STUDENT THESIS GUIDE

STUDENT THESIS GUIDE Master s Thesis Option The individual thesis option allows the student to pursue research of personal interest, but requires a significant amount of independent initiative and effort. Students electing the thesis option should have a well-formulated research question that will hold their interest for the duration of the thesis. The purpose of this document is to outline the individual thesis process and provide guidelines for the final written thesis. Students share the copyright of any publication that results from an individual thesis for a period of two years from the date of graduation. After this time, Ithaca College faculty retains the right to use the research data for their own publication. The Department of Occupational Therapy interprets this to mean that in the case of dissemination (by presentation or publication) of the thesis project, the student will be listed as first author with their advisor as second author. The advisor may move forward with dissemination if the student does not pursue dissemination within two years post-graduation, at which point, the advisor will be listed as first author and the student as second author. The individual thesis process will begin during the spring semester of the senior year for BS/MS students or during the spring semester of the first year of the professional entry-level MS program. During this time you will register for a onecredit research seminar course with the graduate chair. This research seminar course is designed to assist you with the thesis process. The outcome of this course includes: - Written introduction (chapter one) - Partial annotated bibliography of your literature review (chapter two) - Outline of your methodology (chapter three) More information on what is contained in each section of the thesis can be found in the thesis preparation section) - Chosen faculty advisor and committee members - Completed Collaborative Institutional Training Initiative (CITI) http://www.ithaca.edu/sponsored-research/cititraining/ - Completed thesis proposal - Presentation of thesis proposal to faculty - Draft of an IRB proposal http://www.ithaca.edu/sponsored-research/irb/ 1

Thesis Process Typical trajectory: Spring: Senior year (BS/MS) 1 st -year (PEL) Summer Fall: Graduate year (BS/MS) 2 nd -year (PEL) Spring: Graduate year (BS/MS) 2 nd -year (PEL) Summer: Graduate year (BS/MS) 2 nd -year (PEL) Summer/Fall - Complete research seminar course with graduate chair - Complete thesis proposal and present to faculty - IRB draft - Appointment of advisor and committee members - Continue to work on literature review while on first fieldwork - Register for Individual Thesis I OTMS 67200 - Finalize, submit, and receive IRB approval - Collect data - Continue work on literature review - Write up methodology - Register for Individual Thesis II OTMS 67300 - Analyze data, interpret findings - Present at the Occupational Therapy Graduate Research Colloquium - Write up final draft of thesis (including introduction, literature review, methods, results, summary, discussion and conclusion) - Continue to edit your thesis with feedback from advisor and committee members (plan on two weeks per draft review per reader) - Submit to graduate chair once advisors and committee members sign off on final document (additional edits may be requested, plan on two weeks for draft review) - When approved by graduate chair, submit to HSHP Dean of Graduate Studies (plan on three weeks for draft review) - When approved by the Dean, thesis must be bound (minimum of two copies), and an electronic copy submitted to the college library Choosing an Advisor and Committee Members The student will chose a faculty advisor and committee members based on their area of expertise and research interests. Students should also consider the work habits, writing styles, and availability of potential faculty to serve in these capacities. All advisors must be members of the occupational therapy program at Ithaca College. Committee members can be outside of the department, but should be members of the college community. In rare cases, members of the committee have been from outside of the college. All advisors and committee members must be approved by the graduate chair and be agreeable to function in this capacity. They must sign the Appointment of Thesis Committee Members form (Appendix A). This signed form will be presented as part of the thesis proposal to faculty. Thesis Proposal Work with your thesis advisor to prepare a thesis proposal as well as a proposal for the All-College Internal Review Board for Human Subjects Research (IRB) when needed. Students must also submit a completed Approval of Thesis Proposal form (Appendix B) and the Request for Funds to Support Graduate Research form (Appendix C) with their proposal. The thesis advisor and committee members should approve the proposal and sign relevant sections before submitting to the graduate chair. The written thesis proposal will consist of the following (2-3 pages single spaced with wide margins): - Title of the proposal - Name of the student, advisor, and advisory committee 2

