Yuho Okita

Occupation-based practice (OBP) is central to occupational therapy, yet its implementation remains inconsistent. This study translated and culturally adapted the OBP Measure into Japanese and evaluated its psychometric properties in 351 occupational therapists. Content validity, structural validity, internal consistency, test–retest reliability, measurement error, and measurement invariance were examined. Content validity was excellent (S-CVI = .97). Confirmatory factor analysis of the revised 33-item model showed mixed fit. Internal consistency was acceptable for four subscales, whereas Interest in OBP showed inadequate internal consistency and relatively weak test–retest reliability. Total-score test–retest reliability was high (ICC = 0.87), with an MDC ₉₅ of 1.94. Configural and metric invariance were supported across career stages, whereas scalar invariance was not fully supported. Overall, the OBPM-J showed promising psychometric properties, although its structural validity, Interest in OBP subscale, total-score interpretation, and comparability across career stages require further investigation.

In client-centred occupational therapy, enabling clients to set personally meaningful goals is considered critical to the success of interventions [1,2]. Goal setting has been shown to enhance clie...

Background: Telerehabilitation expanded rapidly during the COVID-19 pandemic and is increasingly used alongside, or as an alternative to, in-person rehabilitation. Goal setting is a core component of client-centered rehabilitation; however, how therapists conduct goal setting remotely remains poorly understood, particularly in East Asian contexts. To our knowledge, no qualitative study has specifically examined remote goal setting in telerehabilitation in Japan, where remote delivery was not yet routine when these data were collected. Objective: This qualitative study aimed to explore how Japanese occupational therapists and physical therapists experienced negotiating and adapting rehabilitation goals during telerehabilitation, including how remote delivery shaped assessment, collaboration, and the purposes assigned to goals. Methods: Individual semistructured interviews (18‐51 minutes; mean 32 minutes) were conducted via Zoom (Zoom Communications, Inc) in Japanese with 9 therapists (7 occupational therapists and 2 physical therapists; 7 male and 2 female; aged 29‐43 years) who had direct experience of remote goal setting. Participants were recruited by purposive and snowball sampling from 9 different workplaces across Japan, including metropolitan areas such as Tokyo and regional areas such as Hokkaido and Nagasaki, and worked in hospital, private-practice, community-based, and academic settings. Data were analyzed using reflexive thematic analysis within a contextualist epistemology, following Braun and Clarke. Trustworthiness was considered using Nowell and colleagues’ criteria, and reporting followed the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. Results: Four themes were constructed: (1) losing touch: uncertainty in remote assessment and goal setting (9/9 participants); (2) from direct intervention to coaching-oriented goal setting (8/9 participants); (3) at home, at ease: needs that surface in clients’ own environments (6/9 participants); and (4) when continuity becomes the goal (6/9 participants). Therapists described remote goal setting as shaped by both constraint and possibility. Partial bodily, nonverbal, and contextual information reduced their confidence in assessment and goal negotiation, and they responded through preparation, visual resources, self-monitoring tools, and collaboration with clients and families. Sessions conducted in clients’ own environments appeared to support comfort and sometimes made everyday needs more visible. When in-person care was unavailable or insufficient, therapists sometimes broadened goals from functional improvement alone to include continuity, ongoing monitoring, and prevention of disengagement. Conclusions: In these therapists’ accounts, remote goal setting was not simply a diminished version of in-person practice but a distinct clinical process requiring deliberate preparation, collaborative communication, and management of uncertainty. Hybrid pathways may combine in-person assessment, when hands-on examination is needed, with continued remote negotiation, monitoring, and revision of goals. Further research should incorporate clients’ and families’ perspectives and evaluate hybrid models of goal setting across diverse rehabilitation populations.

