Shortage Of Occupational Therapists Research Articles

Occupational Therapy in Haiti: A Pilot Study to Identify Intervention Methods Used during Short-Term Medical Missions.

Due to the shortage of occupational therapists (OTs) in Haiti and over 800,000 individuals with disabilities, most occupational therapy assessments and interventions are provided by OTs on short-term medical missions (STMMs). Learning which methods OT use to provide assessments and interventions during these STMMs is the first step to understanding how to facilitate follow-up and carry-over for clients and ensure longevity for STMMs in Haiti. This study used a cross-sectional, descriptive design to gather data on methods used by OTs. Thirty-three OTs, who travelled to Haiti on STMMs, completed a 16-question, online survey. The most common method provided by OTs was education to patients, caregivers, and local providers. Training of Haitian rehabilitation technicians was also prevalent. There was an association between the years of the OTs' clinical experience and the effort of OTs to train local providers, but this result was not statistically significant. Further research should be implemented on specific methods that can be used in the absence or shortage of Haitian OTs to ensure follow-up for Haitian clients. The sharing of data regarding OT methods on STMMs will promote evidence-based, client-centered, and cost-effective therapy to enhance effective client outcomes.

Complexities and actualization: embedding a home-based functional improvement intervention within a Medicaid Waiver

CAPABLE is a multi-component intervention tested through CMMI Innovation funds to improve self-identified functional goals of low-income older adults. CAPABLE components include fixing the home environment and providing up to 10 home visits by occupational therapists and nurses to address functional challenges to self-management. Linking environment and function to health are not traditional home care and Medicaid waiver practices yet potential program outcomes (reduction of functional disability, depression, polypharmacy and nursing home placement) align with Medicaid Waiver goals. Using normalization process theory, we present challenges and opportunities implementing CAPABLE in a new setting: a home health agency in Medicaid Waiver program. We examine dissemination and implementation dynamics of the intervention, micro-environmental context (staff and agency), macro-environment context (policy, demographic and utilization trends), group conventions, and embedding. Methods include focus groups, semi-structured interviews, joint-home visits, and taped home visits. Results include the following implementation challenges: health providers misperceive the CAPABLE program as similar to routine care, have scant experience implementing evidence-based care, and require culture shift from clinician-directed to client-directed care. Home repair and modification integrated within the lens of a medically necessary Medicaid requirement is complex, and there is a shortage of occupational therapists. In contrast, results of the multiple process measures show the following implementation supports: mission-driven staff that became dedicated to the approach once evidence-based strategies helped participants achieve improved function, waiver social workers included in the waiver care model bolster CAPABLE treatment principles, bi-directional communication with State policy makers about scaling CAPABLE to the entire Waiver if health care costs decrease for CAPABLE participants relative to non-CAPABLE Waiver participants. Findings advance the D&I field by applying rigorous theory and process measures to examine a complex intervention disseminated to a site which includes multiple strengths and challenges to normalization. Funding for the research was provided by the National Institute on Aging, the Center for Medicare and Medicaid Innovations Center, the John A. Hartford Foundation, the Robert Wood Johnson Foundation, the Blue Cross and Blue Shield of Michigan Foundation, and a Medicaid Match Grant: Translating Evidence into Practice.

Rural rehabilitation practice: perspectives of occupational therapists and physical therapists in British Columbia, Canada

Providing rehabilitation services to address the health needs of rural residents requires overcoming the challenges of geography, limited referral options and a shortage of occupational therapists (OTs) and physical therapists (PTs). However, little is known about how rehabilitation professionals in rural areas enact their practice to meet and overcome these challenges. To address this gap and contribute to enhancing health for rural residents, this study was designed to explore rural rehabilitation practice from the perspectives of OTs and PTs in rural British Columbia (BC). A purposive sample of OTs and PTs in rural communities (population <15 000) in northern BC was recruited for this qualitative study. Potential participants received an invitation mailed to workplaces and were selected to ensure a variety of work experiences, roles and practice settings. In semi-structured interviews, participants were asked to describe the skills and knowledge they perceived as unique to rural practice and strategies they used to overcome challenges. Guided by interpretive description, transcripts were analysed inductively using broad-level coding, and findings were collapsed into interpretive categories. Interpretations and implications for education, practice and policy were reviewed with participants to ensure relevance to rural practice. From interviews with 6 OTs and 13 PTs, serving a total of 15 rural communities, rehabilitation practice and participants' definition of health were understood to be substantially shaped by rurality or the contextual features of geography, determinants of health and access to services. Participants considered general practice 'a specialty' requiring advanced skills in assessment. They described 'stretching their role' and 'participating in, and partnerships with, community' as ways to overcome resource shortages. Reflective practice, networking and collaboration were deemed essential to maintaining competence. Rural clinical placements, mentoring and improving access to continuing professional development were regarded as central to the recruitment and retention required to sustain optimal levels of service to residents. The research findings illustrate the unique influence that the rural context has on the practice of OTs and PTs in BC. They underscore the importance of facilitating learning about rural health within professional training programs and of providing accessible professional development resources to address health human resource shortages and meet the rehabilitation needs of rural residents.

