http://hdl.handle.net/123456789/1106 2026-08-15T08:13:32Z http://hdl.handle.net/123456789/1332 Sleep Quality Status and its Associated Factors among the Person with Stroke at a Rehabilitation Center in Bangladesh: A Cross-Sectional Study Hasan, Shihabul Background: Sleeping is a crucial physiological state that enhances physical and mental health, memory, metabolism, and immunity. Sleep disturbances are prevalent among stroke survivors, significantly impacting their recovery and quality of life. Aim: To measure sleep quality status and associated factors among the person with stroke at a rehabilitation center in Bangladesh. Methods: The study used a cross-sectional design to conduct a face-to-face survey with 152 stroke patients’ where was 74.3% male and 25.7% female who received outpatient intervention from the Occupational Therapy Department at the Centre for the Rehabilitation of Paralysed (CRP). Standardised questionnaires Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the sleep quality and patterns of stroke patients from the month before the data collection date. Statistical analysis was performed using the SPSS 26 version software, focusing on the associations between PSQI and demographic variables. Results: 71.7% (n=109) of participants reported experiencing poor sleep quality according to PSQI criteria. Among the 109 participants, 55.3% suffered from insomnia and the remaining 44.7% suffered from sleep-disordered breathing. Older age (61-70 years) was significantly associated with poor sleep, where male suffered more 68.8% rather than female 31.2%. Among participants was found an increase with insomnia, which was 3.43 times higher among those without insomnia (AOR=3.426, CI=1.886-160.705, P=.001). Morning alertness was also significantly associated with sleep quality, with tired participants having 2.7 times higher poor sleep compared to refreshed participants (AOR= 2.698, CI= .659-1.711, P= .020). Participants who faced upper limb pain were 0.83 less have poor sleep (AOR = 0.834, CI = 0.211-0.891, P = 0.023) than those with no pain. Comorbidities such as diabetes (P=.004), mental health issues (P=.016), immobility (P=.010), and shoulder subluxation (P=.049), Stress (P=.005), upper-limb pain (P=.021), and nocturnal bathroom visits (P=.011) were associated with poor sleep quality. Conclusion: Over two-thirds of stroke patients are suffering from sleep disturbances, insomnia and sleep-disorder breathing were the most common sleeping-related problems. Older age (61–70 years), male sex, waking up tired, diabetes, mental health problems, immobility, shoulder subluxation, upper-limb pain, stress, and frequent nocturnal bathroom visits associated with poor sleep. There were no associations with socio demographic factors, stroke characteristics (stroke type, lesion side and recurrence), lifestyle and environmental variables. Sleep assessment should be performed routinely (e.g., using the PSQI). Management of pain, stress, depression, optimization of daytime naps, educate sleep hygiene routine, CBT-I and multidisciplinary care for comorbid conditions. Need to conduct larger sample and intervention-based studies after stroke. These findings suggest that clinical practice and national policy in Bangladesh need to include protocols for sleep management. Important components of this integration should focus on staff training, patient counselling, and the use of technologies such as sleep monitors and mobile applications. Keywords: Sleep, Stroke, Sleep disorder, Sleep issue, Sleep problem, sleep disturbance. This thesis is submitted in partial fulfillment of the requirements for the Degree of Master of Science in Occupational therapy, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh 2025-11-14T00:00:00Z http://hdl.handle.net/123456789/1331 Knowledge, Attitude & Practice of Bangladeshi Occupational Therapists in Occupational Therapy Practice: A Cross-sectional study Akter, Sharmin Background: Occupational Therapy (OT) is a vital client-centred health profession in Bangladesh, yet a comprehensive understanding of the professional competencies of its practitioners remains underexplored. Assessing the Knowledge, Attitude, and Practice (KAP) of occupational therapists is crucial for identifying strengths, gaps, and avenues for professional development to enhance service quality and align with global standards. Aim: This study aimed to explore the Knowledge, Attitude, and Practice of Bangladeshi occupational therapists regarding occupational therapy practice and to examine associations with key demographic and professional variables. Methods and Materials: A quantitative, cross-sectional study was conducted over six months among 320 registered occupational therapists practicing across Bangladesh. Participants were selected via convenience sampling from diverse healthcare, academic, and rehabilitation settings. Data were collected using a structured, self administered questionnaire encompassing socio-demographic details and validated self-developed KAP scales. Descriptive statistics (frequencies, percentages, means, standard deviations) and inferential statistics (Fisher exact test, correlation analyses) were employed for data analysis using SPSS version 16.0. Results: The findings revealed exceptionally high levels of KAP among participants. The majority demonstrated good knowledge (96.9%), positive attitudes (97.2%), and good professional practices (98.1%). Over 94% of therapists correctly identified the core focus of OT as promoting functional independence. Strong adherence to evidence based practice, documentation, and interdisciplinary collaboration was reported. However, significant associations were found between KAP levels and demographic factors. Therapists aged 30 years or younger and those with 1-10 years of experience exhibited significantly better knowledge than their older and more experienced counterparts (P<0.001). Practice quality was also significantly higher among urban practitioners compared to those in semi-urban and rural areas (P=0.001). Furthermore, educational attainment was positively associated with more favorable attitudes (P=0.001). Conclusion: Bangladeshi Occupational Therapists possess a strong foundational knowledge, highly positive professional attitudes, and consistently good clinical