bluuebunny/crossref_metadata_2025 huggingface dataset:
“Sorry You Had to Go Through That”
Authors: Cargile Aaron Castelán , Salazar Leslie Ramos
Published: April 2015

Social suffering is distress engendered by cultural, social, and political forces. Responses to stories of such suffering serve as rejoinders in an identity negotiation process and can foster either healing or compounded distress—for both individuals and communities alike. Because there is no published study (to our knowledge) that focuses on the language individuals use in responding to stories of social suffering, the present study aimed to develop a theoretically grounded and empirically derived taxonomy of these responses. In order to develop and validate such a taxonomy, we collected a total of 172 audio-recorded responses to two true stories of race-based social suffering from two samples of undergraduate students at a large university in the greater Los Angeles area. The resulting coding scheme is presented here along with evidence of its reliability and validity.
Violence against the Antiwar Demonstrations of 1965–1968 in Yugoslavia: Political Balancing between East and West
Authors: Vučetić Radina
Published: April 2015

In the 1960s, Yugoslavia faced street violence and riots during demonstrations against the Vietnam War. These protests can be understood only in the context of Yugoslav foreign policy, as they represented political balancing between East and West. The state sponsored and organized demonstrations against the war in Vietnam, events at which strong anti-American sentiments were expressed, while on the other hand the state used violence to stop such demonstrations in order to maintain its good relations with the United States. Displaying sympathy with the Vietnamese people while playing the role of America's communist ally was part of Yugoslavia's political double game, which the country had played since its break with the Soviet Union in 1948.
The association between thyroid autoantibodies in serum and abnormal function and structure of the thyroid
Authors: Yan Yue-Rong , Gao Xi-Lian , Zeng Jing , Liu Yang , Lv Qing-Guo , Jiang Jing , Huang Hui , Tong Nan-Wei
Published: April 2015

Objectives

To evaluate the association between thyroid autoantibodies and abnormalities in thyroid function and structure, and to investigate any risk factors.

Methods

A cross-sectional survey was undertaken in Chengdu residents ≥18 years with no previous thyroid disease. The study participants provided demographic and clinical data. Thyroid function and serum concentrations of the thyroid autoantibodies antithyroperoxidase antibody (TPOAb) and antithyroglobulin antibody (TgAb) were measured.

Results

A total of 1334 subjects were included in this study. The prevalence of TPOAb and TgAb positivity was significantly higher in female than in male subjects. The prevalence of thyroid autoantibodies in those with subclinical hypothyroidism and clinical hyper- and hypothyroidism was significantly greater than in euthyroid subjects. The concentration of TPOAb and TgAb in subjects with both TPOAb and TgAb was significantly higher than in those who exhibited only one type of thyroid autoantibody. Using multivariate logistic regression analysis, female sex, thyroid volume, thyroid hypo- and heteroechogenicity were found to be risk factors for the presence of autoantibodies.

Conclusions

Thyroid autoantibodies were common in the general population. Women with thyroid enlargement, hypoechogenicity and heteroechogenicity might benefit from routine screening for thyroid autoantibodies and thyroid function.
An Exploration of Individuals' Expectations of their Stay on an Elderly Care Unit
Authors: Dady Karen F , Rugg Sue
Published: April 2015

This article describes the elements of a qualitative cross-sectional study which explored the relationship between the expectations and the experience of 20 individuals with regard to their stay on an elderly care unit. The study data were gathered using semi-structured interviews and analysed using content analysis techniques.

The participants were found to hold a variety of expectations about the tangible and conceptual elements of their experience. Their comments focused primarily on the outcomes experienced rather than on the processes occurring. Their expectations appeared to change in conjunction with both time and experience, with common themes emerging.

The study concluded that the participants' expectations were formed on hunches and/or previous information. They described their situation largely in terms of a mismatch between their expected and actual experience or with regard to unexpected situations. The results suggested that the unit concerned might usefully provide additional information to those admitted. They also raised some broader issues of potential interest to occupational therapists as a whole.
Advantages and Disadvantages of the Home Setting for Therapy: Views of Patients and Therapists
Authors: Stephenson Sue , Wiles Rose
Published: April 2015

A qualitative study was undertaken to explore patients' views and perceptions of a home-delivered therapy service. Fifteen subjects with hemiplegia were recruited from one health district, 10 women and 5 men. All subjects had experienced at least three consecutive sessions of both home-delivered therapy and hospital-based therapy in the preceding 18 months. A semi-structured interview was undertaken with each subject. Transcribed data were analysed using the grounded theory approach (Glaser and Strauss 1967). Five main themes were identified: ‘Convenience’, ‘Therapeutic environment’, ‘Social contact’, ‘Control’ and ‘Grateful recipient?’ Two discussion groups were held with six therapists after the data collection phase to explore their perceptions of the themes emerging from the interviews.

