Occupational Challenges Research Articles

Supporting sustainable occupational lives for partner caregivers of people with dementia

Introduction This qualitative research explores the experience of partner caregivers and how their partner’s dementia impacts on their daily living and occupational lives, with the aim of informing the sustainability of homecare and decreasing the likelihood of formal care. Method Ten participants were recruited through Alzheimer’s Society groups. They were interviewed using the same semi-structured interview process and asked questions about their daily activities and caregiving role. The data was analysed using Braun and Clarke’s thematic analysis process and themes generated using inductive coding and reasoning. Findings Three main themes were identified: (1) losing occupational activities and roles; (2) adapting to a new occupational life and (3) adjusting to a new relationship in the trajectory of their partner’s illness. Conclusion This study highlights the complex occupational challenges experienced by partner caregivers of people with dementia. It suggests that there is a role for occupational therapists in sustaining homecare by working with partner caregivers as ‘expert service users’. Involvement should be provided at critical points of the caregiving journey and include co-creating technology solutions for social inclusion, sustaining adaptive engagement in personal occupations, creating opportunities for restoration and supporting caregivers to preserve their partner’s personhood.

Viral Vector Systems for Gene Therapy: A Comprehensive Literature Review of Progress and Biosafety Challenges.

National Institutes of Health (NIH) defines gene therapy as an experimental technique that uses genes to treat or prevent disease. Although gene therapy is a promising treatment option for a number of diseases (including inherited disorders, some types of cancer, and certain viral infections), the technique remains risky and is still under study to make sure that it will be effective and safe. Applications of viral vectors and nonviral gene delivery systems have found an encouraging new beginning in gene therapy in recent years. Although several viral vectors and nonviral gene delivery systems have been developed in the past 3 decades, no one delivery system can be applied in gene therapy to all cell types in vitro and in vivo. Furthermore, the use of viral vector systems (both in vitro and in vivo) present unique occupational health and safety challenges. In this review article, we discuss the biosafety challenges and the current framework of risk assessment for working with the viral vector systems. The recent advances in the field of gene therapy is exciting, but it is important for scientists, institutional biosafety committees, and biosafety officers to safeguard public trust in the use of this technology in clinical trials and make conscious efforts to engage the public through ongoing forums and discussions.

Occupational Health Exposure and Perceived Effects of Portland Cement Dust Pollution on Cement Factory Workers

The perceived occupational and environmental health challenges arising from the exposure of cement dust pollution on Bua cement factory workers were investigated in this study to establish if there is any significance of cement dust exposure on workers’ health. The study was designed as a cross-sectional type of research that adopted a purposive group based strategy for sampling. 110 cement factory workers with a minimum of two years’ work experience were selected for the study. 90 respondents were randomly selected from a community situated at about 21km away from the factory and used as control. Structured questionnaire was used for data collection and SPSS statistical package was used to analyze the data. Inferential statistics was used to test the hypotheses at p <0.05, ascertain correlation of the variables and authenticate the analysed results. The result revealed that 15 types of ailment were reported among the sampled respondents with factory workers recording higher percentage occurrence of ailments than respondents from the control. Factory workers were more susceptible to the itemized ailments recorded when compared to respondents from control. Significant difference in the prevalence of perceived health ailments between factory workers and control was established. Workers from storage and transportation section were revealed to have higher percentage (77.3%) compliance level on the use of safety gadgets during work hours than workers from other sections. Also, a significant relationship between the perceived health risks associated with cement dust exposure and the health of factory workers was established. The researchers made reasonable recommendations to forestall further health complications that might arise from working on a cement production factory.

OCCUPATIONAL HEALTH AND SAFETY CHALLENGES FACING SANITARY WORKERS IN SEKYERE CENTRAL DISTRICT IN GHANA

In Ghana, most employers and employees are less conscious with matters of safety. The goal of this study was to investigate the occupational health and safety challenges facing sanitary workers in Sekyere Central District Assembly. A purposive sampling was used for the selection of 37 respondents. Carefully structured questionnaires, interviews, and field observations were used for data collection, which were afterward analyzed using the Statistical Package for the Social Sciences V20. The study showed that all the respon-dents faced safety, health, and working tools and equipment and work posture challenges which affected their job performance (p = 0.019). About 96.4% experienced great pain due to their work posture. The body parts mostly affected were the waist and back (57%) and upper limbs (46%). About 71.4% were not provided with personal protective equip-ment (PPEs) for their work. This, however, did not affect their job performance (p = 0.339) but was significantly correlated with the degree of sustaining injuries (p = 0.012). They suffered from a wide range of diseases which resulted in absenteeism at work and job performance (p = 0.000). The unsafe working environment affected their job performance (p = 0.002). Although job dissatisfaction of workers never affected their job performance, it was likely to cause injuries at the work place and this could impact negatively on the safety of the workers leading to poor overall work output. Regrettably, workers were never offered any in-service training.