practices. The profession is well-positioned with a motivated and competent workforce. However, the study highlights critical challenges, including a potential knowledge update gap among senior therapists and significant urban-rural disparities in practice quality. To sustain and build upon this strong foundation, the implementation of structured continuous professional development (CPD) frameworks, expansion of postgraduate education, and targeted support for rural practitioners are strongly recommended. Keywords: Knowledge, Attitude, Practice, Occupational Therapy, Bangladesh. This thesis is submitted in partial fulfillment of the requirements for the Degree of Master of Science in Occupational therapy, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh 2025-11-14T00:00:00Z http://hdl.handle.net/123456789/1330 “Behavioral and Emotional Dysregulation and Its Associated Factors in Children with Neurodevelopmental Disorder: A Cross-Sectional Study” Saha, Piyas Background: Children with neurodevelopmental disorders (NDDs) frequently experience emotional and behavioral regulation difficulties that limit learning, participation, and daily functioning. In Bangladesh, limited context-specific evidence exists, highlighting the need for research to inform effective, culturally responsive interventions. Aim: The study aimed to assess the level of behavioral and emotional dysregulation among children with neurodevelopmental disorders and to explore the factors associated with these difficulties. Methods and Materials: A cross-sectional study was conducted with 160 children diagnosed with Autism Spectrum Disorder, ADHD, Cerebral Palsy, and Intellectual Disability, recruited from special schools and therapy centers through purposive sampling. Caregivers completed a validated Behavioral and Emotional Checklist. Data were analyzed using descriptive statistics and Fisher’s Exact Test to explore associations with age, gender, parental education, family structure, and screen time. Results: Among the 160 children with neurodevelopmental disorders, 67.5% exhibited poor behavioral regulation, whereas 58.8% demonstrated poor emotional regulation. Behavioral dysregulation was significantly associated with parental education (P = .001), family structure (P=.001), daily screen time (P=.001), constipation (P =.013), regular playtime (P=.001), and diagnostic category (P =.001). Emotional dysregulation was significantly related to excessive screen exposure (P =.001) and parental education (P < .05).Behavioral regulation difficulties were slightly more prevalent than emotional challenges, highlighting the strong influence of environmental and caregiving contexts. Conclusion: Children with NDDs often face serious emotional and behavioral regulation problems that reduce their participation and quality of life. The findings highlight the need for early, family-centered occupational therapy that focuses on structured routines, caregiver education, and reducing excessive screen time. From a humanitarian perspective, stronger public awareness, inclusive education, and early identification programs are essential to reduce stigma, support families, and ensure equal access to services. Collaboration among occupational therapists, educators, healthcare professionals, and policymakers is crucial to promote inclusion, resilience, and better developmental outcomes for children with NDDs. Key Words: Neurodevelopmental disorders; Behavioral regulation; Emotional regulation; Occupational therapy; Parental education; Screen time; Family-centered intervention. This thesis is submitted in partial fulfillment of the requirements for the Degree of Master of Science in Occupational therapy, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh 2025-11-14T00:00:00Z http://hdl.handle.net/123456789/1329 Hand Function and Life Area Participation among the Children with Cerebral Palsy: A Cross-Sectional Study Afroze, Farea Background: Participation is a complex, context-dependent concept shaped by factors such as severity of CP, age, self-management abilities, and functional mobility. Children’s engagement in daily activities largely depends on these factors and varies widely. Hand function plays a critical role in determining their level of participation across life areas. Understanding this relationship is essential for designing comprehensive rehabilitation and supportive interventions. Aim: To find out the impact of hand function on Life Area Participation among Children with Cerebral Palsy. Methods: This cross-sectional quantitative study surveyed 102 school-going children with CP in Dhaka city and Savar using face-to-face interviews. Standardized tools, the Children Participation Questionnaire (CPQ) and the Manual Ability Classification System (MACS) were used to assess life areas participation and hand function. Data was analyzed using SPSS version 26 for both descriptive and inferential statistics. Result: The mean age of children with CP was 9.18±1.89 years, with most classified at MACS level II. Participation scores were diversity 42.51±4.85, intensity 121.08±33.27, with whom 168.29±38.85, enjoyment 185.84±31.85, and parent satisfaction 163.69±39.25. Children receiving more than three weekly therapy sessions had poorer hand function than those receiving fewer (P<.032), and quadriplegic CP showed the poorest hand function and participation (P<.001). All participation domains except “with whom’’ were negatively correlated with MACS level (P < .001), while the “with whom’’ domain showed a strong positive correlation (P < .001). Conclusion: Children with CP who attended three or fewer weekly therapy sessions demonstrated better hand function, while those with quadriplegic CP showed poorer performance. Upper extremity function was strongly linked to participation across life areas, especially parental satisfaction. Improving hand function, along with caregiver training and environmental support, can significantly enhance overall participation in children with CP. Keywords: Cerebral palsy; Manual ability; Life area participation; Occupations; Hand function. This thesis is submitted in partial fulfillment of the requirements for the Degree of Master of Science in Occupational therapy, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh 2025-11-14T00:00:00Z