The subjects identified convenience and being comfortable within the home as two significant advantages of home therapy. The therapists highlighted the greater relevancy of the home environment for intervention and goal setting. The disadvantages identified by the subjects included the lack of equipment and floor space and the demotivating effect of the home setting. The therapists identified the difficulty of determining control within a therapy session.

The study demonstrated that the assumptions about the advantages and disadvantages of community-based rehabilitation services made by service providers are not necessarily experienced by the users of such services.
Rehabilitation Programmes for Early Psychosis
Authors: Lloyd Chris , Bassett Jo , Samra Pam
Published: April 2015

Early psychosis is a relatively new area of practice in the field of mental health. Early intervention for people with psychosis is increasingly being recognised as a crucial component of quality care. Rehabilitation interventions in early psychosis assist in promoting recovery and involvement in community life, reduce the development of disability and facilitate the achievement of personal goals. The development of models of care and best practice in early psychosis intervention has been promoted by the Commonwealth of Australia. This paper describes a model of care and best practice in early psychosis intervention — the Early Psychosis Programme — which has been implemented in an integrated mental health service.
Adapted Technology for People with Special Needs: The Case of Smart Cards and Terminals
Authors: van Schaik Paul
Published: April 2015

Adapted technology, in particular smart cards and terminals, can help people with special needs, such as those with physical disabilities, in the information age to carry out common activities independently. This paper illustrates the possibilities of the technology with results from the SATURN (Smart Cards And Terminals Usability Requirements and Needs) project. Economically viable smart card technology can now provide a range of adaptations to accommodate the requirements of this population. The practicability of this technology is illustrated with case studies. When implementing the technology, the selection of appropriate adaptations by occupational therapists and other professionals will be paramount. Forces towards implementation can lead to wider availability of the technology in the near future in order to enhance the quality of life for people with special needs.
Using Programme Logic Models in Evaluation: A Review of the Literature and the Spinal Outreach Team Experience
Authors: Cox Ruth J
Published: April 2015

The evaluation of intervention is becoming increasingly important in occupational therapy practice and management. Programme logic models aim to assist evaluation by linking programme interventions with intended outcomes. These models include a hierarchy of programme inputs, processes, outputs, outcomes and impacts.

This article reviews the literature regarding programme logic models and uses a case example, the Spinal Outreach Team, to illustrate the utility and limitations of this approach to evaluation. A figure is included which illustrates part of the programme logic model developed for the team. It is concluded that use of a programme logic process by occupational therapists facilitates the development of comprehensive evaluation plans and relevant performance indicators.
Occupational Science and Community Mental Health: Using Occupational Risk Factors as a Framework for Exploring Chronicity
Authors: Fieldhouse Jon
Published: April 2015

This article offers an overview of Wilcock's theories, from the field of occupational science, and relates them to the community care of people with severe mental health problems. Wilcock's occupational risk factors — imbalance, deprivation and alienation — are described and are seen to be reinforced both by the adaptive nature of this client group's problems and by the difficulties experienced by community-based services as they evolve to address the unfolding complexity of clients' needs. The potential for chronicity to be compounded and deepened in this way is highlighted, with particular reference to vocational and social disability, and the possible implications of a wider acknowledgement of occupational risk factors are discussed in relation to day-to-day practice and service configuration.
Designing the Home Falls and Accidents Screening Tool (HOME FAST): Selecting the Items
Authors: Mackenzie Lynette , Byles Julie , Higginbotham Nick
Published: April 2015

The Home Falls and Accidents Screening Tool (HOME FAST) was developed as a screening instrument for use in a community preventive care trial for older people. This paper describes the first stage of the development of this screening tool. The objectives of the study were (i) to review existing home safety measures, (ii) to field test an instrument containing a pool of home safety items with the goal of identifying those hazards associated with falls in the home and (iii) to select the items for inclusion in a 25-item tool using an expert panel.