Heat Adaptation in Military Personnel: Mitigating Risk, Maximizing Performance.

The study of heat adaptation in military personnel offers generalizable insights into a variety of sporting, recreational and occupational populations. Conversely, certain characteristics of military employment have few parallels in civilian life, such as the imperative to achieve mission objectives during deployed operations, the opportunity to undergo training and selection for elite units or the requirement to fulfill essential duties under prolonged thermal stress. In such settings, achieving peak individual performance can be critical to organizational success. Short-notice deployment to a hot operational or training environment, exposure to high intensity exercise and undertaking ceremonial duties during extreme weather may challenge the ability to protect personnel from excessive thermal strain, especially where heat adaptation is incomplete. Graded and progressive acclimatization can reduce morbidity substantially and impact on mortality rates, yet individual variation in adaptation has the potential to undermine empirical approaches. Incapacity under heat stress can present the military with medical, occupational and logistic challenges requiring dynamic risk stratification during initial and subsequent heat stress. Using data from large studies of military personnel observing traditional and more contemporary acclimatization practices, this review article (1) characterizes the physical challenges that military training and deployed operations present (2) considers how heat adaptation has been used to augment military performance under thermal stress and (3) identifies potential solutions to optimize the risk-performance paradigm, including those with broader relevance to other populations exposed to heat stress.

Multi-dimensional wellness interventions for older adults with serious mental illness: A systematic literature review.

Aging persons with serious mental illness present unique challenges for community mental health services. This population is increasing in numbers in mental health treatment settings. The combination of serious mental illness with the vicissitudes of aging suggest that a broader conceptualization of this population may improve services. SAMHSA's 8 Dimension of Wellness offers a comprehensive strengths-based framework for interventions to maximize older persons' abilities and address the complex bidirectional effects of physical, emotional, social, spiritual, occupational, financial, intellectual, and environmental challenges to wellness. This systemic literature review identifies unidimensional and multidimensional wellness interventions for older adults with mental illness. We conducted a systematic literature review to identify wellness interventions provided to persons with serious mental illness with a mean age of 45 or higher. Twenty-six articles representing 14 distinct wellness interventions were identified. None of the articles used SAMHSA's 8 Dimensions of Wellness framework. The physical wellness (n = 21) and social (n = 15) dimensions were the most frequently described in the literature. There was no mention of either the intellectual or spiritual dimensions. The quality of the research of these interventions varied; 14 papers described a randomized controlled trial. The SAMHSA wellness framework has not been used to design interventions for older persons with serious mental illness. Interventions for aging persons should support comprehensive wellness, including the intellectual and spiritual domains. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

CN33 - Patient safety and the power of nursing presence

BackgroundThe goal of patient safety is to reduce and eliminate preventable harm resulting from processes of care including the safe delivery of medication. Patient and occupational safety challenges are increasing in cancer care with the expanded use of oral chemotherapy, immunotherapy, and other novel treatments. In the United States, the Food and Drug Administration approved 59 novel drugs in 2018 including 19 applications of new cancer drugs and biologics as well as 38 supplemental indications and four biosimilars. Many of these novel agents will be delivered in settings that may not include the presence of a cancer nurse. Presence is a fundamental concept of nursing practice that involves active listening to facilitate understanding and meaningful connection between the patient and family and other members of the healthcare team. The safe delivery of cancer treatment is a critical component of the EONS Cancer Nursing Education Framework which defines the pivotal role of the presence of the cancer nurse in educating patients and caregivers about the safe use of cancer and symptom management medications, early recognition of side effects, and appropriate self-management approaches. As cancer care moves from traditional settings of the hospital, ambulatory clinic, or oncology provider’s office, nurses will be confronted with the need to redefine nursing presence in an era of increasingly complex healthcare delivery systems. MethodsA literature search will be presented drawn from a review of PubMed, CINAHL, and EBSCO data bases using search terms related to “patient safety”, “nursing presence”, “vigilance”, and “medication safety”. ResultsNot applicable. ConclusionsThis presentation will explore current literature related to the role of presence of the cancer nurse in safeguarding patient outcomes and quality cancer care. The session will include discussion and recommendations to increase the effective use of nursing presence and intentional communication by cancer nurses in diverse settings. Legal entity responsible for the studyThe author. FundingHas not received any funding. DisclosureThe author has declared no conflicts of interest.

