narges shafaroodi

Evaluation of educational services through appropriate tools is very important. The present study was conducted to translate the Evaluation and Feedback for Effective Clinical Education (EFFECT) questionnaire from English into Persian and assess the validity and reliability of the translated version.

Initially, the EFFECT questionnaire was translated from English into Persian based on the International Quality of life Assessment (IQOLA) for cultural adaptation. To quantitatively evaluate the content validity of the questionnaire, the content validity ratio (CVR) and the content validity index (CVI) were used. To assess internal consistency, ninety-four occupational therapy students completed the translated EFFECT questionnaire. To measure test-retest reliability, 35 occupational therapy students filled out the translated questionnaire again after two weeks interval.

The EFFECT scores of the items ranged from 3.95 to 4.77, all of which were at an acceptable level. The CVR scores of 48 items (necessity) were higher than 0.59. Seven items received CVR scores of less than 0.59. Fifty-one items obtained CVI scores of higher than 0.79 (clarity). Four items did not achieve a minimum acceptable score of 0.79. The test-retest reliability range of 0.75 to 0.91. The Cronbach’s alpha varied from 0.84 to 0.94, revealing a very desirable internal consistency in all seven domains. The total value of Cronbach’s alpha was 0.98.

The Persian version of the EFFECT questionnaire has good validity and reliability in occupational therapy education and can be employed as an appropriate tool to assess the quality of clinical education in occupational therapy.

Clinical education is a bridge between theory and practice. The purpose of this study was to develop strategies to promote the quality of occupational therapy fieldwork education.  

The qualitative content analysis was used to identify the promoting strategies of fieldwork quality in occupational therapy from students' and fieldwork educators’ perspectives during the 2019–2020 academic sessions. Participants were 12 fieldwork educators (mean age=39.33 yr, Male=5, female 7) and 14 students (mean age=23.28 yr, Male=7, female 7) in the code extraction phase and 16 fieldwork educators (12 of them were in code extraction phase too) in actions of strategies scoring phase.  

Following the content analysis of the data, the prompting strategies categorized into 4 major categories and 10 subcategories: factors related to Fieldwork educators (Improving clinical teaching skills, Enhancing fieldwork management skills, Motivating fieldwork educators, and Fostering coordination between fieldwork educators), related to Educational Planning (Modifying clinical fieldwork planning, Revising curriculums), related to Students (Empowering students, Motivating students) and related to Fieldwork settings ( Improving the social environment, Improving physical environment ). Based on the qualitative content analysis and 3 expert panels. Finally, the 23 promoting actions were identified.  

Improving the quality of fieldwork education in occupational therapy needs a systematic collaboration between educators, students, and educational planners. Doing the promoting actions on fieldwork education process in occupational therapy may improve the quality of fieldwork education process.

 Students with emotional and behavioral disorders (EBD) have lower academic efficiency than students with other disabilities and exhibit high levels of problematic behaviors and low levels of social functioning. This research aims to investigate the impact of self-determination activities on communication skills and scholastic achievement of students at risk of emotional-behavioral disorders.   

 The study was conducted through a randomized controlled trial during the academic year 2018-2019. The samples included 54 female students (14 to 16 years) at risk of emotional-behavioral disorders from secondary schools in Tehran, Iran. The sampling was conducted through a random cluster method. The applied tools encompass Youth Self-report and Assessment of Communication and Interaction Skills. Academic success was measured by students' grade point average (GPA) in two terms. The intervention was held in 8 sessions of 90 minutes, once a week, after the first term of academic of students for the intervention group and the control group did not receive any intervention during this period. The data were analyzed by SPSS-22, MANCOVA, T-test, and Chi-Square tests.  

 The results of the multivariate analysis of covariance analysis showed self-determination has an impact on communication skills (physicality, information exchange and relations) of students at risk of emotional-behavioral disorders (p<0.05). Comparing the difference between the averages of the two students' means, it was found that there was a significant difference in the two groups after the intervention (p<0.001). Also, after the intervention, there was no significant difference between the two groups but the GPA of students in the intervention group increased from 13.19 to 15.61.   

 The findings suggested self-determination is effective for academic success and communication skills of students at risk of emotional-behavioral disorders and can be used in educational programs for these students.

