Meredith Gronski, OTD, OTR/L, CLA, is Assistant Professor and Chair, Department of Occupational Therapy, Methodist University, Fayetteville, NC;
Meghan Doherty, OTD, OTR/L, is Assistant Professor, Department of Occupational Science and Occupational Therapy, Saint Louis University, St. Louis, MO.
Am J Occup Ther. 2020 Mar/Apr;74(2):7402180010p1-7402180010p33. doi: 10.5014/ajot.2020.039545.
Research studies supporting occupational therapy interventions to address feeding, toileting, and sleep can be applied to practice in early intervention and preschool settings to improve the outcomes of young children and their families.
To examine the effectiveness of interventions within the scope of occupational therapy practice to improve activities of daily living, rest, and sleep for children ages 0-5 yr and their families.
Five databases (MEDLINE, PsycINFO, CINAHL, OTseeker, ERIC) and Evidence-Based Medicine Reviews, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, and Database of Abstracts of Reviews of Effectiveness were searched for studies published between January 2000 and March 2017.
Inclusion criteria were Levels I-III evidence, being within occupational therapy's scope of practice, including participants with a mean age younger than 6 yr, and addressing self-care, activities of daily living, and rest and sleep.
Forty articles were appraised, and three themes emerged: interventions to address feeding and eating, interventions to address toileting, and interventions to address rest and sleep. Additional subthemes of behavioral approaches, parent and caregiver education, and contextual intervention were revealed.
Occupational therapy practitioners should consider the use of interventions with moderate or strong evidence as described in this review. Limitations include risk of bias and limited evidence for several interventions.
This article provides a broader perspective on evidence-based practice by examining studies within the scope of occupational therapy practice published outside of current occupational therapy publications. The review includes studies from nutrition, nursing, and psychology, which address interdisciplinary care, family coaching and education, and behavioral approaches within the professional scope of occupational therapy to improve the functional performance, routines, and quality of life for young children and their caregivers.
支持职业治疗干预措施以解决进食、如厕和睡眠问题的研究可以应用于早期干预和学前环境中，以改善幼儿及其家庭的结果。
研究职业治疗实践范围内的干预措施对改善 0-5 岁儿童及其家庭的日常生活活动、休息和睡眠的有效性。
2000 年 1 月至 2017 年 3 月，在五个数据库（MEDLINE、PsycINFO、CINAHL、OTseeker、ERIC）和循证医学评价、Cochrane 系统评价数据库、Cochrane 对照试验登记处、以及疗效评价文摘数据库中搜索研究。
纳入标准为 I-III 级证据、在职业治疗范围内、包括平均年龄小于 6 岁的参与者、并解决自理、日常生活活动以及休息和睡眠问题。
评估了 40 篇文章，出现了三个主题：解决进食和饮食问题的干预措施、解决如厕问题的干预措施以及解决休息和睡眠问题的干预措施。还揭示了行为方法、父母和照顾者教育以及环境干预的子主题。
职业治疗师应该考虑使用本综述中描述的具有中度或高度证据的干预措施。限制包括偏倚风险和一些干预措施的证据有限。
本文通过检查发表在当前职业治疗出版物之外的职业治疗实践范围内的研究，为循证实践提供了更广泛的视角。该综述包括来自营养、护理和心理学的研究，涉及跨学科护理、家庭指导和教育以及行为方法，在职业治疗的专业范围内，以提高幼儿及其照顾者的功能表现、日常习惯和生活质量。