The field testing took place in a rural area of Australia, where the pooled checklist was used to evaluate hazards within the homes of 83 older people. No individual hazards were associated with the risk of falls at home and, although participants who had experienced falls had a higher mean number of home hazards (mean = 13.7, SD 8.2), the differences between fallers and non-fallers was not significant. Items relevant to a rural population were indicated through field testing. Further psychometric testing of the HOME FAST and a meaningful method of scoring the checklist are now warranted.
Empowered or Discouraged? A Study of People with Learning Disabilities and their Experience of Engaging in Intimate Relationships
Authors: White Emily , Barnitt Rosemary
Published: April 2015

Vulnerable people constitute the majority of referrals to occupational therapy services, due to age and social, psychological and economic circumstances. People with learning disabilities may fit all these categories. An argument has been put that vulnerable people should not be subjects in research (de Raeve 1994) and that there may be unacceptable risks in being a subject in a socially sensitive research project (Barnitt and Partridge 1999). However, avoiding research with people with learning disabilities would mean that the voice of these clients would not be heard and it is known that they have expressed the wish to be consulted and involved in research (Atkinson 1989).

A collaborative study was carried out with eight adults with learning disabilities who lived in a community residential home. Interviews were completed which dealt with aspects of intimate relationships. Three themes emerged from the interviews: the experience of intimate relationships, the future of a current relationship and the involvement of others in relationships. The findings showed that the people interviewed had a generally positive experience of such relationships. However, while the attitudes of staff and family towards intimate relationships were mostly empowering, some negative views still existed. The results have implications for occupational therapists working with people with learning disabilities.
Client-Centred Practice: Is it Compatible with Early Discharge Hospital-at-Home Policies?
Authors: Lane Linda
Published: April 2015

Current Government initiatives promote the provision of health care in the community rather than in medical institutions. Over the last decade there has been a growth in the number of early discharge hospital-at-home initiatives which provide a level of nursing and rehabilitation care in the home that previously would have been provided in an acute hospital. Simultaneously, there has been a move away from medical to client-centred models of health care delivery. These new client-centred models of health care emphasise collaboration between client and professional and encourage users of health care services to take greater control over and responsibility for their health care. Some occupational therapists may question whether the principles of client-centred care are compatible with the policy of discharging patients early from hospital while they remain in need of health care.

This paper briefly reviews some of the principles of the Canadian Model of Occupational Performance; discusses some of the barriers to providing client-centred services in the early discharge hospital-at-home setting; and reflects upon whether the principles of client-centredness are consistent with early discharge from hospital policies.
Educating Occupational Therapists for Mental Health Practice
Authors: Craik Christine , Austin Chris
Published: April 2015

The last of four elements of the Mental Health Project, established by the College of Occupational Therapists to produce a position paper on the way ahead for research, education and practice in occupational therapy in mental health (Craik et al 1998a), focused on educating occupational therapy students to work in mental health.

First, the views of practitioners about their pre-registration education were derived from one component of the practitioners' survey (Craik et al 1998b). One hundred and eleven (81%) practitioners considered that their pre-registration education had been sufficient or partially sufficient to meet their needs on first working in mental health.

Secondly, the views of occupational therapy educators were elicited by a short qualitative survey that replicated three questions about future issues in mental health, which had formed a key constituent of both the practitioners' survey (Craik et al 1998b) and the managers' survey (Craik et al 1999). Important issues for educators were focusing on clients who would benefit most from occupational therapy in community and primary care settings, preparing undergraduates for the unique approach of occupational therapy and the need for more research to support evidence-based practice. Both groups highlighted the value of positive fieldwork placements.
The Casson Memorial Lecture 2000: Reflect on the Past to Shape the Future
Authors: Mayers Christine A
Published: April 2015

The Casson Memorial Lecture 2000, given on 21 July at the 24th Annual Conference of the College of Occupational Therapists, held at the University of Keele.
Fitness for Purpose of Occupational Therapy Graduates: Two Different Perspectives
Authors: Barnitt Rosemary , Salmond Rosemary
Published: April 2015

A research study that looked at fitness for purpose of 312 occupational therapy and physiotherapy graduates was carried out between 1996 and 1999. The research was commissioned by the Department of Health and managed jointly by the Universities of East Anglia and Southampton. A particular emphasis of the research was the influence of joint undergraduate education on the performance of graduates in first post. A full report of the research can be found in Wiles et al (1999).

Recommendations arising from the research report led to debate with service managers about the meaning of the results and thus the conclusions drawn. This paper was therefore prepared to explore the different perceptions of an educator and a service manager with regard to three themes arising from the research. These were the selection of students for occupational therapy education, the expectations of new graduates about their first post and the transition from student to therapist.
Home-Based Occupational Therapy: Stroke Patients' Satisfaction with Occupational Performance and Service Provision
Authors: Gilbertson Louise , Langhorne Peter
Published: April 2015

This study evaluated a short post-discharge home-based occupational therapy service for stroke patients, including an assessment of the patients' satisfaction with occupational performance and service provision.