Experiences of occupational health doctors and nurses about the role of physiotherapists in occupational health rehabilitation: A qualitative study.

Background:Occupational health physiotherapy has been practiced in the UK over several decades. In the past decade, the role of occupational health physiotherapy has gained recognition as a profession that can be embedded within occupational health departments; however, limited information is known about the role of physiotherapists from professional groups outside the allied health domain in this context.Objective:The aim of this study is to explore the experiences of occupational health doctors and nurses about the role of physiotherapy in occupational health rehabilitation.Methods:This study is a qualitative investigation underpinned by an interpretative construct. Thirteen semi-structured interviews were conducted. Two occupational health doctors and 12 nurses were purposively recruited from two National Health Service (NHS) hospitals. Data were analyzed using thematic content analysis, coded manually and verified by member checking.Results:The benefits of occupational health physiotherapists were rapid access intervention, advanced knowledge and clinical reasoning, evidence-based practice, and providing an additional perspective. The emerging themes of the challenges that occupational health physiotherapists may face include dealing with occupational health challenges, managing role conflicts, personal qualities and attributes, and role substitution.Conclusion:Participants described numerous roles of occupational health physiotherapists ranging from clinical to organizational components. On-going research is needed to support the role development of physiotherapists providing occupational health rehabilitation and to further advocate for its relevance in this setting.

Occupational Health and Safety Challenges From Employment-Related Geographical Mobility Among Canadian Seafarers on the Great Lakes and St. Lawrence Seaway.

Seafaring involves multiple patterns of mobility. Ships are mobile workplaces that connect and disconnect from land. Many move within and between national boundaries. Maritime labor forces are recruited from multiple locations engaging in varying commutes to and from homeports—international commutes for international labor forces and internal commutes for national labor forces. Mobilities expose seafarers to a range of occupational health and safety hazards, which can be exacerbated by mobility-related constraints on regulatory protections. Based on legal analysis and twenty-five semi-structured interviews with Canadian seafarers, managers, and key informants, this exploratory study examines how employment-related geographical mobility may create occupational health and safety challenges for Canadian seafarers working on the Great Lakes and the St. Lawrence Seaway. Findings show that few legal instruments are available to protect seafarers from commuting-related occupational hazards and that occupational health and safety challenges are numerous. Seafarers’ occupational health and safety rights on board are restricted and they are systemically discouraged from raising safety concerns.

Exploring the Lived Experience of Adults With Sensory Processing Disorder (SPD): A Phenomenological Study

Abstract Date Presented 04/05/19 Sensory processing disorder (SPD) poses unique occupational challenges. However, most of the understanding is through a pediatric lens. To obtain information about the adult lived experience, a phenomenological study was conducted using Colaizzi's seven-step method and interpretive phenomenological analyses and the PEO model. The resulting conclusion is that adults with SPD experience an extreme paradoxical relationship with occupations. Primary Author and Speaker: Nicole Quint Additional Authors and Speakers: Chelsea McKenna, Amanda Messingschlager, Alexia Bien, Emma Smith

UM OLHAR QUANTO A EXPOSIÇÃO A RISCOS ERGONÔMICOS PELA ÓTICA DOS PROFISSIONAIS DA INDÚSTRIA DE PANIFICAÇÃO

Levantamento em campo contemplando demandas ergonômicas predominantes na indústria panificadora quanto às manifestações relacionadas à rotina do padeiro em seu ambiente laboral; abrangendo os desafios no setor em termos de segurança e saúde no trabalho. Os resultados confirmaram hipóteses levantadas ao longo do artigo. Sugeridas melhorias potencialmente aplicáveis no setor.