Premature neonates are at greater risk of developmental problems such as cerebral palsy, developmental delays, and hearing and vision problems. The challenge of healthcare professionals who support preterm neonates and their parents is not only ensuring neonates’ survival but also optimizing infant development. Interventions to reduce adverse health outcomes are very important. The present study was focused on exploring the effect of the Creating Opportunities for Parent Empowerment (COPE) schedule on the developmental outcomes of premature infants 

The randomization process was done using a randomized block design, and neonates were assigned randomly to the treatment (n=20) and control (n=20) groups. Neonates in two groups were matched in gestational age, birth height, head circumference at birth, birth weight, Apgar scores (1 min, 5 min), prematurity, and new Ballard score. So, there was not a significant difference between them at the baseline. In the intervention group, the parents received a COPE schedule in a set of CD’s in conjunction with written instruction and supplemental activities (guidebook). COPE schedule was performed in 5 steps. In the control group, neonates received only routine services and interventions, and the research therapist performed no additional interventions. New Ballard examination was done in all neonates at the time of enrollment, followed by administration of Ages and Stages Questionnaire (ASQ) by an occupational therapist, who was double-blinded for the study, to any available parent (mostly mothers) at 6 months of corrected age. 

The results showed more maturity in “communication”, “gross motor”, “problem-solving”, and “personal-social” in the intervention group, and the observed differences between the two groups in these outcomes were statistically significant (P<0.05).

This educational-behavioral intervention program could promote mothers’ knowledge about their neonates and improve the developmental aspects of premature infants during their first months of life.

Identifying and removing the barriers faced by speech and language pathologists (SLPs) for implementing evidencebased practice (EBP) can facilitate its administration among Iranian SLPs.

The present study was conducted to explore the barriers to implementing EBP among Iranian SLPs.

A total of 14 SLPs were recruited using a purposive sampling technique. Semi-structured interviews were conducted for data collection. The interviews continued until data saturation was reached. Data were recorded and transcribed verbatim, and qualitative content analysis was used for data analysis.

Data analysis yielded three themes, including individual factors, organizational (workplace) factors, and extra organizational factors, and 13 subthemes.

This study demonstrated that Iranian SLPs are faced with several barriers to using EBP in clinical practice, which may be related to both the SLPs themselves and their surroundings. These barriers should be considered by policymakers, administrators, teachers, and rehabilitation team members to facilitate the implementation of EBP by SLPs.

Clinical education is a vital factor in the process of learning in medical sciences universities. The aim of the present study was to explore the perspectives of fieldwork educators and students concerning barriers to occupational therapy fieldwork education in Iran.

A qualitative research was conducted from May 2019 to April 2020 to address the study objectives. The data analysis was performed using conventional content analysis based on Graneheim and Lundman’s approach. Purposive sampling was used to enroll 12 educators and 14 students of various backgrounds (physical disabilities‑adult, physical disabilities‑pediatrics, psychosocial‑adult, and psychosocial‑pediatrics) in the study.

The findings indicated that the main themes were related to fieldwork educators, fieldwork settings, educational planning, students, and educational regulation.

It can be concluded that the perspectives of students and occupational therapy educators regarding the field of clinical education are not only important but also useful for the attainment of effective clinical education and the development of knowledge related to rehabilitation nursing education. Therefore, educational planners should develop effective programs based on these themes.

Despite its many positive effects, having a job can expose people to stress and threats that negatively affect health and well-being, and consequently, upset their occupational balance. Occupational therapy is one of the most stressful jobs and always exposes therapists to health-related threats due to direct contact with patients and constant and repetitive movements. This study aimed to investigate burnout and occupational balance among occupational therapists in Tehran.

This cross-sectional study investigated 166 occupational therapists working in the public and private clinics and centers of Tehran. Sampling was conducted using the multistage method. The participants completed demographic questionnaires, the Maslach Burnout Inventory, and the Life Balance Inventory. Then, the Spearman Statistical Test was used to examine the relationship between burnout and occupational balance.

The results revealed a strong (r= -0.29) and significant (P=0.001) negative relationship between emotional fatigue and the total life balance list, a strong (r= -0.32) and significant (P=0.0001) negative relationship between depersonalization and total life balance and identity, and a strong (r= -0.32) and significant (P=0.0001) negative relationship between success and total life balance list.

According to the results of this study, burnout negatively affects the identity and interests of occupational therapists but does not affect their health and communication.

The profile of occupational engagement in People with Severe Mental Illness (POES) is one of the time-use-based instruments, which can uncover the rhythm of activity and rest, as well as the variety and range of meaningful occupations. The current study aimed to report the translation process and assess the inter-rater reliability of the Persian version of POES.