A single-site, blind randomised controlled trial was conducted. One hundred and thirty-eight patients were randomly allocated to either a conventional outpatient follow-up or conventional services plus 6 weeks of home-based occupational therapy. The data were collected before discharge and at 7 weeks and 6 months after discharge using the Canadian Occupational Performance Measure (COPM), the Dartmouth COOP Charts, the London Handicap Scale and a patient satisfaction questionnaire.

At 7 weeks the intervention group reported significantly greater changes in performance and satisfaction on the COPM, better emotional scores (Dartmouth COOP Charts) and improved work and leisure activity scores (London Handicap Scale). No other differences in subjective health status were described. By 6 months, the intervention group was more satisfied with several aspects of service provision but no other differences in subjective health experience were reported.

A 6-week post-discharge home-based occupational therapy service can improve patients' perceptions of their occupational performance and satisfaction with services but may not have a long-term effect on subjective health outcomes.
The Utility of the Modified Barthel Index for Traumatic Brain Injury Rehabilitation and Prognosis
Authors: Shah Surya , Muncer Steven , Griffin Jenelle , Elliott Leesa
Published: April 2015

The aim of this correlational study was to examine the utility of the Modified Barthel Index (MBI) in measuring functional outcome and in determining its predictive ability at the commencement of rehabilitation. All 79 patients with a traumatic brain injury admitted in 12 months were the participants in the study. Functional status, as measured by the MBI total scores on admission to and discharge from comprehensive rehabilitation, and all available independent variables on admission were extracted.

The study found that 85% of admissions were male. The participants' mean age was 28 ± 10.67 years, 73% of them were single and 97% had a diagnosis of closed traumatic brain injury confirmed by a CAT scan. Their rehabilitation stay was 61 ± 65 days. The admission MBI scores were 75 ± 30 and the discharge scores were 93 ± 29. In a stepwise regression, initial deficit as measured by the MBI, delay in commencing rehabilitation and age contributed to explaining 68% of variance. However, when the MBI scores were transformed, the fourth root of the admission score alone explained 84% of variance. This predictive ability is far superior to the findings of many other studies.
Multicentre Trials: Planning and Achieving TOTAL
Authors: Drummond A E R , Parker C J
Published: April 2015

This article provides an overview for those conducting multicentre rehabilitation trials. It aims to highlight potential problems and difficulties which may not be obvious initially.

TOTAL (Trial of Occupational Therapy and Leisure) was a multicentre rehabilitation trial. The aim was to test whether a leisure-based intervention was more effective than activities of daily living (ADL) based therapy at improving the mood, leisure participation and independence in ADL of stroke patients. During the study period, 466 patients were recruited from five centres in the United Kingdom. Postal assessments were sent out at 6 and 12 months after discharge to evaluate mood, leisure independence and ADL performance.

The possible difficulties in recruiting centres are presented. The problems encountered were staff shortages, insufficient numbers of patients, concern over aspects of the protocol and funding issues. Day-to-day problems in running the trial and how these may be resolved are also discussed, such as access to the trial coordinator, finance, the need for written agreements and regular communication with each centre.

While the complexity of conducting a multicentre trial should not be underestimated, preparation, good planning and an awareness of potential problems makes it a feasible proposition.
An Investigation into the Use of the Assessment of Motor and Process Skills (AMPS) in Clinical Practice
Authors: Chard Gill
Published: April 2015

This study aimed to investigate how occupational therapists used the Assessment of Motor and Process Skills (AMPS) in their clinical practice following an AMPS training course. Questionnaires and group interviews were used over a 9-month period to follow up 53 occupational therapists and establish how they were using the AMPS in their workplace. It explored the difficulties that they experienced in implementing the AMPS in their clinical practice and using the AMPS with their client group and within their clinical team.

The results showed that 96% of the occupational therapists were using the AMPS in their clinical practice at 5 months following training and 83% were still using it at 9 months. The difficulties experienced included problems associated with low staffing levels, high workloads or lack of time to introduce new work skills. Success was dependent on a supportive working environment, especially from managers, and adequate time available to allow for the development of a new skill. Occupational therapy managers need to support therapists following training to make the best use of the time and the cost involved in training individuals to use the AMPS.
To Serve Better: Addressing Poor Performance in Occupational Therapy
Authors: Bannigan Katrina
Published: April 2015

A health care professional is not always ‘the right person, doing the right thing, in the right way, in the right place, at the right time and with the right result’ (Mead, quoted in Potter 2000, p3). In some renowned cases, health care professionals' interventions have resulted in the deaths of patients. For this reason and others, such as unacceptable variation in practice, poor performance is one of the six aspects of clinical governance, which is an integrated quality framework (Sealey 1999). Clinical governance, although a National Health Service development, has implications for all occupational therapists, whatever setting they work in.

