Occupational Therapy Theory Research Articles

The Ecology of Human Performance: A Framework for Considering the Effect of Context

In theory and in practice, context (as an area of concern to occupational therapists) has not received the same attention as performance components and performance areas. The Ecology of Human Performance serves as a framework for considering the effect of context. Context is described as a lens from which persons view their world. The interrelationship of person and context determines which tasks fall within the person's performance range. The Ecology of Human Performance framework provides guidelines for encompassing context in occupational therapy theory, practice, and research.

Prosthesis Training as a Context for Studying Occupational Forms and Motoric Adaptation

Occupational therapy authors frequently emphasize the importance of the use of objects in the development of motor skill. This study investigated the use of object-produced visual input in learning control of flexion and extension of an above-elbow training prosthesis. Fifty-two male college students were randomly assigned to two training procedures: (a) two 1.5-min periods in which they used a flashlight attached to the hook of the prosthesis to connect dots on paper with light, or (b) the same time periods in which they had the opportunity to practice moving an equally weighted prosthesis, but without the light or dots. To assess motoric adaptation after training under one of the two conditions, each subject traced a continuous line through a maze with a pen attached to the hook. Deviations from the line were measured reliably. Data analysis with a Mann-Whitney test revealed that subjects in the group that trained with added materials traced with significantly more skill than subjects in the other group (one-tailed U = 225.5, p = .02). As predicted by occupational therapy theory, the object-produced visual input enhanced the learning of a motor skill relevant to rehabilitation. Although there is a need for more study across different occupations and populations, clinicians are urged to consider the possible benefits of the use of objects in the development of motor skills, as opposed to objectless exercise. Prosthetic training provides a useful context for future research addressing theoretical issues in motor learning.

A curriculum based on systems theory.

This paper describes an entry-level curriculum based on systems theory that was designed to promote integrated thinking and a shared image of practice among all of the members of an educational community that included students, faculty, and clinicians. Initiated in 1983, the program integrates occupational therapy theory, critical thinking, and knowledge about person-environmental transactions with traditional medical, biological, psychological, and sociological course work to create a unique educational experience. The curriculum model is based on a spiral learning process that encourages integrated thinking. Furthermore, all concepts are systematically tied to the occupation core, the central theme of the program. Fieldwork is used to reinforce ideas presented in the classroom and features discrete learning experiences where students demonstrate their integration of knowledge and skills. In an evaluation of the program, responses from 78 clinician, 51 alumni, and 132 student questionnaires; feedback from 132 fieldwork supervisors; and longitudinal data from 33 alumni confirmed that graduates are critical thinkers who appreciate the diverse needs of clients while demonstrating an appreciation for the curative effect of meaningful, goal-directed activities.

Models for Practice in Occupational Therapy: Part 1, Defining Terms

The first part of this article attempts to clarify some of the confusion around the use of language to explain the theory of occupational therapy, including terms such as models, frames of reference and philosophical assumptions. It defines and differentiates between the terms and describes the components of a good model for practice.

Clinical reasoning process for service provision in the public school.

This paper outlines the clinical reasoning process used to guide decisions on the provision of occupational therapy services in the Wake County Public School System in North Carolina. The process is based on a theoretical framework derived from occupational therapy theory and public law. Benefits of using the clinical reasoning process include (a) increased consistency of decision making among therapists; (b) increased appropriateness of decisions regarding whether a student needs educationally based occupational therapy services, what type of occupational therapy service would meet the student's need, and how often this service should be provided; and (c) improved ability of therapists to articulate to all those involved with a student the reasoning behind decisions to provide educationally based occupational therapy services. The schematic diagrams that depict this process provide a useful tool for therapists with varied work experiences entering school-based practice.

Schizophrenia:

In Zanzibar, as in many "third world" places, there are two health care systems, one traditional and the other "European." Among the Swahili people of East Africa spirits are believed to be the cause of disturbed behavior or "madness." Data and observations gathered during one year of mental health practice in Zanzibar and over many years of practice in the U.S. are compared to examine how cultural values shape beliefs, practices and attitudes related to "madness." Implications for occupational therapy theory and practice are drawn.