In the present study, the translation process took place in three phases: forward-translation, backward-translation, and two expert panels review. To assess inter-rater reliability, all the POES forms were rated by the first and the third author.

The data achieved from 47 patients with schizophrenia were carefully analyzed. The inter-rater reliability analysis shows the intra-class correlation values were 0.86 in single and 0.92 in average measures.

The reliability results are entirely consistent with the previous studies on POES.

Several strategies can reduce unethical practices in the occupational therapy. The aim of the present study was to identify strategies for imoproving ethical performance in the clinical work of occupational therapists in the field of adult physical dysfunction.

A total of 10 graduated occupational therapists with at least two years of experience were selected using purposive sampling method.  Data were collected making use of semi-structured interviews in private clinics and occupational therapy wards. Content analysis was used for data analysis.

Data analysis showed emergence of two categories both of which represent the strategies for promoting ethical performance in the clinical work of occupational therapists in the field of adult physical dysfunction. These categories include: organizational strategies and individual strategies.

  The findings of the current study showed that in order to resolve ethical problems in the occupational therapy sector, it is necessary to formulate and approve necessary rules for the management of private and public occupational therapies and to issue these rules to the responsible organs for supervision and even to add a course on ethics to a the Bachelor's degree program and/or to establish periodic ethics workshops in occupational therapy for graduates as well as to address ethical issues related to the field of occupational therapy in all theoretical and practical lessons and trainings in order to increase the awareness of occupational therapy students so as to establish ethics among them.

  Several factors lead to unethical functioning in occupational therapy. The aim of the present study was to explore factors affecting unethical performances at the clinical work of occupational therapists in the field of adult physical dysfunction.

A total of 10 graduated occupational therapists with at least two years of experience were selected using purposeful sampling method.  Data were gathered through semi-structured interview in private clinics and occupational therapy sections. Data were analyzed using content analysis approach.

Data analysis led to the emergence of two categories both of which represent the factors affecting unethical practice in the clinical work of occupational therapists in adult physical dysfunction field. These categories include: environmental factors and individual factors.

The findings of the present study showed that lack of awareness of occupational therapists regarding the principles of professional ethics related to occupational therapy and also the lack of comprehensive rules in this regard are important causes of the unethical practices by therapists. These important factors make the occupational therapists encounter numerous ethical problems related to the rights of clients during their clinical experiences and more research is needed in order to provide the necessary strategies for preventing and promoting the practice of professional ethics among occupational therapists.

Commitment, a component of clinical competence, includes accountability and responsibility for professional roles and tasks; and, it has a positive correlation with job satisfaction and performance. This study aimed to elaborate on the concept of commitment in the field of occupational therapy using qualitative content analysis. The data was collected through interviewing 13 occupational therapists both in a focus group interview (including four participants) and in one-to-one interviews (nine other participants). The collected data was analyzed based on the Grenheim method, and commitment concept was defined under three main themes: (i) commitment to patient (five subthemes), (ii) commitment to self (three subthemes), and (iii) commitment to profession (three subthemes). This study’s findings indicated that to acquire clinical competence, therapists should be committed to their patients, to themselves, and to their profession. Future research is needed to further examine how and to what extent these commitment themes affect clinical competence as well as the interaction among them.

Clinical education is a vital part of occupational therapy education process. High clinical education quality in fieldwork settings leads to higher clinical competency and occupational proficiency. One of the most effective clinical education methods in equalizing the conditions of clinical education to students is the correct use of educational models related to each field of medical sciences. In the field of clinical education, various models have been designed with a specific subject. However, limited research has been done on the introduction of the usability of these models in occupational therapy settings. This study was conducted to determine which models have the potential to be used as clinical education models in occupational therapy.

A scoping review was conducted and studies published in English between 2000 and 2018 that examined clinical education models were selected.

A total of 8 articles were entered in the review, and a central theme of implementing clinical education models in occupational therapy was determined by thematic analysis. This central theme consisted of 3 categories: (1) evaluative models, (2) acting models, and (3) evaluative/acting models.

Occupational therapists, especially who work as educators should be aware of the different types of clinical education models and try to use these models in clinical education process and minimize the variation of teaching methods in fieldwork settings to promote the clinical education quality.  However, more research should be done to improve evidence-based occupational therapy practice in clinical education.