This discussion paper presents the concept of poor performance in the context of performance management, which is a mechanism for the early identification and the remedying of poor performance. Early recognition, feedback on performance, decisive intervention and effective self-regulation are the headings used to frame this discussion. The implications for occupational therapists nationally, locally and personally are also explored. The central theme is that identifying and dealing with poor performance is every occupational therapist's personal responsibility.
Falling from Grace or into Expert Hands? Alternative Accounts about Falling in Older People
Authors: Ballinger Claire , Payne Sheila
Published: April 2015

Falls in older people are a priority area for both research and clinical intervention in the United Kingdom. There is, however, currently an absence of research exploring the meaning and interpretation of a fall.

Semi-structured interviews were conducted with 20 therapists and with eight older people with fractured hips. The therapists' accounts appeared to draw on a ‘risk discourse’ which constructed a fall as a predictable and preventable event, highlighting individual patient characteristics as causative factors and suggesting that therapists were more knowledgeable about this subject. The accounts of the older inpatients, conversely, made use of a ‘moral discourse’, in which commendable personal qualities and competencies were emphasised.

It is suggested that this work has implications for therapy in that many falls prevention initiatives and health promotion materials may be falsely premised on an acceptance of vulnerability by older people.
A Physical Activity Intervention in a Community Alcohol Service
Authors: Ussher Michael , McCusker Monica , Morrow Valerie , Donaghy Marie
Published: April 2015

People recovering from alcohol-related or drug-related problems are often in poor physical condition and have an extremely sedentary lifestyle. This article describes a study in which an occupational therapist in a community alcohol service implemented a physical activity intervention. The aim of the intervention was for clients with substance misuse problems to increase independent physical activities, to engage more in community-based activities, to increase their awareness of the benefits of exercise and to perceive benefits in their health following the programme. Seven people attended a 6-week programme consisting of nine sessions. Each session included an exercise class and group-based physical activity counselling.

Case studies for five of the participants are presented. It was shown that it is possible for an intervention combining physical activity counselling with supervised and independent exercise to have an impact on the lives of a few individuals with substance misuse problems. Four of the five participants made substantial gains in all the target areas relating to independence, integration, education and health. It was also shown that it is feasible for an occupational therapist to play a pivotal role in promoting fitness-oriented activities for those with substance misuse problems. Controlled studies are required with larger samples, longer follow-up periods and the comparison of different intervention elements.
Occupational Therapy in Community Mental Health Teams: A Continuing Dilemma? Role Theory Offers an Explanation
Authors: Hughes Julie
Published: April 2015

Occupational therapists working in community mental health teams (CMHTs) experience the difficulty of balancing the expectations of their profession with those of the team, their employers, the purchasers and the client group within the wider context of health care. This paper uses role theory as a framework to examine why occupational therapists may perceive threats to their professional identity and experience pressure to conform to the defined CMHT ‘role set’. It examines the concepts of role definition, role signs, role ambiguity, role incompatibility and role conflict and the resulting role stress.

Occupational therapists need to identify their role problems and either develop strategies to resolve them or suffer role strain. Conformity to the expectations of the role set may mean becoming less effective and less able to distinguish their role from that of the other members of the CMHT. This will have very real consequences for the future of occupational therapy within both CMHTs and the wider context of health care.
Safe Use of Disability Equipment and Manual Handling: Legal Aspects — Part 2, Manual Handling
Authors: Mandelstam Michael
Published: April 2015

Part 1 of this article dealt with disability equipment. Part 2 deals with the law of manual handling and its practical implications for occupational therapists and their patients, clients and colleagues. It does so by considering the Manual Handling Operations Regulations 1992 themselves together with associated guidance, complementary health and safety at work legislation, the common law of negligence and a substantial body of case law handed down from the courts. In particular, it covers legal terms such as reasonable practicability, risk assessments and resource implications, emergency or exceptional situations, and balancing the health and safety of staff with the needs and wishes of patients and clients.