1991 Muriel Driver lecture. The environment: a focus for occupational therapy.

Individuals in Canada with a disability encounter environmental constraints that limit their active participation in the daily life of our communities. Fundamental inequities in participation and integration continue to exist and there is a need for a concerted effort to eliminate these disabling environments. Several factors, including the built environment, societal production of space, classification of individuals based on norms, the perception of disability as deviance, the power of health disciplines and bureaucracy are examined to determine their contribution to the creation of these disabling environments. Recent modifications to occupational therapy theory and practice, while meaningful, have not fully explored ways in which disabling environments limit occupation. Prevailing ideas about occupation and the environment are examined for their contribution to solving these environmental problems. Principles which can assist occupational therapy intervention directed at changing disabling environments are described. The intent is to define methods of changing disabling environments, based on the desires and active participation of people with disabilities

Anger Management

Many occupational therapy techniques and theories addressing anger have been incluenced by general misconceptions about anger within the field of psychology and the general public. Until occupational therapists develop a unique perspective for defining anger and understanding how anger affects one's ability to function in one's occupational roles, they will continue to depend upon other professions to provide information on addressing anger problems. Part one of this two-part series on anger management formulates a construct of normal anger pertinent to occupational therapy practice and identifies complexities and misconceptions which have obscured the nature of anger. The second article presents basic concepts of anger management and mismanagement, provides clinical applications of these concepts, and delineates how anger affects human occupation. To accomplish this purpose, the Model of Human Occupation was used as a framework for integrating information on anger from the social sciences into a perspect...

Adult Physical Dysfunction Content in Professional Curricula

This study examined the content of occupational therapy professional curricula as it pertains to adult physical dysfunction and the opinions and perceptions of faculty responsible for this content area. Survey results from 28 of 66 academic institutions offering professional-level education were received and analyzed. A great diversity in content and emphasis was reflected in the areas of medical conditions, general approaches to evaluation and treatment, specific evaluations, and specific treatment techniques and modalities. Most of the respondents were pleased with students' performances in physical dysfunction Level II fieldwork, believed that course work was applicable to local clinical settings, and agreed that courses were constantly changing to reflect evolving occupational therapy theory. Approximately 30% of the respondents believed that they had inadequate time to prepare students for entry-level practice, and about half agreed that their department had the necessary equipment to teach evaluation and treatment content.

Status of Practice in Mental Health: Assessment and Frames of Reference

Educational orientation and clinical practices for Australian mental health occupational therapists were surveyed to determine theoretical approaches and assessment procedures used. Questionnaires were sent to clinicians and educators to estimate current differences and similarities between educational content and clinical practice. Combined results indicate the need for increased effectiveness in teaching conceptual theories of occupational therapy, more structured classroom and fieldwork learning experiences, and improved instruction in and application of assessments by clinicians.

Knowledge and Use of Theory among Occupational Therapists: A Canadian Survey

Recent interest in occupational therapy theory has focussed attention on the utility of theory for clinical-practice and for research. However, for many therapists, knowledge and use of theory have changed notably since their educational days, and the process of keeping up to date on theory development may be difficult. This paper presents the results of a survey aimed at identifying the extent of use of theory and the level of knowledge about theory among practicing therapists in Canada. A random sample of 187 therapists from across the country was surveyed to ascertain their knowledge of authors and ideas in the occupational therapy theory literature. Results indicate that overall knowledge level is moderate. Factors which significantly predict theory knowledge include year of graduation, training in or outside Canada, academic qualification, and self-assessment of theory knowledge. There were no significant differences in theory knowledge according to area of clinical practice.

Choosing a Motivation Construct

Motivation is a key concept and concern to occupational therapists; however, no true occupational therapy motivational model exists. Previous studies of motivation by occupational therapists have tended to focus on unidimensional, content theories of motivation, which do not adequately explain this construct. The authors present a review of several major theories of motivation and propose one — Lawler's motivation model — as an appropriate model for guiding occupational therapy practice and research. Based on expectancy theory, this model incorporates many conceptual factors consistent with occupational therapy theories and beliefs.