Premature neonates are at great risk for cerebral palsy, developmental delays, hearing problems and visual impairments. Interventions to reduce the morbidities and adverse health outcomes in these neonates and improve parent-infant interaction are highly important. This study was conducted to determine the effect of the Creating Opportunitiesf or Parent Empowerment (COPE) program on the perceived mat ernal parenting self-efficacy of premature parents

This was a randomized controlled trial with equal randomization (1:1:1 for 3 groups) and parallel group design. Forty-five preterm neonates were randomly allocated into treatment (n=15), supervision (n=15), and control (n=15) groups. COPE program was provided for a 4-phase educational-behavioral intervention program to the treatment and supervision groups. Primary outcome was parental self-efficacy, which was assessed with the Perceived Maternal Parenting Self-Efficacy. All measurements were taken before and after completion of the study with the valid equipment and by the blind assessors.

COPE mothers reported significantly stronger beliefs regarding their parental role and have more confidence to their ability in caring of neonates compared with control mothers (P-value <0.001).

An educational-behavioral intervention program would strengthen mothers’ beliefs and knowledge about their neonates and would remove barriers to enhance their ability for caring of neonates and enhance parent-infant interaction.

The volitional questionnaire is an observational tool to assess motivation, which is based on the MOHO model and completed by an assessor based on the individuals’ observation when performing an occupation or activity. The present study aims to translate and evaluate the validity and reliability of this instrument in individuals with severe mental illnesses and to provide an appropriate tool for volitional assessment. In this study, the volitional questionnaire was translated into Persian according to the IQOLA protocol. To assess the content validity, an expert panel was held with six experts. The face validity of the test was measured through completing a questionnaire by ten occupational therapists. To investigate the inter-rater reliability of the test, two testers completed the questionnaire for 30 individuals. The internal consistency of the instrument was calculated by performing the Cronbach's alpha coefficient, through completing the questionnaire for 98 individuals. The participants in the expert panel stated that concept of motivation is properly reviewed by the items of questionnaire. All the questionnaire items had a significant important score of 0.7, indicating the suitability of its face validity. Inter-rater reliability (ICC = 0.93) was ideal, and the internal consistency of the questionnaire (Cronbach's α = 0.86) was appropriate. The questionnaire has desirable validity and reliability and can be used by specialists as a suitable tool for clinical evaluation and therapeutic planning of individuals with severe mental illnesses.

The present study explored challenges in orthotics and prosthetics clinical learning environments in Iran.  A qualitative content analysis method was used to obtain data on orthotics and prosthetics clinical educator’s experiences. Qualitative data were obtained using semi-structured in-depth interviews involving 7 clinical educators; all selected by the maximum variation purposeful sampling method. Interviews continued until data saturation. During the interview sessions, notes and ideas were classified and assorted. The study themes were relationships, personal characteristics, facilities, and policies. Analysis of the qualitative data provided insights into the barriers to the desired delivery of clinical education services. The present research contributes to clinical educators’ experiences in respect of the clinical learning process. Clinical learning concerning orthotics and prosthetics education remains crucial. The findings emphasize the importance of listening to educators, and consider how relationships and contexts impact clinical learning. Understanding the challenges in clinical education environments has increased the quality of clinical education in orthotics and prosthetics field.

People with chronic mental health condition like schizophrenia experience a lot of changes in their lives, in addition to their symptoms. The present study used a thematic analysis to explore the participation of people with schizophrenia in daily life from family’s perspective. It has uncovered some of the contributing factors in the everyday life participation of this group. Semi-structured interviews were held with 8 family members of patients with schizophrenia. All the interviews were recorded and transcribed verbatim. The data were then analyzed in 6 phases of thematic analysis. Three main themes and 10 subthemes were extracted from the interviews. The main themes included impaired function, family types, and treatment dimensions. The subthemes identified within the family circumstance theme were supportive family, pitying family, ignored family, and confused family. According to the findings, besides the effects of the disease and its treatment on the performance of people with schizophrenia, the family also has a substantial role in the participation of their ill member in daily life activities. Considering the identified effects of families on patients’ participation and their needs, designing family-based interventions and training programs can facilitate the participation of patients with schizophrenia in everyday life

Ethics is an important issue in various scientific fields, including rehabilitation and occupational therapy. Since ethics can be affected by the environment, culture, and religion, there was a need to identify a systematic examination of the published literature about ethics in occupational therapy in Iran.  Therefore, the purpose of this scoping review was to identify, summarize, and describe existing literature on ethic in occupational therapy in Iran.

A scoping review was conducted based on the five steps framework of Arksey and O’Malley. Two researchers separately searched international and Iranian database by using relative keywords for articles published from January 2000 to February 2019.