- A synopsis paragraph of the proposal that will include (in bulleted format) the problem statement, hypothesis or objective of the study, expected outcome, and relevance to occupational therapy - A paragraph on the methodology arguing the feasibility of the completion of the study within the time limit of the Individual Thesis I & II courses - A paragraph on the rationale of financial assistance needed from the graduate program with a completed Request for Funds to Support Graduate Research form - Status of the IRB proposal - Copies of all measures administered Work with your thesis advisor and committee members to review and finalize the proposal. Submit the proposal to the graduate chair following approval of your thesis advisor. Give an oral presentation of your thesis proposal to occupational therapy faculty. These oral presentation should include the information listed above, along with time for Q&A. Presentation should not exceed 30 minutes. Approval of the thesis proposal is contingent upon IRB approval. Thesis Preparation When preparing a written thesis, students have two formatting option of which to choose: traditional or manuscript. The choice of traditional or manuscript format is one that resides with the student but should be made in consultation with the thesis advisor. Both formats should be written using most recent American Psychological Association Publication Manual (APA) guidelines. The traditional thesis format has six chapters: (1) introduction; (2) review of literature; (3) methods; (4) results; (5) discussion; and (6) summary, conclusions, and recommendations. The traditional thesis is written in the past tense, as it is a report describing a project that has happened. The advantage of writing a traditional thesis is that the format is well established and only need be applied to a specific topic. A disadvantage to the traditional format is that it may prove difficult to convert this large document to a manuscript for publication The manuscript thesis format has two major sections: introduction, review of literature, and methods; and research manuscript containing an introduction, methods, results, and discussion). The elements contained within are essentially the same as Chapter 1 (introduction), 2 (literature review), and 3 (methodology) of the traditional format. The research manuscript section is prepared in accordance with author guidelines provided by an appropriate journal (or APA Manual if desired) as selected by the student in conjunction with the thesis advisor. The advantage of this format is that the final document may potentially be ready for journal submission. The disadvantages to the manuscript format are that writing each manuscript section may be an original effort providing less structure for the student than the traditional format. Furthermore, there is inherent redundancy in the two sections of the manuscript format as both require introduction, methods, and references be included in each section. When using either thesis format remember the most important rule of research to be as clear, concise, and logical as possible. This applies to every sentence, paragraph subtopic, chapter, and section written. Good writing takes time and even the best writers proofread repeatedly and redraft their work frequently. Do not expect thesis writing to be any different. Attention to detail is critical for high-quality document preparation. Here are a few examples of details to be addressed: - Subtitle hierarchy as presented in the table of contents should match text exactly - Lists of table, figure, and reference titles should match exactly with appearance in text 3

- All tables, figures, references, and appendices must be clearly identified in the text - Graphics that must appear in landscape orientation should be avoided but if required should be bound with their top edge at the left margin - Spacing throughout the text should be double-spaced unless otherwise noted by APA guidelines Preliminary Pages Preliminary pages precedes the text of the thesis and are their own individual page. The order of preliminary pages is as follows: 1. Thesis title page (Appendix D) 2. Approval page (Appendix E) 3. Abstract (preferably less than 250 words and always less than two pages) 4. Acknowledgments (as needed) 5. Dedication (as needed) 6. Table of contents (Appendix F and G) 7. List of tables (required if tables appear in text) 8. List of figures (required if figures appear in text) The preliminary pages are followed by the text prepared in traditional thesis format. The text, or body of the thesis, ends on the last page of chapter six or at the end of the references and are subsequently followed by appendices to the thesis. References in the manuscript thesis format follow the completion of the manuscript portion and also follow the end of the entire thesis; each list of references is specific to the section that precedes it. Appendices, in either thesis format, are all added at the end of the document and appear lettered sequentially in the order they appeared in the text. Pagination Pagination of the thesis begins with page one on the first page of the introduction and continues sequentially with Arabic numerals through the last page of the appendices. Preliminary pages (including the abstract) are paginated with lower case roman numerals, beginning with the title page. Page numbers appear right-justified one inch from the top of the page with no pages left unnumbered. Exceptions are the first page of each chapter, the first page of each appendix, and the preliminary pages (using Roman numerals) which are all center-numbered at the bottom of the page. Introduction (Chapter One) The introduction is intended to present the topic to the reader and gain their appreciation for the relevance and importance of the research. To best get the reader interested in the thesis topic avoid a long, technical preamble but instead be clear, concise, logical, factual, and to the point. The introduction in a traditional thesis (chapter one) contains a preamble followed by subunits titled: statement of purpose; hypotheses; research question(s); scope of the problem; assumption of study; definition of terms; delimitations; and, limitations. While all of these subunits pertain to most theses it is conceivable that a student and thesis advisor might mutually agree to omit a subunit for a given thesis. The objectives for each of these subunits are as follows: 4