This scoping review aimed to identify studies that incorporated mobile phones or computing devices into rehabilitation interventions including goal-setting as part of the intervention. It examined their characteristics, target users, and supporting evidence to guide practice and future research. A search of six databases was conducted following the Joanna Briggs Institute guidelines for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixty-eight articles were identified, involving interactions using mobile phones (n = 46) and computing devices (n = 36). Synchronous telehealth delivery modes were the most investigated (n = 15 for mobile phones; n = 16 for computing devices), with phone conversations being the most common for mobile phones (n = 23) and videoconferencing most prevalent for computing devices (n = 18). Neurological and developmental conditions were the most frequently studied (n = 17 for mobile phones; n = 16 for computing devices). Mobile phones predominantly facilitated physical health goals (n = 11), while computing devices supported both physical health (n = 7) and daily activity goal-setting (n = 7). Research gaps included a lack of studies on telehealth technology selection, service provider competence, and end-user engagement. Additionally, few studies targeted psychiatric and behavioural conditions (n = 3 for mobile phones; n = 2 for computing devices), and none explored video conferencing platform selection. In conclusion, this study found more research on goal-setting using mobile phones, with stronger evidence, but none examined communication quality. Research on psychosocial populations was limited, despite their high cancellation rates. Challenges in rapport building, miscommunication, and therapeutic relationships in telehealth were highlighted, indicating areas for further research.

Objective: To evaluate the clinical utility, reliability, and validity of the second-generation aid for decision-making in occupation choice-2 (ADOC2), an iPad application designed for client-centred and occupation-centred goal setting. Design: This study consisted of two components: (1) The development and refinement of the ADOC2 application, focusing on user interface design and structured goal-setting functionality; and (2) the clinical evaluation of its utility, validity, and reliability. Setting: Eleven rehabilitation facilities in Japan (10 hospitals, 1 home-based setting). Participants: A total of 116 occupational therapy clients and 56 occupational therapists participated in the study. Main measures: Clinical utility was assessed using a structured questionnaire previously validated for the original ADOC. Validity was examined through correlations with the Canadian Occupational Performance Measure (COPM) and the EuroQol 5-Dimension 5-Level (EQ-5D-5L). Test–retest reliability of satisfaction and performance scores was analysed using weighted kappa coefficients. Results: Over 90% of participants reported positive experiences with ADOC2 during the goal-setting process. The COPM scores showed strong correlations with ADOC2 ratings, while EQ-5D-5L scores showed weaker but expected correlations. Weighted kappa analyses indicated substantial to almost perfect agreement for test–retest reliability. Conclusions: ADOC2 is a clinically useful, valid, and reliable tool for facilitating client-centred goal setting in occupational therapy practice.

Purpose: Goal setting is a crucial aspect of client-centered practice in occupational therapy (OT) for mental health conditions. However, it remains to be seen how goal-setting has been delivered in mental health, particularly the OT process. The purpose of this scoping review was to explore the nature and extent of goal setting delivered in mental health and informed OT practice. Design/methodology/approach: The authors followed the guidelines of Arksey and O’Malley (2005) and searched three databases using key search terms: “mental disorder,” “goal setting,” and “occupational therapy” and their synonyms. Findings: After excluding duplicate records, the authors initially screened 883 records and resulted in 20 records in total after the screening process. Most of the identified articles used goal-setting delivered by both a health professional and a client (n = 14), and focused on people with schizophrenia or schizoaffective disorder (n = 13), but three interventions were delivered by occupational therapists. Further research needs on goal-setting in mental health OT, exploring the reliability and validity of different goal-setting strategies and investigating the effectiveness of goal-setting for promoting behavior change and client engagement across various mental health conditions and settings. Research limitations/implications: The scoping review has some limitations, such as not investigating the validity and reliability of goal-setting strategies identified, and excluding conference papers and non-English articles. Originality/value: This scoping review presents a mapping of how goal-setting has been delivered in mental health and informed OT practice. The findings suggest limited research in OT and highlight the need for more studies to address the evidence gap in individualized client-centered OT.