After considering the inclusion and exclusion criteria for the founded articles, seven articles were selected for evaluating the scoping review. Three articles have been performed quantitatively and four articles have been done qualitatively.

The lack of sufficient studies in the field of ethics in occupational therapy shown that it doesn’t take an important place in the following area of research. Therefore, this scoping review revealed the need for the conduction of extensive studies and further research in this area.

Clinical education is one of the main parts in medical education, and rehabilitation sciences are not exception. Through clinical education programs, students gain required qualifications to enter professional life. Several factors impact on students' clinical education, and identifying these factors could help in the improvement of clinical education and could improve knowledge transferring to clinical practice especially in rehabilitation sciences in Iran. The purpose of present review study is identifying the factors potentially affecting the clinical education of rehabilitation students in Iran. A systematic review study conducted based on the evidence-based method on published articles from 2000 to 2017. The search process was carried out on MEDLINE, CINAHL, PsycINFO, and EMBASE databases. A total of 167 papers were selected. Given identical findings and considering eligibility criteria, 12 articles in the fields of clinical education, clinical competence, professional ethics education, and clinical reasoning were ultimately chosen. The results indicate that many factors might influence the clinical education of rehabilitation science students. Environmental factors (including ministry policies, educational curriculums, clinical education environments, and educational facilities/equipment) and individual factors (the knowledge and skills of students and characteristics of clinical trainers) were identified as the most influential factors in clinical education.

Clinical competence is one of the most controversial topics in the field of health care, which has a great importance in various areas of therapy, including education, clinical, and management. The present study was conducted to explore the skills required for obtaining the clinical competency of occupational therapists.
The current qualitative study was conducted following content analysis. The participants included 13 occupational therapists with a minimum of two years of clinical experience. The information was obtained through a focus group with four attendees and an individual interview with nine other graduate occupational therapists. Data was analyzed based on Graneheim method (2004).
Three categories emerged from the data, including reflection (with subcategories of self-judgment and critique of others), communication (with subcategories of communication with client and colleagues), and technical skills (with subcategories of disease recognition, assessment and comprehensive planning, and time and energy management).
The findings of the present study suggest that occupational therapists need different skills to obtain clinical competence and, according to the participants, improvement of supervisory, support, and educational systemas well as individual interest in the profession can help them to acquire skills and use them. Yet, more studies are needed to shed more light on this area.

The goal of models in occupational therapy is providing a structured format which leads to systematic comprehension in the process of evaluation, intervention, and treatment. Kawa model which is a conceptual model is recently developed in occupational therapy. This model uses a river as a metaphor to represent humans’ life and allows clients to participate actively in the process of treatment. By narrating the life story and depicting symbolically, clients can recognize their problems in the context of their lives preferably.
In order to find relevant documents, a number of keywords were searched in medical specialized search engines. In addition, according to Dr. IWAMA’s recommendation who is the founder of the KAWA model, his book was considered as the main reference.
KAWA model can be exploited as a practical occupation-based model and a method for leading different processes in occupational therapy. One of the most significant features of Kawa model is offering an opportunity to clients for depicting their life circumstances very comfortably and calmly. Interviewers should have professional point of view toward concepts of Kawa model. Moreover, interviewers should have adequate experience and appropriate ability to communicate well with clients. Kawa model also helps both client and therapist to reach a better understanding of the client’s problems.

Clinical reasoning is at the heart of clinical work; it is affected by different field factors. A clear understanding of the reasoning process could solve practitioner's problems on how to make their underlying theories, assumptions and values more explicit. The aim of this research is to understand how clinical reasoning process is formed in the context of occupational therapists working in different clinical settings in Iran.
A purposeful and theoretical sampling of 15 occupational therapists working in clinical settings was performed through semi-structured interviews. All the data were recorded, transcribed, and analyzed using Strauss and Corbin’s (2008) grounded theory approach and constant comparative analyses.
Conceptual model was developed to explain the relationships among the main categories extracted through the grounded theory. Achieve an observable change emerged as the core category. Other important categories linked to the core category were, performing the continuum of clinical reasoning, context of clinical reasoning, and effective factors in clinical reasoning.
Findings showed that achieving an observable change in the client was the main consequence of the action/interaction strategies. Some facilitating factors related to the therapist, helped to process reasoning with a holistic and client-centered view, while also helping to develop the self-belief and professional identity. The dominance of medical views and a lack of health insurance were two intervening factors that constrained the dynamics of clinical reasoning within the context of practice.