Preamble: tell readers about the study by explaining the logic used to arrive at the purpose of the research. Describe highly pertinent previous literature that logically leads to the description of the new problem and underlies the importance of the research. The preamble should be 2-4 pages of text and lead directly to the statement of purpose. Statement of purpose: statement of the problem in general form the details of which will later be presented in the hypothesis. Hypotheses: detail the purpose statement by telling the reader how the problem will be addressed. Hypotheses identify the variables (e.g. independent and dependent) to be measured and often briefly state how they will be measured. A hypothesis can be directional or non-directional which are both predictive in nature (i.e., the author predicts how variables will differ or at least that they will differ). When using such hypotheses the author must be willing to predict the outcome of the research. A null hypothesis can also be used and predicts there will be no difference between conditions studied. A thesis may present more than one hypothesis depending on the number of research questions to be addressed. Data analyses, qualitative or quantitative, should be directly related to and driven by the stated hypotheses of the research. In other words, each hypothesis should be specifically addressed by data analysis. Scope of the problem: clearly identifies the factors to be studied and the tools used. The audience to whom findings are relevant is often identified. Well written preamble, purpose statement, and hypotheses subunits can often be substituted for scope of the problem/problem statement. Research question(s): the recasting of the purpose statement into question form. Assumptions of study: underlying facts or premises that are required to be correct for data to be of acceptable quality. If an assumption is incorrect then related data are likely invalid and the study may become meaningless. Good assumptions expose important issues that often must form the theoretical basis for a research project (e.g. endurancetrained individuals in this study had a greater sympathetic response during the exercise test than untrained subjects) whereas obvious assumptions (e.g., the subjects told the truth when answering the questionnaire) are not terribly valuable to understanding the nature of the problem. Definition of terms: provides clear, operational definitions for critical terms. Constructs, variables, and terms that may have multiple definitions but are being applied in a specific manner for the thesis should be identified and their precise usage described and referenced. Delimitations: describe important choices or decisions made by when defining the parameters of the study. These are options exercised in a specific way that often lead to a limitation in the generalizability of the study s results. An example of a delimitation is when it is decided (a delimitation) to collect data on a particular subject population, (e.g., a sample of elementary schools girls). This will limit the generalizability of data as explained in the next section. Limitations: description of the degree of generalizability of data that often is caused by a decision made by the investigator. Limitations can also result when an assumption is known to fail or an extraneous/influential variable goes unmeasured or uncontrolled. An example of a limitation is when it is decided (a delimitation) to collect data on a sample of elementary school girls, generalization of the results is probably limited to girls of a similar age. These data cannot likely be generalized to boys of high school age. Another example of a limitation is if one makes the assumption that questionnaires are answered honestly or diets are followed faithfully but finds unidentified subject(s) may have cheated. Review of Literature (Chapter Two) The review of literature follows the introduction in the thesis but, in fact, the literature review is the first step in planning a successful research project. The review should contain a thorough presentation of previously recognized 5

