Occupational Therapy Perspective Research Articles

The influence of environment on the fieldwork experience: Exploring interprofessional student perspectives

To determine the impact and importance of the physical, social and institutional environments on the outcome of their first fieldwork experience from the perspectives of occupational therapy (OT) and physical therapy (PT) students. Eighty two percent (n=84) of OT and 65% (n=51) of PT students completed the survey. The majority of students were female, aged 20-25 years, and supervised using a one student to one educator supervision model. A paper survey was mailed to all OT and PT students during their junior fieldwork placement. Demographic, nominal score data and responses to closed-ended questions generated descriptive statistics. Qualitative data resulting from the open-ended questions underwent content analysis. OT and PT students' fieldwork experiences and perceptions of their environment were remarkably similar, however, OT students indicated the physical environment (e.g., having a desk, access to a computer) and orientation (e.g., having a tour) were more important to their impressions of the placement as positive. By knowing how the environment impacts the fieldwork experience for students, stakeholders involved in the fieldwork process are in a better position to identify and be proactive in making changes to improve placement quality.

Culturally-Tailored Education Programs to Address Health Literacy Deficits and Pervasive Health Disparities among Hispanics in Rural Shelbyville, Kentucky: From an Occupational Therapy Perspective

Culturally-Tailored Education Programs to Address Health Literacy Deficits and Pervasive Health Disparities among Hispanics in Rural Shelbyville, Kentucky: From an Occupational Therapy Perspective

Challenges in Making Differential Diagnosis of Psychiatric Illness: An Occupational Therapy Perspective

This editorial has offered a commentary about the article, Limitations of Clinical Psychiatric Diagnostic Measurements by Aden Jacob, a research scientist working at the Gray Institute for Radiation Oncology and Radiobiology, Medical Physics Radiotherapy at the University of Oxford in the United Kingdom [1]. My first reaction to the article was, “Why would an oncologist write an article about the American Medical Association’s limitations in classification of psychiatric diagnoses? My curiosity led me to Google to search for answers. I found the author’s website. I did not seek this information to belittle or challenge the author’s credentials. I thought that other readers might be curious as well.

Occupational therapy needs of patients with thoracic cancer at the time of diagnosis: findings of a dedicated rehabilitation service

Guidelines recommend screening patients with cancer to identify their rehabilitation needs. To help quantify this area of need and associated workload from an occupational therapy perspective in patients with thoracic cancer, we report the experiences of a dedicated rehabilitation service. Consecutive patients were screened soon after diagnosis using items associated with occupational performance in the Sheffield Profile for Assessment and Referral for Care questionnaire. Those reporting predetermined levels of distress underwent a full occupational therapy evaluation; this generated a problem list from which individualised goals and interventions were instigated. Of 540 patients screened, 273 (51 %) reported levels of distress which warranted a full occupational therapy assessment. Of these, 260 (95%) reported a total of 681 problems (median of 4 [2-5] per patient). Mostly these lay within the domain of self care (553, 78%) in the categories of transfers, functional mobility and bathing/showering. A total of 646 goals (median of 2 [1-3] per patient) were formulated, resulting in 652 individual interventions, most frequently the provision of equipment (79%) or advice (32%) and referral to another professional/agency (23%). Patients considered that most goals were achieved (98%) and that the provision of equipment was useful (97%). About half of patients with thoracic cancer screened have occupational therapy needs around the time of diagnosis. Problems are mostly in the area of self-care, with equipment provision the most frequent intervention provided. Future work should examine the efficacy of occupational therapy interventions further.

Health at Work: An Analysis of Black's and Frost's Independent Review of Sickness Absence — What can Occupational Therapists Offer?

This opinion piece looks at the recent report on Health at Work — an independent review of sickness absence by Black and Frost, and offers comment on the implications of the review for the profession of occupational therapy. It considers some key proposals from the occupational therapy perspective in order to inform thinking and response to the review. Further, it raises some critical questions and challenges for the profession in responding to and asserting its place at the table in an initiative that has at its heart the fundamental role and skills of occupational therapists.

A Natural Approach in Mental Health Practice: Occupational Adaptation Revealed

A single case study of the stories told by one occupational therapist about her clients in mental health settings is presented in this article. Qualitative analysis revealed key concepts of the role of the occupational therapist as defined by occupational adaptation theory, along with unique perspectives of occupational therapy in mental health settings. The outcome of this study is a demonstration of the unique insight occupational therapy brings to addressing client recovery in mental health settings, specifically from an occupational adaptation perspective. This insight should enlighten others as to the necessity of skilled occupational therapy in mental health settings.

Walking as a Meaningful Leisure Occupation: The Implications for Occupational Therapy

Introduction: In response to growing interest in leisure in occupational therapy and the importance of understanding how occupations maintain, enhance and promote health and wellbeing, a qualitative phenomenological study was conducted to explore the experiences of walking for leisure. Method: Six healthy student participants, identified as regular walkers, were interviewed using a semi-structured format. Data were analysed following interpretative phenomenological analysis methodology. Findings: Participants expressed how and why walking was meaningful to them; the four main themes were social connectedness, wellbeing, connection to nature and achievement from a challenge. Findings suggest that occupational therapists could use walking and leisure occupations in intervention, and that there is scope for an occupational therapy perspective in health promotion. Conclusion: Determining the subjective meaning of engaging in walking as a leisure occupation has implications for occupational science and health promotion in helping to explain why people do what they do.

