bluuebunny/crossref_metadata_2025 huggingface dataset:
Chinese Culture and Occupational Therapy
Authors: Jang Yuh
Published: April 2015

A study of the relationship between Chinese culture and occupational therapy is presented in this paper. Based on a literature review and direct observations and analysis by the author, it was found that Chinese culture and occupational therapy share common thinking on the concept of the use of activity, the concept of balance and harmony, the environmental influences in treatment and evaluation, intrinsic motivation and meaningful existence.

The major difference between Chinese culture and occupational therapy is the perception of the role of the sick person. In the Chinese society, the role of the patient is dependent and passive, but occupational therapy believes that the patient should be independent and actively participate in the therapy. The implications of these aspects for clinical practice are also described.

This article is reprinted from the Journal of the Occupational Therapy Association of the Republic of China, 1993, Volume 11, pp 95–104, by kind permission of the author and the Journal.
The Social Contact Group: An Example of Long-Term Group Work in Community Mental Health Care
Authors: Bryant Wendy
Published: April 2015

Social contact groups offer support and social activities to long-term users of community mental health services. In this study, seven groups in Surrey were compared with 10 groups elsewhere, using information supplied by group leaders. From this comparison, those features that characterise social contact groups have been identified. In addition, those individuals attending the groups in Surrey were invited to identify the benefits of membership. Their positive response indicated the success of these groups in meeting their need for social contact and suggests that this approach should be considered by those developing day services for people with long-term needs. Occupational therapists, with their expertise in analysing and coordinating activities, have a major role to play in organising these groups in conjunction with other mental health workers.
Clinical Reasoning through Story Telling: Examining a Student's Case Story on a Fieldwork Placement
Authors: McKay Elizabeth Anne , Ryan Susan
Published: April 2015

This article considers narrative (story telling) as the way In which human experience Is made meaningful. Narrative reasoning has been Identified as a means of enabling occupational therapists to explain their practice. A review of the literature Includes the concepts of the professional artist, narrative reasoning, expert and novice practitioners, and experiential learning and reflection.

A single case study looked at the use of narrative reasoning by a second year occupational therapy student (novice) on a fieldwork placement and an experienced therapist (expert) who was supervising her. During the routine fieldwork visit of the academic staff member to the student, both novice and expert were asked to tell their story about one particular client with whom they were working. The findings highlighted the fact that the expert and the novice told different narrative stories but that, by asking probing and reflective questions, the student's story could be enhanced to Include more narrative. This study has Implications for the education of students in both university and the fieldwork setting.
Teaching IT in OT: An Introduction to Therapeutic Uses
Authors: Mogey Nora
Published: April 2015

Teaching administrative and therapeutic aspects of information technology (IT) in an Increasingly crowded curriculum demands an innovative approach to teaching and learning in order to maintain sound educational practices. At Glasgow Caledonian University, the students use an authoring system to create a simple piece of software, appropriate to a therapeutic environment, it is argued that this very practical exercise maximises the students' awareness of the therapeutic potential of IT and develops practical, transferable IT skills.
Minority Ethnic Groups and Occupational Therapy, Part 2: Transcultural Occupational Therapy, a Curriculum for Today's Therapist
Authors: MacDonald Ruth , Rowe Nick
Published: April 2015

This article is the second of two contributions looking at the under-representation of people from the United Kingdom's minority ethnic groups in the occupational therapy profession. These articles suggest three broad areas that should concern occupational therapy practitioners and educators; the recruitment of people from minority ethnic groups to the profession; the admission process to occupational therapy education and training courses; and the curriculum and ethos of those courses. Part 2 deals with the last concern, that of the curriculum, as part 1 addressed the Issues of recruitment and admission. The authors strongly advocate that these three Issues cannot be treated in isolation but must be dealt with simultaneously.
Trends in Hand Grip Strength in Some Adult Male Zimbabweans
Authors: Amosun Seyi-Ladele , Moyo Alice , Matara Carmelo
Published: April 2015

The Department of Occupational Health and Safety at Work, of the Ministry of Labour, Manpower Planning and Social Welfare in Zimbabwe, has consistently reported an appreciable number of occupational injuries involving the hand. In the central hospitals, routine hand assessment includes range of movement, sensory and muscle strength tests, as well as hand grip strength tests. Differences had been observed in the hand grip measurements obtained when compared with norms developed by Kellor et al (1971). The aim of this study was, therefore, to assess the trend in the grip strength of a sample of adult male Zimbabweans.