literature/knowledge on all topics important to developing the research hypotheses/questions and discussing the results of the thesis. Several topics and related keywords may need to be searched on several databases for an acceptable review of literature to be written. The review should not extend into marginally relevant areas and should generally be 15-30 pages. A good review is carefully organized using a conceptual framework. The review of literature begins with a brief preamble that tells the reader what to expect from the review and outlines the subtopics to be addressed. Examples of reviews are available in previously completed bound copies and electronically on the IC library website. Please maintain format consistency in the review of literature as is expected throughout the thesis. The review of literature is concluded with a brief summary that reiterates the highlights of the review in less than one page. Methods (Chapter Three) The methods section is a careful, precise, and complete description of the details involved with all thesis data collection. The broad aim of the methods section is to allow another investigator to pick up the document and repeat the research project exactly as it was originally conducted. The subunits of the section are typically subjects, design/measurement/procedures/tests/protocols/instrumentation, data analyses, and summary. According to the specific methods of the study the subunit for design/measurements/procedures/tests/protocols/instrumentation may be split into separate subunits for emphasis when necessary or truncated to de-emphasize a process unimportant to the description of the research. Please maintain format consistency in the methods section as is expected throughout the thesis. If any tables or figures appear in the methods section please follow APA guidelines. The section is concluded with a brief summary that reiterates the highlights of the methods in less than one page. Results (Chapter Four) (including preparation of tables and figures) The results section provides a concise representation of what was found by the research. Here the data are presented and statistical analyses are reported. The chapter is typically organized by variable or by hypothesis or research question tested. The text is primarily a series of brief factual statements that highlight relevant information that can be found detailed in tabular or graphic form. In traditional thesis format, the results section is concluded with a brief summary (less than one page) that reiterates the highlights of the results. Tables in the results section (and throughout the text and appendices) should be consistent in presentation. Tables should stand alone, appear on pages independent of text and must be referred to in the text prior to their appearance. Tables should appear on the page immediately following their introduction in the text. Tables are generally doublespaced as are the notes that follow. It is acceptable to combine two or more short tables on one page provided they are each referred to on the previous page, each table can be doubled spaced, and at least two double-spaces are to be maintained between tables. It is common for a notes paragraph to immediately follow the table. Notes explain any abbreviations or symbols used in the table and provide any other information the reader requires for the table to stand alone (i.e., be understood without needing to refer to the text or any other page). Follow APA guidelines. Figures, like tables, should stand alone, appear on pages independent of text and must be referred to in the text prior to their appearance on the subsequent page. Most information above regarding tables applies to figures. Figures, however, have no title above but instead a caption below. Symbols are explained in a legend that is imbedded within the body of the figure. Much of the information in the APA guidelines related to figures applies to journal publication and not to thesis preparation, however, some of the information may be instructive. 6

Before adding, always ask, Does a table or figure add clarity to the document? Moreover, if tables or figures become too numerous it should be asked if some would be better positioned as appendices. Tables, particularly statistical tables, are typically put into appendices when using manuscript thesis format. Discussion (Chapter Five) The discussion addresses the results of the thesis in light of hypotheses, research questions, and previously published literature. Without repeating the review of literature, the discussion addresses questions related to previous work and compares similarities/dissimilarities of present results with previous research results. Applications of the findings for use by practitioners should also be addressed here. The discussion should also describe any shortcoming of the study, explain the significance and reasons for these events, and potentially relate these issues to future research. The organization of topics within the discussion should be carefully and logically considered but cannot be prescribed in any generic outline. Remember that the discussion is for explaining results but not for presenting data a second time. Do not use statistical terminology or jargon too freely in the discussion. Talk about concepts, not numbers and statistical significance. This is the place to explain the importance of the findings, describe their meaning and application. Always end the discussion with a final paragraph that drives home the main findings of the study. In traditional formats the discussion is concluded with a brief summary that reiterates the highlights of the discussion in less than one page. Summary, Conclusion, and Recommendations (Chapter Six) This chapter is only found in the traditional thesis. The summary is an expanded abstract that provides highlights from the previous five chapters with emphasis on the methods, results, and discussion. The conclusions are typically enumerated statements that address the findings of the study and often directly parallel the hypotheses or research questions. The recommendations for future study are also enumerated and identify important extensions of the thesis that would enhance the existing knowledge base. References The APA Manual is the rule here. It is critical that references appearing in the text agree exactly with those in the reference list. The APA Manual also covers rules for citing authors within the text. Always carefully double check that all citations appear in both the text and reference list and that all authors are properly listed. Appendices The last part of the thesis is the appendices. The first of the appendices should be the approval letter from the All- College Institutional Review Board for Human Subjects Research. The second should be a copy of the completed IRB application. The remaining appendices should contain any information that is vital to fully understanding a point in the thesis or replicating a method of the study, but the information is not vital to the flow of the text. That is, a reader may not be interested in checking the information in an appendix but would still appreciate the importance of the point that referred the reader to the appendix. Manuscript style theses typically place detailed statistical tables and figures in appendices. All appendices must be addressed in the text of the thesis. The APA Manual provides useful guidelines for construction of appendices. If a reference is used in an appendix, it must be cited at the end of the appendix unless that citation can be found in the references. 7

Thesis Binding Information A student s grade will not be changed from an I (incomplete) to a letter grade until the department has received two bound copies or evidence that the binding process has been initiated (email confirmation from company). Students must also upload an electronic copy of their thesis to the IC library: http://ithacalibrary.info/etheses/upload.html. The HF Group Lee Ogden VP & General Manager 63 E Broad Street Hatfield, PA 19440 www.thehfgroup.com Toll free: 800-230-2253 Fax 215-368-7308 logden@thehfgroup.com Students must send copies with original signature sheets. The company recommends UPS. The department requires: One (1) copy for department (to graduate chair) One (1) copy for advisor (more to committee members as a courtesy) One (1) for student 8