Work Ability and Health Promotion Offers needed by Healthcare Personnel in Germany: Results of an Expert Survey

The burden on nursing staff in Germany is continuously increasing. Specific health promotion programs can help to reduce this burden. To develop such programs, the concrete needs of nurses for instructions and training have to be determined. The aim of the project "PFLEGEprevent" (funded by the Bayerisches Staatsministerium für Gesundheit und Pflege) is to develop a prevention program that focuses on the special needs of the nursing staff. The project is structured in four subprojects: (1) identification of needs, workloads and occupational challenges of caregivers and the scientific evidence (national expert survey and systematic literature review), (2) development of a specific prevention program, (3) implementation and evaluation of the prevention program (Intervention study; DRKS00012870), (4) development of a manual to instruct the implementation of the prevention program (transferability). In subproject (1) the current subjective work ability of the nursing staff in Germany and their need for preventive offers were revealed by a national expert survey. The survey was directed to nurses in outpatient, semi-inpatient and inpatient care facilities and clinics. In addition to personal information and questions on current work and organization, the subjective work ability of the nurses (based on the Work Ability Index, WAI) and the need for preventive offers were queried. A total of 1381 questionnaires were analysed. The majority of surveyed healthcare staff was female (81%). On average they were 40.1 years old (SD=12.0) and had worked in the care sector for 16.3 years (SD=10.9). The mean of the WAI score was 37.2 (SD=7.1) points, which indicates a good work ability. However, there were differences in work ability between types of institution and number of years in job. The care staff needed instructions mainly on the topics of stress, communication and teamwork. Active training was required for relaxation, back muscle training and strengthening. 75% of respondents said they would participate in a 5-day prevention program.

Occupational Challenges in Military Service Members With Chronic Mild Traumatic Brain Injury.

The purpose of this study was to identify the needs of military service members with chronic symptoms after mild traumatic brain injury (mTBI) that fall within the scope of occupational therapy practice. In this qualitative descriptive study, service members with a history of mTBI (N = 12) participated in semistructured interviews about their injury history, symptoms, daily routines, challenges, and plans. Two main themes were identified: occupational changes and plans for the future. Occupational changes contains six subthemes: (1) rest and sleep, (2) activities of daily living and instrumental activities of daily living, (3) work, (4) social participation, (5) play and leisure, and (6) education. Plans for the future contains three subthemes: (1) supports, (2) barriers, and (3) fears. Occupational therapists who work with this population should consider all areas of occupation, especially sleep, during assessment and treatment planning. Some clients may require additional support for preparing for civilian life.

The current and future contribution of occupational therapy and occupational science to transforming the situation of forced migrants: Critical perspectives from a think tank

ABSTRACTThis paper reports on the collective ideas of the occupational scientists and therapists who attended the “Refugees – Addressing Key Social Issues” think tank at the Occupational Science Conference held in Hildesheim (2017). Forced migration is recognized as a prevalent issue in today’s society. Forced migrants face many occupational challenges, which are being exacerbated by restrictive migration policies. This paper outlines the discussions held during the think tank and presents an occupational perspective of forced migrants’ needs, followed by a desired vision of what an occupationally just world would look like for forced migrants, and future directions to guide occupation-based social transformation.

PROMOTING IDENTIFICATION AND SUPPORT OF LEARNERS WITH VISUAL PROBLEMS IN PUBLIC PRIMARY SCHOOLS, CENTRAL KENYA

Visual impairment in childhood has implications in all aspects of the child’s development. It posses educational, occupational and social challenges, with affected children being at risk of behavioral, psychological difficulties, impaired self-esteem and poor social integration. Moreover, visual problems are an important contribution to poor school performance. Visual problems are known to deteriorate and become visual impairments if they are not identified and treated early. Despite this realization, high risk learners in primary schools remain unnoticed, undiagnosed and do not benefit from special education services and interventions. The purpose of this study was to document challenges that teachers in public primary schools experienced in identifying and assisting children with visual problems. Utilizing a descriptive survey design, a study involving 36 teachers was conducted in 12 public primary schools in Central Kenya. Questionnaires and observation schedules were used. The study established the major challenges faced by teachers in identifying learners with visual problems as: lack of knowledge and skills in special education and visual screening as well as lack of school visual screening programs. Strategies suggested to address the challenges included special education training and special education seminars for teachers and introduction of school visual screening programs for all the learners.