Thera-Free: ten years of providing free and quality occupational therapy services to the underserved

In many countries, occupational therapy services remain inaccessible and inequitably distributed. This results in entire communities and populations not being served. A possible solution to the problem is the program Thera-Free conceptualized in the Philippines. This article describes the program and how it has been used to address the shortage of occupational therapists in the country. A case study details how the program was implemented in an island province and the challenges the program has and continues to face. It describes the initiatives of two occupational therapists who worked with a private group of women and the community to bring Thera-Free to the island-province. Finally, strategies to move the program forward are offered.

Does the clinical context affect the validity of bathroom recommendations made by home health aides?

Introduction When there is a shortage of occupational therapists, an organizational model that involves home health aides in the process of recommending bathroom equipment could have a positive impact on the physical and psychological health of these workers. Currently, the involvement of home health aides is often limited to clients already receiving their services. The purpose of this study was to compare the criterion validity of recommendations made by home health aides regarding bathroom equipment for community-living adults presenting bathing difficulties under two clinical contexts: new referrals (group 1) and clients already receiving bathing assistance from home health aides (group 2). Methods Community-living adults with bathing difficulties ( n = 96) were visited by an occupational therapist (gold standard) and by one of four home health aides. Both evaluations took place within 10 days and evaluators were blind to the recommendations made by the other. Results Participants in the two groups differed on residential status, medical diagnosis and functional autonomy level. However, there was no significant difference between the groups in the criterion validity of the recommendations made by the home health aides. Conclusions Involvement of home health aides could be considered with a broader group of clients to increase the likelihood of bathrooms being properly adapted to the needs of both client and worker. Relevance to industry This study can support workers and homecare managers in their decision regarding whether to involve home health aides in a new and controversial role.

Changing practice speciality in occupational therapy: Exploring the experience. Part two

Despite an ongoing shortage of occupational therapists in the UK, the career behaviours of senior occupational therapists are under-researched. This article explores Senior occupational therapists' experience of changing practice specialities as a potential retention strategy. The background to this area was considered in part one of this article. In the second part of this article, the authors detail an interview-based qualitative study conducted with 10 Senior I/II occupational therapists who had changed practice specialities within the previous decade. Thematic analysis of the study data led to the emergence of five inter-related study categories. These reflected participants' reasons for changing practice speciality, the practical steps taken, the elements that made changing easier or more difficult and the resulting effects. A model of the process of changing practice speciality was derived from these data. This saw participants as influenced by a range of personal, professional and organizational elements. These, in turn, influenced the practical steps taken to effect change. Reported outcomes included increased job satisfaction and retention within the profession. These findings suggest that changing practice speciality can improve recruitment and retention among Senior occupational therapists, to the benefit of all concerned.

Changing practice speciality in occupational therapy: Exploring the experience. Part one

Official sources report an ongoing shortage of occupational therapists in the UK. Despite this, the career behaviours of senior occupational therapists have gone largely un-researched to date. This twopart article explores one aspect of this field; namely such therapists' experience of changing practice specialities. Having used this process as a retention strategy earlier in her career, the first author questioned whether other occupational therapists were acting in the same way. In this, the first part of this article, the authors outline the background to this area, exploring research on practice speciality choice, career transition, retention and attrition in a variety of healthcare disciplines, including occupational therapy. This material shows that, while individuals' experience of changing practice speciality necessarily varies, the reasons given are broadly personal, professional and/or organizational in nature. The authors used the material reviewed as the basis for an interview-based qualitative study of 10 senior I/II occupational therapists who had changed practice specialities within the previous decade. The methods used to explore this area, the findings from the study conducted and the implications of these results for occupational therapy practice, are detailed in part two of this article.

An occupational therapy refresher course: a 5-year follow-up report.