Appendix A: Appointment of Thesis Committee Members Appointment of Thesis Committee Members Student s Name: Campus Address: Phone: Email: Permanent Address: As student in the occupational therapy program preparing for the master s thesis, I have shared my proposed topic of investigation, time frame, and design of the investigation with the individuals named below, who have agreed to serve on my thesis committee: Student Signature: Thesis Advisor Name: Address: Department: Phone: Email: Advisor Signature: Additional Thesis Committee Members (Named only when you and your thesis advisor feel their assistance is warranted) 1. Name: Department: Address: Phone: Email: Advisor Signature: 2. Name: Department: Address: Phone: Email: Advisor Signature:

Appendix B: Approval of Thesis Proposal Approval of Thesis Proposal Student s Name: Campus Address: Phone: Email: Permanent Address: Title of Proposed Thesis: Thesis Advisor Name: Phone: Email: TO BE COMPLETED BY GRADUATE COMMITTEE: The graduate committee has reviewed your thesis proposal and has made the following determination: The thesis proposal is approved, pending review by the Internal Review Board for Human Subjects Research if necessary. The thesis proposal appears to represent an appropriate area of inquiry, with a methodology that suggests the thesis can be completed within the time allowed in the graduate program. The thesis proposal requires additional information in order to be approved. Specific concerns are listed below: The thesis proposal is not approved. Potential problems with execution of the study or writing of the proposal suggest that the thesis may not be successfully completed within the time allowed in the graduate program. Graduate Chair: Chair Signature: Phone:

Appendix C: Request for Funds to Support Graduate Research Request for Funds to Support Graduate Research Requested by: Date requested: Date needed: Title of research project: Thesis Advisor: Items requested: Anticipated cost: TOTAL: How items will be purchased (department purchase request, purchase with request for reimbursement, etc.) Approved by: Chair Signature:

Appendix D: Thesis Title Page (example) Thesis Title A Master s Thesis Presented to the Faculty of the Graduate Program in Occupational Therapy Ithaca College In partial fulfillment of the requirements for the degree of Master of Science By Student Name Month Year

Appendix E: Approval Page (example) Ithaca College School of Health Sciences and Human Performance Ithaca, New York CERTIFICATE OF APPROVAL This is to certify that the thesis of Student Name submitted in partial fulfillment of the requirements of the degree of Master of Science in the Department of Occupational Therapy, School of Health Sciences and Human Performance, at Ithaca College has been approved. Thesis advisor: Committee member: Committee member: Candidate: Graduate chair: HSHP Graduate Dean:

Appendix F: Manuscript Thesis Format (example) Table of Contents Proposal Chapter 1: Introduction................................................. 1 Background/ Problem............................................ 1 Rationale...................................................... 1 Purpose of Study................................................ 2 Definition of Terms.............................................. 2 Chapter 2: Review of Literature........................................... 4 Farming: An Occupational Hazard................................... 4 Inaccurate Reporting of Injuries and Access to Care..................... 5 Limited Use of the Medical Model................................... 6 Physical and Environmental Hazards and their Associated Affects......... 7 Relevance of Proper Body Mechanic Execution to Farming............... 9 Relevance of Assistive Technology to Farming......................... 12 Chapter 3: Methods and Procedures....................................... 15 Research Design................................................. 15 Research Questions............................................... 15 Participants and Selection Method.................................. 15 Measurement Tool............................................... 16 Procedures..................................................... 17 Analysis of Data.................................................. 18 Study Limitations and Assumptions.................................. 19 Proposal References.................................................... 21 Manuscript.............................................................. 26 Introduction.......................................................... 26 Farming: An Occupational Hazard................................... 27 Inaccurate Reporting of Injuries and Limited Use of Medical Model........ 27 Physical Hazards and Associated Conditions........................... 28 Relevance of Proper Body Mechanics Execution to Farming.............. 29 Relevance of Assistive Technology to Farming......................... 30 Methodology......................................................... 31 Research Design and Research Questions............................. 31 Participants and Selection Method................................... 31 Measurement Tool................................................ 32 Procedures...................................................... 33 Analysis of Data.................................................. 33 Results............................................................... 33 Participants Demographics......................................... 33 Research Questions 1 & 1a......................................... 34 Research Questions 2 and 2a........................................ 34 Research Question 3.............................................. 35 Discussion............................................................ 37 Study Limitations....................................................... 39 Future Research Recommendations......................................... 40