Nowadays, due to the wide variety of models and applying these models in different areas of the field, occupational therapy can have an important role in providing rehabilitation services to patients. In this case, one of the proposed models that has a variety of roles in environmental accommodations is Ecology of Humane Performance (EHP) model. Applying this model is the appropriate intervention in progressive disorders like neuromuscular disease. The purpose of the present study was applying the strategies of EHP model in a family with 3 members suffering from Spinal Muscular Atrophy type 3 (SMA3).
Case Report: The present case report is about a family with 6 members, (4 children and the parents who have a family relationship). This family has 4 children (2 girls and 2 boys) 3 of whom (2 sons, 1 daughter) are diagnosed with SMA3.
Using EHP model in this family, significant results in the field of functional mobility, quality of life, life satisfaction, and driving were obtained in such a way that family members were satisfied with their treatments.

Although the effect of educational methods on executive function (EF) is well known, training this function by a playful method is debatable. The current study aimed at investigating if a play-based intervention is effective on metacognitive and behavioral skills of EF in students with specific learning disabilities.
In the current randomized, clinical trial, 49 subjects within the age range of 7 to 11 years with specific learning disabilities were randomly assigned into the intervention (25 subjects; mean age 8.5±1.33 years) and control (24 subjects; mean age 8.7±1.03 years) groups. Subjects in the intervention group received EF group training based on playing activities; subjects in the control group received no intervention. The behavior rating inventory of executive function (BRIEF) was administered to evaluate the behavioral and cognitive aspects of EF. The duration of the intervention was 6 hours per week for 9 weeks. Multivariate analysis of covariance was used to compare mean changes (before and after) in the BRIEF scores between the groups.
The assumptions of multivariate analysis of covariance were examined. After controlling pre-test conditions, the intervention and control groups scored significantly differently on both the metacognition (P=0.002; effect size=0.20) and behavior regulation indices (P=0.01; effect size=0.12) of BRIEF.
Play-based therapy is effective on the metacognitive and behavioral aspects of EF in students with specific learning disabilities. Professionals can use play-based therapy rather than educational approaches in clinical practice to enhance EF skills.

Aging often accompanies declines in muscular capabilities that hinder the performance of daily functions. One of the paramount objectives in occupational therapy is preserving clients’ independence through their ability to conduct instrumental daily living activities.

The current study aimed to evaluate the validity and reliability of two subscales of the independent living scales (ILS) in the elderly Iranians aged 60 - 85.

The translation of the two subscales, money management subscale and home management and transportation, were analyzed by experts to develop the final version of each. Afterwards, the face validity, content validity ratio (CVR) and content validity index (CVI) methods were examined. To assess the reliability of the subscales, test-retest reliability techniques were used. The internal consistency of the items was measured using Cronbach’s alpha coefficient.

The simplicity, relevance, clarity and the necessity of the translated items were acceptable, based on the CVI and CVR scores. Face validity was also acceptable with respect to agreement rate (> 80%), as well as the impact score (> 1.5) for all items. Test-retest reliability was acceptable with respect to the intraclass correlations (ICC) and the standard error of the mean (SEM) scores (ICC = 0.92, SEM = 1.39 for money management; ICC = 0.95, SEM = 0.941 for home management and transportation). Cronbach’s alpha coefficients were 0.80 and 0.74 for money management, and home management and transportation, respectively.

The results of the study showed that Persian versions of the money management subscale and home management and transportation subscale from the ILS are highly reliable and valid tools to measure these domains of performance in older adults, and they can be used as clinical and research tools to assess instrumental activity of daily living (IADL) by professionals.

Occupational therapists may be encountered in their clinical practice with a variety of unethical issues. The aim of this study was to explore unethical issues of occupational therapists practice in adult physical dysfunction field. 10 graduated Occupational therapists with at least two years experience were selected by targeted sampling method. Data were gathered by semi-structured interview in private clinics and Occupational therapy clinics. Data analyses showed that unethical practice of occupational therapists in the physical dysfunction field categorized in four categories. These categories include: deviation of the treatment، neglect of clients benefit، disregarding of communication principles and emphasis on financial benefits. The findings of this study show that occupational therapists have various ethical problems related to client’s rights in addition to their clinical practice، that according to the participants in this study، lack of awareness about professional ethics related to the occupational therapy and also lack of comprehensive rules in this field are the major causes of unethical practices that the necessity for further research has raised in this area.