Armitage Samantha, Swallow Veronica, Kolehmainen Niina
a Samantha Armitage, Occupational Therapist , Sheffield Children's NHS Foundation Trust , Sheffield , UK.
b Veronica Swallow, Associate Professor, Academic Unit: Adult , Child and Mental Health Nursing, University of Leeds , Leeds , UK.
Scand J Occup Ther. 2017 May;24(3):208-213. doi: 10.1080/11038128.2016.1201141. Epub 2016 Jul 25.
There is limited evidence about the effectiveness of occupational therapy interventions for participation outcomes in children with coordination difficulties. Developing theory about the interventions, i.e. their ingredients and change processes, is the first step to advance the evidence base.
To develop theory about the key ingredients of occupational therapy interventions for children with coordination difficulties and the processes through which change in participation might happen.
Grounded theory methodology, as described by Kathy Charmaz, was used to develop the theory. Children and parents participated in semi-structured interviews to share their experiences of occupational therapy and processes of change. Data collection and analysis were completed concurrently using constant comparison methods.
Five key ingredients of interventions were described: performing activities and tasks; achieving; carer support; helping and supporting the child; and labelling. Ingredients related to participation by changing children's mastery experience, increasing capability beliefs and sense of control. Parents' knowledge, skills, positive emotions, sense of empowerment and capability beliefs also related to children's participation.
The results identify intervention ingredients and change pathways within occupational therapy to increase participation. It is unclear how explicitly and often therapists consider and make use of these ingredients and pathway.
关于职业治疗干预对协调困难儿童参与结果有效性的证据有限。构建关于这些干预措施的理论，即其要素和变化过程，是推进证据基础的第一步。
构建关于职业治疗干预对协调困难儿童的关键要素以及参与度变化可能发生的过程的理论。
采用凯西·查马兹所描述的扎根理论方法来构建该理论。儿童和家长参与半结构化访谈，分享他们在职业治疗方面的经历和变化过程。使用持续比较法同时完成数据收集和分析。
描述了干预的五个关键要素：进行活动和任务；取得成就；照顾者支持；帮助和支持儿童；以及标记。这些要素通过改变儿童的掌握经验、增强能力信念和控制感来与参与度相关联。家长的知识、技能、积极情绪、赋权感和能力信念也与儿童的参与度相关。
研究结果确定了职业治疗中增加参与度的干预要素和变化途径。目前尚不清楚治疗师在多大程度上明确且频繁地考虑并利用这些要素和途径。