Oversimplification: The Hobgoblin of Theory and Practice in Occupational Therapy

Oversimplification: The Hobgoblin of Theory and Practice in Occupational Therapy

The Role Change Assessment

Occupational role performance is a key concept of occupational therapy theory and practice. The Role Change Assessment was developed to facilitate the systematic evaluation of the rolc performance of older adults. It uses a semi-structured interview format to examine 48 roles in family and social, vocational, self-care. organizational, leisure, and health care categories. This article describes the need for and development of the instrument and illustratcs its use through case reports.

Historical Research: Ordering the Past to Chart Our Future

Present concerns about the state of theory and practice in occupational therapy can be explained in light of past developments, both successful and unsuccessful efforts. This article explains why occupational therapists still use arts-and-crafts modalities, the practice of which can be traced to early therapists influenced by the philosophy and practices of a social movement that swept across America from 1895 to 1920. This analysis is based on historical research, a methodology not common in occupational therapy literature.

Occupational Therapy Theory: Values Held by Undergraduate Students

This study examined the priorities for theory application and for theory development of 149 students from four different undergraduate occupational therapy curricula. Data were analyzed using Kruskal-Wallis one-way analysis of variance by ranks and again using the F test followed by Duncan's Multiple Range Test. Results of the two analyses were consistent. Compared to registered occupational therapists, undergraduate students hold higher priorities for theory application and lower priorities for theory development. The data support a developmental sequence for theory valuing: value for theory application → value for research → value for theory development.

Qualitative Methods in Occupational Therapy Research: An Application

Recent occupational therapy literature has pointed to significant similarities in the principles of qualitative research methods and the underlying assumptions and values of our profession. This article presents an overview of qualitative methods, an analysis of the relationship between qualitative and quantitative approaches in social and cultural research, and a brief discussion of the issues of reliability, validity, and researcher objectivity in qualitative research. The application of qualitative methods in a research project on juvenile arthritis is used to illustrate an exploration of the importance of such methods to occupational therapy theory and practice.

Who Needs a Theory of Occupational Therapy? Do You?

A group of Melbourne based occupational therapy educators and clinicians question the need for a paradigm for occupational therapy. They claim that professional status is more dependent upon expert organization (formal and informal) of the profession and its external relations than on conceptual and theoretical consensus. Identification of the state‐of‐the‐art of occupational therapy is held to be an important first step in the move towards better organization and relations with other health professions. Occupational therapists Australia‐wide are asked to assist in the identification process.

Work-Related Programming in Occupational Therapy

This paper presents an examination of the historical evolution of work-related theory in occupational therapy as it paralleled environmental influences (social, political, technical) and how that has affected the thrust and position of the profession today.

The Occupational Therapist's Role in Employee Health Promotion Programs

The first challenge in developing an effective health promotion program for employees is the performance of a health needs assessment on the target population. In an effort to meet this challenge, 600 corporate employees were surveyed and compared with respect to the allotment of time to work, leisure, and self/family care activities; health risk factors; perceived health; and activity satisfaction. The results of the study indicated that the employees participating in the corporate health and fitness programs were not the high risk individuals who consume the majority of the corporate medical dollar. The role of the occupational therapist in meeting the needs of high risk employees is discussed. A brief review of the literature addresses research efforts in the area of health promotion in industry and the role of the occupational therapist in disease prevention. The appropriateness of occupational therapy education, training and theory in relation to health promotion programs and the utilization of the five occupational performance components in the evaluation of employee populations is outlined. Finally, the role of the occupational therapist working in specific areas of health promotion is reviewed, including: back pain reduction, substance abuse treatment, cardiac fitness/rehabilitation and hypertension control, smoking cessation, weight reduction, stress management, industrial accident and injury prevention, and self-responsibility for health instruction.