Factors Affecting Nurses’ Perceived Organizational Commitment: A Qualitative Study

Objective: Nurses’ organizational commitment is one of the most important factors that facilitates their professional evolution and influences the method of care provision, quality of care, and patients’ satisfaction. The aim of this study was identified the factors that affect nurses’ perceived organizational commitment.
 Material and Methods: This qualitative study, conducted on 16 clinical nurses employed in Social Security Hospital of Khorramabad, Iran, during five months from May to September 2015, used deep semi-structured interviews. Purposive sampling method was used for the selection of nurses and the data were analyzed using conventional qualitative content analysis. Lincoln & Guba’s criteria were used to secure data accuracy and stability.
 Results: Sixteen subcategories, five categories, and three themes were distilled during content analysis process. The abstracted themes included “organizational factors”, “occupational challenges”, and “contributory management”.
 Conclusion: Our findings showed that numerous factors present in nurses’ profession and work environment may influence the rate of nurses’ interest and commitment in the hospital and the related organization. Hence, nurse managers can foster the promotion of nurses’ organizational commitment through creating the required suitable conditions.
 Bangladesh Journal of Medical Science Vol.18(2) 2019 p.303-311

Craftivism for occupational therapists: finding our political voice

Craftivism is an ongoing movement, combining craft with activism, to bring about positive change in the world. There is a growing emphasis on the need for occupational therapists to engage with the politics of the profession to tackle occupational challenges and injustice. This opinion piece considers whether, with the historical links to and resurgence of craft internationally within the profession, now is the time for occupational therapists to engage in craftivism to effect positive change and transformation for a just and inclusive society. It suggests that craftivism may enable the profession to find its political voice and suggests ideas for action.

Occupational challenges in a digital society: A discussion inspiring occupational therapy to cross thresholds and embrace possibilities

The digital transformation of society and the increased need for digital competence implies extensive changes in peoples’ everyday lives and occupations. Heretofore, the discussion in the field of occupational therapy about the consequences of digitalisation has been vague. The aim of this discussion paper is to outline some reflections and to offer some arguments on how to meet the changes following digitalisation and its impact on occupational therapy. The discussion focuses on three issues: the new conditions for participation in a digital society and the role of occupational therapy and occupational therapists in the evolving digital society as well as what occupational therapists need to be pro-active and to embrace the ongoing changes in a digital society. In conclusion, occupational therapy needs to advance its position and become pro-active to cross the threshold and to embrace the possibilities that digitalisation holds for peoples’ everyday lives to support occupational justice and health.

Occupational Health and Safety Challenges from Employment-Related Geographical Mobility Among Canadian Seafarers on the Great Lakes and St. Lawrence Seaway.

Seafaring involves multiple patterns of mobility. Ships are mobile workplaces that connect and disconnect from land. Many move within and between national boundaries. Maritime labor forces are recruited from multiple locations engaging in varying commutes to and from homeports -- international commutes for international labor forces and internal commutes for national labor forces. Mobilities expose seafarers to a range of occupational health and safety (OHS) hazards, which can be exacerbated by mobility-related constraints on regulatory protections. Based on legal analysis and twenty-five semi-structured interviews with Canadian seafarers, managers, and key informants, this exploratory study examines how employment-related geographical mobility (E-RGM) may create OHS challenges for Canadian seafarers working on the Great Lakes and the St. Lawrence Seaway. Findings show that few legal instruments are available to protect seafarers from commuting-related occupational hazards and that OHS challenges are numerous. Seafarers’ OHS rights on board are restricted and they are systemically discouraged from raising safety concerns.

Occupational challenges and adaptations of vulnerable EU citizens from Romania begging in Sweden

ABSTRACTIntroduction: People from European Union (EU) countries such as Latvia, Romania and Bulgaria who beg on the streets have become a common part of the townscape in Sweden. While demanding situations in their home countries drive them abroad to earn their living, those who turn to begging still face challenges in their everyday lives. Additional knowledge is needed, from their perspective, about the occupational challenges of begging, as well as how they adapt to those challenges.Aim: To describe the occupational challenges and related adaptations of vulnerable EU citizens begging in Sweden.Methods: We used a descriptive qualitative design. Individual interviews with 20 Romanian participants were conducted and analysed using qualitative content analysis with a deductive and inductive approach. Results: Six categories of occupational adaptation responses were identified: Keeping the family tier intact despite distance; Dealing with shame and stress; Managing body and mind when begging despite the monotony; Living as cheaply as possible; Trying to get a night's sleep without drawing attention to oneself; and Seeking alternatives for earning their living.Conclusion: Everyday life, when begging abroad, is filled with occupational challenges requiring occupational adaptations, for better or for worse, to sustain basic human needs. To further understand the needs of this vulnerable and marginalised group in society, human rights discourses that go beyond the individual level are needed.