It is concluded that an awareness of manual handling law is likely to facilitate better understanding and organisation of responsibilities, policies, procedures and practices. In turn, this will benefit staff, patients and clients by raising standards of decision making, and is likely to increase safety, reduce potential legal liability and save time and money.
Leisure Activities in Rheumatoid Arthritis: Change after Disease Onset and Associated Factors
Authors: Wikström Ingegerd , Isacsson Åke , Jacobsson Lennart T H
Published: April 2015

The objective of this investigation was to examine the relationship between leisure-time occupations, quality of life and disease activity among patients with rheumatoid arthritis. Fifty patients with rheumatoid arthritis ± 39 females and 11 males, aged 30–45 years and belonging to functional class I-III according to Steinbrocker et al (1949) ± were recruited from the register at a hospital clinic and from a private outpatient clinic. The participants completed a questionnaire concerning education, occupation, pain, morning stiffness, current leisure activities and those pursued before the onset of the disease, and including the Quality of Life Scale (QoLS).

The patients had given up two-thirds of their leisure activities since the onset of the disease. This decrease was observed for both sexes. It correlated positively with present disease activity, measured as pain on a visual analogue scale and as morning stiffness, and negatively with the present QoLS. Longitudinal studies are needed to disentangle further the causes and consequences of loss of leisure activities in rheumatoid arthritis patients.
A Comparison of Self-Report versus Observation of Performance Using the Assessment of Living Skills and Resources (ALSAR) with an Older Population
Authors: Hilton Kate , Fricke Janet , Unsworth Carolyn
Published: April 2015

This study assessed the capacity of 15 older people to report their instrumental activities of daily living (IADL) function accurately. The Assessment of Living Skills and Resources (ALSAR) (Williams et al 1991) was used to measure IADL function in the clinical and home environments. The subject's self-reported function was also compared with performance-based measurement of three IADL tasks from the ALSAR (use of the telephone, meal preparation and medication management) in the subject's home environment. The sensitivity of the ALSAR 3-point scale was examined through comparison with the Medical Rehabilitation Follow Along scale (Granger et al 1995).

The findings highlighted problems associated with the use of self-reporting for the assessment of IADL in the older population. The ALSAR 3-point scale was shown to be sufficiently sensitive to detect IADL function when used with performance observation; however, further research is required to ascertain sensitivity when it is used as a self-report tool.

The findings suggest that occupational therapists attain more accurate results when carrying out IADL assessment procedures by using performance-based measures.
Support Groups for People Who Have Experienced Psychosis
Authors: Hyde Paula
Published: April 2015

Support groups are not usually provided for people who have experienced psychosis. Ten clients who had been admitted to hospital following a psychotic episode were invited to take part in a support group session each week for 10 weeks. This study aimed to examine the participants' experience of this type of intervention by using observation and interview. Qualitative research techniques were used and the information was gathered by in-depth interviews with clients and by the writing of fieldwork notes about the group and the post-group peer supervision. The transcribed interviews and fieldwork notes were subjected to content analysis where emerging themes were identified and the findings were confirmed by respondent validation.

The findings suggested that this type of therapy enabled the members of the group to offer support to each other and to help with reality testing. They were able to mitigate, to some extent, the damaging effect of being diagnosed ‘psychotic’ by validating the experience in a personal sense. The group members shared coping strategies and, in some cases, were able to shift away from using non-coping strategies. They were therefore able to take a more active part in their own treatment.

The occupational therapists found the experience to be positive in terms of their own professional development: it improved their listening skills and encouraged their use of reflection to evaluate their own contribution. They also felt that the availability to them of immediate post-group peer supervision was beneficial. This support seemed to be reflected back into the group experience for the clients. This type of support group was found to be appropriate where clients had been admitted to hospital and were preparing for discharge.
Applying Research Evidence to Practice
Authors: Roberts Anne E K , Barber Graeme
Published: April 2015

One of the important factors in the process of clinical governance is the use of research evidence to inform practice. However, it is not enough to search for and appraise research evidence. Once the information has been appraised, it may be necessary to change practice in order to implement the knowledge.

This paper considers the responsibility of occupational therapists to address this change. It is widely accepted that it is notoriously difficult to bring about change in established professional practice. Strategies to help to effect change in practice are discussed and recent research regarding the most effective strategies is considered. The value of combined strategies, including continuing education, clinical guidelines and opinion leaders, is addressed.
Supervision in Occupational Therapy, Part 1: The Supervisor's Anxieties
Authors: Sweeney Grace , Webley Paul , Treacher Andy
Published: April 2015

Supervision, as a research field, has received a considerable amount of attention within counselling psychology, social work and psychotherapy. Although there is no lack of theoretical writings on supervision within these disciplines, the theories themselves have provided little guidance for continuing research and practice. This has resulted in confusion concerning the purpose of supervision, its distinctiveness from other similar activities, the role and function of the respective participants in the process, and the tasks and methods to be employed.