The shortage of occupational therapists prompted the faculty of the program in occupational therapy at the University of Minnesota to develop a reentry (refresher) course. A questionnaire sent to all enrolled in the 2-week refresher course during a 5-year period revealed that three intended groups of therapists have benefited: those reentering practice, those considering a change to another area of specialty, and those updating their educational background. Respondents indicated that the course increased self-confidence, theoretical knowledge base, and ability to apply theory to practice. Both reentering therapists and those changing specialty areas of practice reported positive employment outcomes.

Occupational Therapy in the Department of Veterans Affairs: Focus on Health Care of the Elderly Veteran

The Department of Veteran Affairs (VA) operates the largest integrated health care system in the world (VA, 1989), with designated departments and programs designed to meet the long-term care needs of the aging veteran. Occupational therapy is an important intervention to maximize the quality of life of older persons. Because of the increasing number of aging veterans and the national shortage of occupational therapists, the VA has been devising programs to recruit and retain occupational therapists in VA medical centers. The combination of long-term care programs and the VA's commitment to ongoing research, education, and occupational therapy services points to a promising outlook for care of our aging veterans.

The Value of Psychosocial Level II Fieldwork

The shortage of occupational therapists choosing to practice in mental health and the increase of therapists electing to specialize in other areas led to a pilot study designed to gather information regarding the value of psychosocial Level II fieldwork. A survey was mailed to 152 practicing occupational therapists who had graduated from Colorado State University in Fort Collins between 1983 and 1988; of the surveys returned, 116 were used in this study. The results indicate that the psychosocial Level II fieldwork experience provides therapists with valuable training and experience regardless of their current area of practice or specialization. The results also suggest that to preserve the holistic approach that occupational therapists offer their clients, psychosocial Level II fieldwork must remain a requirement of occupational therapy programs.

Enriching the Fieldwork II Experience

The shortage of occupational therapists working in mental health is of serious concern to the profession. This article will briefly describe the current issues related to manpower, recruitment and level II fieldwork education. It will then discuss the development, utilization and impact of one educational program designed to increase student interest in mental health by supplementation of the level II fieldwork experience. In conclusion, this paper will give suggestions for future strategies that may lead to both improved level II education and increased student interest in mental health as a career choice.

Occupational Therapy: A Study of Supply and Demand in Georgia

In 1986 the University of Georgia's Institute of Higher Education conducted a statewide needs assessment of the supply of and demand for health care professionals in over 25 health care fields. Of the 638 hospitals, nursing homes, home health agencies, and freestanding ambulatory surgical centers surveyed, 321 replied (50%). Respondents reported that occupational therapy positions have one of the highest vacancy rates and pose severe recruitment difficulties. The occupational therapy vacancies in Georgia hospitals were 16.1% and averaged 15% in all surveyed facilities. In the hospital setting, the length of time needed to hire an occupational therapist ranged from 0 to 280 days with 3 months as average. Nevertheless, the respondents projected a 41% increase in employment of occupational therapists by 1995. Occupational therapy employment opportunities in Georgia far exceed the supply, and this imbalance will continue until the turn of the century. Although much publicity has been focused on the severe nursing shortage nationwide, in Georgia and apparently in other states, the shortage of occupational therapists is also severe. A concerted effort is required to turn this situation around.

An Introduction to Self-Assessment

This article is an introductory exploration of the value of self-assessment with particular reference to the Disabled Persons (Services, Consultation and Representation) Act 1986, taking into account the present shortage of occupational therapists and the possible sharp rise in the requirement for formal assessments.

Points of View on Working Together: Qualified and Unqualified Staff in an Occupational Therapy Department for Adults with a Mental Handicap

This article describes how a head occupational therapist tried to overcome the problem of a chronic shortage of occupational therapists by redefining staff roles. One of the helpers who was affected by this strategy gives his opinion of its effectiveness and describes what it feels like to be an unqualified member of staff in an occupational therapy department.

Attitudes of Occupational Therapy Students Toward Older Persons

As the older population increases in number and proportion within the population, services adapted to the needs of the older person will be in demand. Ageism is believed to hinder the development of such services. Occupational therapy espouses a functional view of health congruent with the multifaceted needs of the elderly, yet a shortage of occupational therapists working with the older population exists. This survey was conducted to investigate attitudes and knowledge level of occupational therapy students (N = 162) toward the elderly. Results indicated that positive attitudes toward older persons were predominant in this sample and correlated with higher knowledge levels about the elderly. The perplexing question of why occupational therapists have not selected this area of practice in the face of increasing demands for service remains.