Doing, Being and Becoming: The Sociality of Children with Autism in Activities with Therapy Dogs and Other People

This article examines theories of sociality against ethnographically informed understandings of the sociality of children affected by Autism Spectrum Disorders (ASD) interacting with therapy dogs and other people. I explore from an occupational science and occupational therapy perspective how theories of human sociality inform our understanding of the ways in which a child's social engagement is supported during child-dog interactions; and how analysis of the data might problematize some theoretical assumptions about sociality, specifically, the primacy of language and theory of mind, and the 'humans only' position.

Services to the Homeless with Serious Mental Illness: From an Occupational Therapy Perspective

Services to the Homeless with Serious Mental Illness: From an Occupational Therapy Perspective

The Mirror Neuron System: Innovations and Implications for Occupational Therapy

Occupational therapy has traditionally championed the use of meaningful occupations in rehabilitation. Emerging research in neuroscience about the putative human mirror neuron system may provide empirical support for the use of occupations to improve outcomes in rehabilitation. This article provides an interdisciplinary framework for understanding the mirror neuron system—a network of motor-related brain regions activated during the production and perception of the same actions—in relation to occupational therapy. The authors present an overview of recent research on the mirror neuron system, highlighting features that are relevant to clinical practice in occupational therapy. They also discuss the potential use of the mirror neuron system in motor rehabilitation and how it may be deficient in populations served by occupational therapy, including individuals with dyspraxia, multisensory integration disorders, and social interaction difficulties. Methods are proposed for occupational therapy to translate these neuroscience findings on the mirror neuron system into clinical applications and the authors suggest that future research in neuroscience would benefit from integrating the occupational therapy perspective.

Outcome Measurement Tools Currently Used to Assess Pediatric Burn Patients: An Occupational Therapy and Physiotherapy Perspective

Given the high incidence of burn injuries in children, it is important that all clinicians involved in the care of these patients, including occupational therapists and physiotherapists, are able to assess patients with valid, sensitive, and reliable measurement tools to optimize outcomes and clinical management. The aims of this study were to identify therapist- relevant outcome measurement tools that have been previously used with pediatric burn patients and to ascertain the outcome measurement tools currently used by occupational therapists and physiotherapists working in pediatric burns units. A literature review was undertaken to identify therapist-relevant outcome measurement tools that have been used in the pediatric burn population. A survey involving therapists working in Australian pediatric burns units was then conducted to identify outcome measurement tools in common usage. Few outcome measurement tools were identified that had been specifically validated for use, or were in common usage in Australia, with pediatric patients with burn injury. The lack of validated and widely used measurement tools adversely impacts on the ability of therapists to accurately assess outcomes of treatment and undertake clinical research involving pediatric patients with burn injury.

Conceptualizing Community Development: Occupational Therapy Practice at the Intersection of Health Services and Community

Despite occupational therapy's theoretical commitment to community development (CD) approaches, current practice models focus on individual interventions rather than community issues. This research examined three cases of Canadian occupational therapists working in CD to conceptualize CD from an occupational therapy perspective. Data collection occurred over 12-14 days at each site and included observations, document reviews, and interviews with 14 colleagues and program participants. Constructivist grounded theory informed data analysis. A conceptual framework was developed that describes the contextual background to CD initiatives and the strategies used: nurturing community partnerships, building community capacity, influencing health services, and linking sectors. Underlying these strategies was the strategic use of self which allowed the sharing of power and legitimacy to create opportunities for meaningful occupational engagement. The conceptual framework helps articulate CD's underlying processes and can be used to understand and guide practice.

A Systematic Review of Cognitive Stimulation Therapy for Older Adults with Mild to Moderate Dementia: An Occupational Therapy Perspective

In response to the need for effective non-pharmacological approaches for individuals with mild to moderate dementia, cognitive stimulation therapy (CST) interventions aim to optimize cognitive function. The present literature review explored the effectiveness of CST and the congruence of this approach with occupational therapy. Twenty-four databases and 13 "grey" sources were searched. Relevant papers were analysed using the McMaster Critical Literature Review Guidelines, the Modified Jadad Quality Scale and the Oxford Centre for Evidence-based Medicine Levels of Evidence Scale. To establish the congruence of CST with occupational therapy, themes were identified using the International Classification of Functioning and professional values outlined by the Canadian Association of Occupational Therapists. Twelve studies demonstrated a trend towards delayed cognitive decline following CST. This intervention strategy is congruent with occupational therapy values and may provide a useful structural framework to build rehabilitation programmes for this population. Psychometric properties of the McMaster Guidelines have not yet been established, and there is no standardized way to extract quantitative data from this measure. There is a need for further research exploring outcomes of CST interventions within the context of everyday function in individuals experiencing cognitive decline.