This paper, the first of three on the experience of supervision in occupational therapy, describes a grounded theory study which set out to investigate the processes underlying supervision in the discipline of occupational therapy from the perspective of the supervisor. The data were collected by interviewing 30 occupational therapy supervisors in the South West of England. The results suggest that supervision is frequently experienced as an uncomfortable and relatively unproductive process within this occupational group. In addition, the data lend support to the possible existence of an egalitarian relationship which operates between supervisor and supervisee, with associated payoffs and risks for each participant in the relationship.

A second paper reporting the supervisee's perspective will be published as part 2, together with recommendations for future practice in part 3.
Assessing Fieldwork Journals: Developmental Portfolios
Authors: Buchanan Helen , van Niekerk Lana , Moore Rob
Published: April 2015

Interactive journals in the form of fieldwork logs and learners' logs were introduced into the fieldwork curriculum of the 4-year undergraduate occupational therapy programme at the University of Cape Town, South Africa. The aim was to promote critical reflection and clinical reasoning. The challenge then lay in assessing these journals to evaluate student performance, while also providing a vehicle for promoting professional understanding. This article describes the development of portfolios as an approach to assessing student journals, together with the evaluation criteria that were developed and the educational rationale underpinning this design.
Occupational Therapy in Mental Health: Managing Stress and Burnout
Authors: Bassett Hazel , Lloyd Chris
Published: April 2015

Stress and burnout for human service workers has received increasing attention over a number of years. It has been suggested that health care professionals may be particularly at risk of stress and burnout because of the amount and type of direct client contact that makes up their work.

For workers in the field of mental health, additional stressors are present owing to organisational restructuring and new models of care. Mental health occupational therapists may be vulnerable to stress and burnout owing to the nature of their work, the types of client they see, the changed work environment and professional issues. It is recommended that occupational therapists become aware of the factors contributing to stress and burnout and develop strategies to maintain their wellbeing in the workforce.
Occupational Therapists' Perspectives of the Needs of Women in Medium Secure Units
Authors: Baker Sonia , McKay Elizabeth A
Published: April 2015

The Department of Health and Home Office (1992) formally acknowledged women in forensic provision as being a vulnerable group, with neglected needs in terms of care and treatment. It also clearly identified a role for occupational therapy in meeting these needs through involvement in multi-agency cooperation. The aim of this investigation was to ascertain if, from an occupational therapy perspective, the needs of women in medium secure care were being met.

A postal questionnaire was administered to 62 therapists working in medium secure provision in England, with a response rate of 73%. The data generated identified occupational therapists' perceptions of female client needs and the intervention available to women in medium secure care and provided a snapshot of therapists' views in relation to current issues in secure care.

The findings demonstrated that occupational therapists working in medium secure care had a good understanding of female client needs and tailored their intervention to be as gender-sensitive as possible within the limitations imposed by the environment. The study also highlighted the requirement for further research to investigate the needs of women in forensic environments from their own perspectives.
Dressing Ability after Stroke: A Review of the Literature
Authors: Walker C M , Walker M F
Published: April 2015

Despite regular occupational therapy, many stroke patients remain dependent for dressing. The latter half of the 20th century has witnessed considerable debate in the literature as to the underlying deficits that influence a person's ability to relearn to dress. This paper critiques the relationship between cognitive and physical skills and recovery in dressing. The implications for occupational therapy are discussed.
The World Wide Web as a Patient Education Resource for Occupational Therapy Personnel
Authors: Sharry Renee , McKenna Kryss
Published: April 2015

Occupational therapists educate patients and clients to equip them to become active participants in their own care and to provide them with specific knowledge, skills and training. To make informed decisions about their health and wellbeing, patients need high quality information. The World Wide Web is growing as a source of health information. For this information source to be effective, its content must be accurate and the way it is written must be appropriate to facilitate patients' understanding.

The aim of this paper is to raise awareness of the World Wide Web as a resource for occupational therapists when educating patients. It reviews the literature regarding the benefits and potential pitfalls of using the World Wide Web for patient education and outlines some guidelines that will help occupational therapists, students and support workers to provide patients with or direct them to sources of reliable web-based health information.
Perspectives on Widening University Access: Critical Voices of Newly Qualified Therapists
Authors: Ryan Susan
Published: April 2015

Widening university access became a priority in the 1990s. Arguments in favour of this proposition have included: increasing the percentage of the population in the higher education sector; extending university opportunities to those not normally deemed eligible; and providing avenues for those wishing to change careers. Many falling into these categories were mature-aged people from varied backgrounds. Few studies have addressed the actual experiences of those mature-aged students as they have entered the higher education sector for the first time in access courses and then, subsequently, their eventual qualifying route.