Conclusion............................................................ 41 Manuscript References................................................... 42 Figures............................................................... 45 Figure 1: Counties with Farmers that Participated in Survey................. 45 Figure 2: Ages of Participants.......................................... 46 Figure 3: Ethnicities of Participants...................................... 47 Figure 4: Educational Level............................................ 48 Figure 5: Participant s Years of Farming Experience........................ 49 Tables................................................................ 50 Table 1: Body Mechanics Currently Being Utilized......................... 50 Table 2: Personal Protective Equipment Currently Being Utilized.............. 51 Table 3: Types of Aides and Associated Examples of AT Devices/Methods Utilized to Minimize the Effects of Injuries Experienced While Farming......... 52 Table 4: Assistive Technologies Used to Minimize the Effects of Injuries Experienced While Farming............................................. 53 Appendices............................................................ 54 Appendix 1: Human Subjects Review Board Proposal....................... 54 Appendix 2: Letter of Approval from All-College Review Board For Human Subjects Research.................................. 59 Appendix 3: Initial Cover Letters and Tear-Off Informed Consent Forms....... 60 Appendix 4: Survey Instrument.......................................... 64

Appendix G: Traditional Thesis Format (example) Table of Contents Chapter 1: Introduction... 5 Background... 5 Research Problem... 8 Rationale and Study Purpose... 9 Research Questions... 9 Chapter 2: Literature Review... 11 Multiple Sclerosis... 11 The Model of Human Occupation... 16 Occupational Therapy: General Effectiveness... 24 Occupational Therapy Treatment: Energy Conservation... 25 Occupational Therapy Treatment: Exercise Therapy... 26 Occupational Therapy Treatment: Assistive Devices... 28 Early Treatment for Multiple Sclerosis... 29 Identified Needs or Wants of PwMS... 31 Changes in Employment Status for PwMS... 33 Access to Adaptive Equipment and Rehabilitation Services... 35 Occupational Therapy Use... 36 Conclusion... 37 Chapter 3: Methods and Procedures... 39 Study Design... 39 Delimitations, Assumptions, and Limitations... 39 Subjects and Selection Methods... 41 Operationalization of Concepts into Variables... 41 Measurement Instruments... 42 Procedures... 44 Data Entry, Analysis, and Interpretation... 45 Scope and Limitations of Study... 45 Chapter 4: Results... 47 Participant Demographics... 47 Use of Occupational Therapy Services... 48 Use of Occupational Therapy and Mobility Purposes... 48 Reasons for Not Using Occupational Therapy Services... 48 Level of Independence when Performing Activities... 49 Quality of Life... 49 Knowledge of Occupational Therapy Services... 50 Occupational Therapy Use for Specific Activities... 50 Perceptions of Occupational Therapy Services... 51 Reasons Occupational Therapy was Helpful... 52 How PwMS Spend the Majority of their Time... 52 Chapter 5: Discussion... 53 Occupational Therapy Use for PwMS... 53 Reasons PwMS are not Using Occupational Therapy Services... 53 Conceptions and Misconceptions about Occupational Therapy Services... 55 Reasons Occupational Therapy was Beneficial... 56 How Respondents Spend their Time... 56 Chapter 6: Implications for Practice... 58 Chapter 7: Conclusion... 61 References... 63 Table 1: Demographics Information of the Sample... 71

Table 2: Use of Occupational Therapy Services... 73 Table 3: Use of Occupational Therapy and Mobility Purposes... 74 Table 4: Reasons for not Using Occupational Therapy... 75 Table 5: Knowledge of Occupational Therapy Services... 77 Table 6: Occupational Therapy Use and Specific Activities... 78 Table 7: Perceptions of Occupational Therapy Services... 79 Table 8: Reasons Occupational Therapy was Helpful... 80 Table 9: How PwMS Spend the Majority of their Time... 81 Appendix A: Human Subjects Proposal Materials... 82 Appendix B: Participant Information Sheet for Hard Copy Version... 85 Appendix C: Participant Information Sheet for Online Version... 86 Appendix D: Survey Instrument... 87 Appendix E: Global Quality of Life Scale... 92