ICF from an occupational therapy perspective in adult care: an integrative literature review

Since its launch there has been increasing interest in the International Classification of Functioning, Disability and Health (ICF) within occupational therapy (OT). The aim of this study was to perform an integrative literature review, in order to present an overview of knowledge, where the ICF constitutes a significant part in relation to OT. A systematic literature search, covering the period 2001–2008, was performed in the databases MEDLINE, AMED, and CINAHL. A total of 112 articles were included and the majority had exploratory and descriptive designs. The results showed that ICF was valuable for research, clinical practice, and education. ICF was used to link existing instruments and to construct new outcome measures. Occupational therapists have been members of expert groups involved in the development of Core Sets for certain health conditions. Several positive aspects were described, e.g. an effective medium for communication at different levels. Many limitations were mentioned, such as unclear concepts and lack of subjective experiences. Suggestions for improvements were described. The conclusion was that the ICF has been used for a broad spectrum of purposes. The results indicated that further research is needed concerning application of the ICF in clinical practice and education.

Translating knowledge to practice: An occupational therapy perspective

Translating knowledge to practice, also called 'knowledge translation', is increasingly recognised as a driving force to strengthen and improve the healthcare system. How knowledge translation fits with occupational therapy practice deserves examination. This paper will explore how an action process model, the Knowledge-To-Action Process, may advance knowledge translation in occupational therapy. Occupational therapists typically view knowledge in a broad sense, encompassing research, tacit knowledge, expert opinion and client evidence. The Knowledge-To-Action Process facilitates application of client, therapist and research knowledge to occupational therapy practice. Examination of knowledge translation through the lens of the Knowledge-To-Action Process creates awareness of the value of client, therapist and research knowledge. It also highlights opportunities as practitioners to implement knowledge translation. Models able to flexibly reflect an occupational therapy perspective of knowledge have a potentially vital role in successful knowledge translation. Furthermore, these models allow therapists and other stakeholders to analyse complex situations and identify targeted knowledge translation strategies.

Occupational Therapy's Perspective on the Use of Environments and Contexts to Support Health and Participation in Occupations

Occupational Therapy's Perspective on the Use of Environments and Contexts to Support Health and Participation in Occupations

As Students Become Adults: The Role of Occupational Therapy in the Transition Process

Under The Individuals with Disability Education Improvement Act of 2004, transition services for students with disabilities should be designed within a results-oriented process that facilitates a student's movement from school to postschool activities based on the student's individual strengths, needs, and preferences. As school to postschool transition encompasses myriad changes in life roles, demands, and skills, choosing a suitable high school placement is a crucial decision in preparation for transition from student to adult. Occupational therapy has essential and unique professional skills to collaborate with teams to support, improve, and address the varied factors that encompass the transition process. However, school-based occupational therapists tend to discontinue services earlier in a student's career, with fewer than 40% of school-based occupational therapists addressing the unique needs of adolescents (Schmitz, 2005; Brubaker, 2001; Kardos & White, 2005). This case study describes the collaborative process of one middle school student, his family, and his school team in search of the most suitable and beneficial high school placement to meet his individual needs and goals. Integral to this project was the experiential exploration of barriers, challenges, the resolving of miscommunications, the collaborative goal-setting process, the creation of the occupational profile, and a working therapeutic relationship. The parents perceived that the involvement of an occupational therapy perspective in transition planning for their child resulted in an improved experience in working with school staff and an appropriate high school placement and provided the groundwork for the development of a suitable and challenging high school program.

Occupational Therapy Perspectives from the Southern Hemisphere

Occupational Therapy Perspectives from the Southern Hemisphere

End-of-Life Issues: An Occupational Therapy and Pharmacy Perspective

End-of-Life Issues: An Occupational Therapy and Pharmacy Perspective

Formação em Terapia Ocupacional na Interface das Artes e da Saúde: a experiência do PACTO

This paper presents the education work offered in the Occupational Therapy Program developed by the Laboratory of Studies and Research in Art, Body and Occupational Therapy of FMUSP. The Laboratory conducts teaching and research activities, in the didactic-assistancial field, with groups and individuals accompaniment for heterogeneous population through the Artistic Compositions and Occupational Therapy Permanent Program (PACTO) and through partnerships made with projects in the art/health interface. Students experiences are sheltered and elaborated in team discussion, weekly supervisions, study groups and theme-deepening seminars. The education qualifies students to: understand and build up practices in the art/health interface under an occupational therapy's perspective; questioning the approaches in the art/health interface in healthcare spaces and in cultural spaces; comprehend social and institutional relations and institutional transformation processes; understanding the occupational therapists' participation in cultural policies and health humanizing policies. We chose to report and scoring aspects of the work done in recent years (2003-2008) in which some teaching strategies were consolidated and showed its effects on students' education and professional exercise. In the Occupational Therapy field there is an increase in the possibilities for professional performance linked to the issues of cultural production, in trans-disciplinary projects dealing with constructing inclusive social networks, with collective participation and production of subjectivity.