This qualitative study listened to the voices of these newly qualified therapists. In telling their educational and practice stories in a multiple layer methodology, their varied experiences provided critical incidents. These gave insights into the way that they felt, the way that they perceived they were treated, some actual experiences with staff and colleagues and, finally, the way that they felt on successfully completing their chosen programme. Their reflections were both analysed and interpreted by the method of analysis of narratives (Polkinghorne 1995). The powerful stories and incidents that arose convey lessons for all those working in the higher education sector, whether they be vocational counsellors, access staff or lecturers in professional qualifying programmes.
Self-Evaluation and Occupational Therapy Fieldwork Educators: Do they Practise what they Preach?
Authors: Reid Alistair , McKay Vincent J
Published: April 2015

In the current climate of lifelong learning and continuing professional development, the importance of self-evaluation is discussed. A cross-sectional survey was carried out to identify the strategies used by fieldwork educators to evaluate their own supervisory skills. It further examined the fieldwork educators' attitude towards, and understanding of, self-evaluation.

One hundred self-administered questionnaires were posted to a random sample of Glasgow Caledonian University fieldwork educators. A response rate of 74.5% was obtained. The respondents claimed to use a wide range of self-evaluation techniques, with the majority using between three and five strategies. While the respondents were found, overall, to view self-evaluation positively, only 55.2% of them appeared to understand this concept fully. Statistical analysis of association indicated that those respondents who understood self-evaluation were more likely to have a positive attitude towards it than those who did not fully understand this concept.

It is recommended that future fieldwork education update courses should focus on informing fieldwork educators about the concept of self-evaluation and reinforcing its benefits. Fieldwork educators should be encouraged to continue to use self-evaluation and be made aware of the advantages of using a variety of strategies.

Conclusion

The respondents in this study supported self-evaluation and used a range of strategies to evaluate their own abilities as fieldwork educators. While 44.8% of the respondents lacked a full understanding of self-evaluation, overall the respondents had a positive attitude towards it.

More research is needed to confirm and expand on the results of this study. It is recommended that this study be replicated with a larger sample from a cross-section of universities. The chi-square tests of association carried out found the expected frequencies to be quite low in some cases. Had the sample been larger, these tests could, perhaps, have been put to more use. Further studies should also concentrate on fieldwork educators' understanding of other concepts taught to and used by students on placement, and on the relationship between the visiting lecturer and the fieldwork educators.
A Pilot Study of the Physiological and Behavioural Effects of Snoezelen in Dementia
Authors: van Diepen Erik , Baillon Sarah F , Redman Julie , Rooke Nan , Spencer David A , Prettyman Richard
Published: April 2015

Recent interest in the use of Snoezelen as an intervention for agitated behaviour in patients with dementia remains supported by limited evidence of efficacy. This pilot study aimed to develop an approach for assessing the effects of Snoezelen on agitated behaviour in patients with dementia and its comparability with an existing control intervention. Ten patients with dementia were randomised to receive a 4-week course of either Snoezelen or reminiscence therapy. The therapeutic effects were assessed using the Agitation Behaviour Mapping Instrument (ABMI) and the Cohen-Mansfield Agitation Inventory (CMAI) and by heart rate recording.

Differences in dementia severity between the two groups hindered direct comparison of outcomes. Both interventions were well tolerated and the majority of both Snoezelen and reminiscence sessions were rated positively. The ABMI ratings suggested that Snoezelen might have reduced agitated behaviour during and immediately after the session but that this effect was short-lived. The CMAI scores indicated reduced agitated behaviour during the intervention period. Heart rate data showed both decreases and increases during the sessions for different participants.

With minor modifications, the measures used will be appropriate for a full-scale comparative trial. Both interventions may have helpful short-term effects and while for some patients the sessions are primarily relaxing, for others they may have a more stimulating effect.
Standardised Tests: An Appropriate Way to Measure the Outcome of Paediatric Occupational Therapy?
Authors: Payne Sally
Published: April 2015

The advent of clinical governance has refocused clinicians on the need to use evidence-based practice, one aspect of which is the identification and measurement of intervention outcomes. Paediatric occupational therapists have traditionally used a variety of standardised tests in their practice and these are often cited as the means by which treatment outcomes are evaluated. However, the tests most frequently used may not be the most appropriate measures of the outcome of occupational therapy.

This paper explores some of the issues surrounding outcome measurement in the field of paediatrics and highlights aspects of outcome measurement requiring further clinical and research consideration. It is suggested that there is a need to develop a conceptual framework for outcome evaluation which is both consistent with the occupational focus of practice and uses outcome tools that are objective, useful and appropriate.