The evaluation of impaired self-awareness (ISA) after brain injury is not widespread in Japan, and there is a lack of Japanese assessments of self-awareness. To translate the original version of the Awareness Questionnaire (AQ), an instrument for assessing ISA, into Japanese using a validated method and examine its reliability and validity in inpatients with stroke. This cross-sectional, prospective study enrolled 130 participants. The double-translation process was used to develop the Japanese version of the AQ. Data were collected from 120 patients. High intra-rater reliability was observed for the patient (Cronbach's α = 0.824) and clinician samples (Cronbach's α = 0.933). High intra- and inter-rater reliability were found for all AQ items [interclass coefficient (ICC) (1, 1) = 0.828, ICC (2, 1) = 0.852, ICC (3, 1) = 0.848]; however, the sub-item analysis revealed only moderate reliability. Validity assessment revealed a low but significant positive correlation (r = 0.209; p < 0.05) between the Japanese version of the AQ and the Japanese version of the Self-Regulation Skills Interview and a low but significant negative correlation (r = 0.197; p < 0.05) between the Japanese version of the AQ and the Mini-Mental State Examination. The Japanese version of the AQ was developed and applied to stroke patients, but the concept of post-stroke ISA may differ from ISA after traumatic brain injury, highlighting the need for a stroke-specific version of the AQ.

This review investigated the effectiveness of adjuvant therapy combined with constraint-induced movement therapy (CIMT) in improving the paretic upper limb functionality in adults with stroke sequelae during the subacute to chronic rehabilitation phase. In this systematic review and meta-analysis of randomized controlled trials (RCT), electronic databases, including PubMed, Web of Science, CINAHL, and MEDLINE, were searched. We included RCTs that investigated the outcomes of adjuvant therapy (i.e. other therapies) added to CIMT compared with CIMT alone. Key trial findings were qualitatively synthesized and analyzed. This meta-analysis examined variables, such as mean scores and standard deviations, using the following outcome measures: Fugl-Meyer Assessment (FMA) upper limb items, Action Research Arm Test (ARAT), Amount of Use (AOU) of Motor Activity Log (MAL), and Quality of Movement (QOM) of MAL. Eighteen eligible RCTs were included in the analysis. Adding CIMT to adjunctive therapy significantly improved FMA compared with CIMT alone (mean difference [MD] 4.02, 95% confidence interval [CI] 2.60-5.44; I² = 85%; 15 studies; 330 participants). Similarly, the ARAT and MAL-AOU scores improved significantly. CIMT combined with several adjunctive therapies effectively improved upper limb function.

Objectives: This scoping review aims to map the literature on goal-setting tools in adult rehabilitation, exploring their characteristics, target users and supporting evidence to inform practice and future research in this area. Methods: We completed a comprehensive search of four databases to identify relevant articles on tools for goal setting in rehabilitation. We followed Arkey and O’Malley's scoping review process to guide article selection, data extraction and data analysis. Results: We identified a total of 165 studies that reported on 55 different goal-setting tools, including tools for goal selection and goal documentation ( n = 31), goal setting and intervention planning ( n = 15), and for measuring the quality of the goal-setting process ( n = 9). Over half of the tools were primarily designed for use in rehabilitation of physical disabilities ( n = 32). Some tools fell under multiple sub-categories based on their characteristics as follows: 22 framework tools, 12 interview tools, 9 outcome measurement tools for goal achievement, 6 outcome measurement tools for goal quality and 25 documentation tools. The majority of goal-setting instruments targeted goals at the level of activity and participation ( n = 51) and aimed to facilitate a client-centred or shared decision-making approach to rehabilitation planning ( n = 46). Conclusions: This study provides a comprehensive overview of existing goal-setting tools, highlighting their characteristics, target users and identified needs. These findings can enhance practitioners’ awareness of the range of goal-setting tools available and can enable more effective utilization of these tools in clinical practice. Further research should investigate how clinicians can combine multiple tools to deliver goal setting.

Background: Collaboration is an important concept in goal-setting in occupational therapy. However, this concept is not stable due to various definitions. The purpose of this study was to clarify the concept of collaboration in occupational therapy. Method: A scoping review was used to search for all articles related to occupational therapy and collaboration. PubMed, Web of Science, CINAHL, and OT Seeker searches were conducted using predetermined keywords. Three examiners independently reviewed and assessed the quality of each study using Walker and Avant’s concept analysis method. Results: Results of the database searches yielded 1873 studies, 585 of which were deemed eligible to include in this review. Results showed five attributes (“active participation for the common objective”, “existence of something to share”, “matured communication and interaction”, “relationship founded on the respect and trust” and “complementing each other”) and two antecedents and several consequences. Conclusions: Our findings may contribute to collaborative goal-setting and occupational therapy.