsessive–compulsive disorder (OCD) presented with difficulty in self-determined routine task performances. Tele assessment was performed pre- and post-tele-occupational therapy (OT) intervention, using Yale Brown Obsessive–Compulsive Scale (Y-BOCS), Self-Determination Observation Checklist (SDOC), American Institutes for Research Self Determination Scale (AIRSDS) parent and educator form, and Routine Task Inventory-Expanded (RTI-E), to assess compulsive behaviors, self-determination from therapist, parent, and educator perspective, and routine task performances, respectively. Postintervention, favorable improvement was observed for the scores of Y-BOCS (25%), SDOC (therapist 29%), AIRSDS (parent 15% and educator 13%), and RTI-E: Activities of daily living (ADL) (20%), instrumental ADL (10%), communication (8.3%), and work behaviors (16.7%). This case report indicates that OT had a positive effect on the self-determined routine task performances in a young adult with autism, ID, and OCD.
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Analysis of burden on family caregivers of hospitalized patients with psychiatric illness: An observational, analytical, cross-sectional study
Pratibha M Vaidya, Heena N Patel
October-December 2020, 52(4):139-143
Background: The caregiver's burden refers to a people's emotional response to the change in their life roles and the increased responsibilities that they need to deal with when they are expected to care for an ill person. The burden on a family can be due to a multitude of reasons which include increased workload, type of caregiving tasks that need to be performed, the amount of time consumed performing these tasks, the personal sacrifices that need to be made to accommodate these, disruption of family routine, and stigmatization by society. The caregiver's gender, age, level of education, employment status, family history of mental illness, family type, etc., are few of the factors considered to evaluate the level of burden on the caregiver in this study. Objective: The objective of this study was to evaluate/gauge the level of burden of family caregivers of admitted psychiatric patients and determine the influence of various factors on this burden. Study Design: An observational, analytical, cross-sectional study was conducted. Methods: One hundred and fourteen family caregivers of age ≥18 years, who have been caring for hospitalized patients with psychiatric illness for more than 6 months, were included in the study. Demographic data gathered included age, gender, family history of mental illness, type of family, relationship with the patient, educational qualifications, and employment status. The caregivers were interviewed using the Zarit Burden Interview to evaluate their level of burden, which consists of 22 questions. The caregivers were asked to rate each question on a scale of 0–4 in ascending order of occurrence. Results: The level of burden in 42% (n = 48) of the family caregivers was moderate, and in 34% (n = 36) of the caregivers, it was severe. Seventy-seven percent of the caregivers from nuclear families (n = 89) experienced moderate-to-severe burden as compared to 68% of those from joint family (n = 25). Younger caregivers of age 18–40 years experienced moderate-to-severe stress. Sixty-seven percent of the caregivers were females (n = 76) and 33% were males (n = 38) of a total of 114 caregivers, and the level of burden was more in males. Employed caregivers had a higher burden than those who were unemployed. Conclusion: The level of burden ranges from “moderate” to “severe” among the family caregivers of hospitalized patients with psychiatric illness, wherein younger, employed caregivers from nuclear families without a family history of mental illness were significantly more burdened.
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Exploring spirituality and its use as a domain of practice among Indian occupational therapists: A qualitative study
Pooja Vivek Vajaratkar, Amitabh Kishor Dwivedi
October-December 2020, 52(4):144-150
Background: Most occupational therapy (OT) practitioners recognize that it is important to integrate client's personal beliefs, values, and spirituality into OT practice. However, ambiguity and diverse practice notions have an impact on the use of spirituality in day-to-day life. Thus, the purpose of the study is to bridge this gap by exploring spirituality as a domain of practice in OT among Indian OTs. Objectives: The objectives of this study were to explore and understand spirituality and its use as a domain of practice among Indian OTs. Study Design: A qualitative narrative study design was chosen for this research. Methods: Fifteen participants (n = 15) who are expert in the field of OT with major inclusion criteria of minimal 10 years' experience were recruited for this study using nonprobability convenient and snowball sampling method. The study was conducted with OTs working in private and public sectors in India. In-depth semi-structured interviews were conducted with senior OTs to explore their knowledge and understanding of spirituality as a domain of OT practice from an Indian perspective. Results: Three major themes emerged from this study were as follows: (1) understanding of spirituality, (2) differences in understanding the meaning of spirituality, and (3) importance of the use of spirituality as a domain of practice in OT. Conclusion: Overall, this study is a first step in understanding the complexity of spiritual considerations in day-to-day practice in Indian context. This study found that there is limited understanding of spirituality among Indian OTs. Lack of clarity in this area found difficult for the Indian OTs to differentiate spirituality from religion. This study also gave insight into how OTs use spirituality as a domain of practice in India. Based on this study, we suggest that there is an upmost need to develop guidelines on practicing spirituality in OT practice by generating further discussion and evidence on this subject.
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October-December 2020, 52(4):155-157
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