Hand grip strength measures for the right and left hands of 204 male Zimbabweans, aged 18–56 years, were taken using a Jamar® dynamometer. The relationship between these grip strength measures and age, height, weight and body mass index was assessed. Grip strength percentage difference between dominant and nondomlnant hands did not obey the 10% rule, which assumes that the dominant hand can be up to 10% stronger than the nondominant hand. Grip strength was negatively related to age but positively related to body weight and height. The need for additional studies to establish normative data for grip strength measurements for use in the clinical situation is Indicated.
Outcomes of a Rehabilitation Programme for Patients with Chronic Back Pain
Authors: Moran Monica , Strong Jenny
Published: April 2015

In order to evaluate the effectiveness of a rehabilitation programme for patients with chronic back pain, data on the subjective outcomes of perceived pain intensity (as measured by the Visual Analogue Scale Horizontal) and perceived level of disability (as measured by the Oswestry Low Back Pain Disability Questionnaire), and the objective outcome of functional capacity (as measured by the West Standardised Evaluation), were collected on 51 subjects prior to entry into a back pain rehabilitation programme and at discharge.

The results at discharge showed a significant reduction in the perceived level of disability and a significant Increase in the functional capacity. The perceived pain intensity did not change significantly. The discussion focuses on the importance of directing therapeutic interventions towards increasing physical function rather than concentrating on the reduction or elimination of pain.
Work and Work Programmes for Clients with Mental Health Problems
Authors: Oxley Celia
Published: April 2015

Work may be defined in a number of ways and cover a variety of activities. As well as paid work, it can cover such activities as hobbies, housework, voluntary work and do-it-yourself. It is an important factor in promoting mental health. Meaningful work may actually reduce a client's psychiatric symptoms. A work rehabilitation programme needs to cater not only for those able to progress to open employment but also for those needing supported or sheltered employment. Consequently, the programme should Include a thorough work skills assessment, work adjustment and work skills training, sheltered employment and transitional/supported employment leading, finally, for those who are able, to open employment.
The Eye of the Beholder: Models in Occupational Therapy
Authors: Kortman Brenton
Published: April 2015

Over the past decade, there has been an increasing focus in the occupational therapy literature on theory and theoretical frameworks. This paper explores the confusion that surrounds some of the terminology used in this literature. The disparity between different theorists' use of terms such as model, paradigm, frame of reference and approach is highlighted. An analysis of major occupational therapy texts and articles on theoretical frameworks from 1962 to 1992 revealed four types of occupational therapy model. The author suggests that attempts by theorists to define terms have been as much an attempt to describe these models as to clarify terminology. A hierarchy of these models is proposed and the individual's role in interpreting and filtering models is also considered.

This article is reprinted from the Australian Occupational Therapy Journal (1994) 41, 115–122, by kind permission of the author and of Blackwell Scientific Pty. Ltd.
Occupational Therapy: A Critical Overview, Part 2
Authors: Mocellin George
Published: April 2015

Part 2 of this article continues the evaluation of philosophical concepts that began in part 1. It concludes by suggesting that the foundation of the profession does not rest on the dictum ‘health through occupation’ but on the field related to the learning and teaching of skills, and stresses the importance and potential that this field has for the future viability of occupational therapy. In this context, the need for recognising the distinction that exists between the inherent competence of Individuals, as closed systems, and their observable behaviour as they openly interact with the environment is emphasised.
Responses of the Occupational Therapy Profession to the Perspective of the Disability Movement, Part 1
Authors: Craddock Judith
Published: April 2015

Since the 1960s, people with disabilities have been developing their own perspective on what it means to be disabled. At the vanguard of this development was the independent living movement which, with other organisations of disabled people, identified disabled people as a group experiencing a particular oppression, disabled by social processes and handicapped by society's lack of commitment to the creation of enabling environments.

Part 1 of this article examines the genesis and development of the disability movement. The ideas and analysis that the disability movement has generated and its critique of the medical model of disability are outlined, and its impact — both ideological and legislative — is reviewed. The changing professional philosophy of occupational therapy is described and the impact on it of changing social values is assessed.

Part 2 will review the explicit responses of the occupational therapy profession to the disability movement. The validity of the social model of disability for occupational therapy interventions will be considered and an analysis will be presented of the implications for the profession's philosophy and practice of the adoption of the social model of disability in appropriate areas of practice.
Adapting for Community Care, Part 1
Authors: Adams Jo
Published: April 2015

This article examines the provision and funding of home adaptations for people with physical disabilities. Part 1 looks at the following components of home adaptations: the implementation of local housing and social legislation; the effect housing tenure has on the ease of obtaining adaptations; and the involvement of a variety of agencies in the adaptation process.

The findings are based on questionnaires and informal interviews of local authority housing departments, community occupational therapists and Disabled Facilities Grant applicants. The article concludes that people with disabilities receive an adaptation service which is skewed according to housing tenure and affected by the variation in local interpretation and implementation of social legislation.
Planning Occupational Therapy Services in Kuwait
Authors: Busuttil Joseph
Published: April 2015

The number of countries that are evaluating their rehabilitation programmes and, in the process, seeking to introduce or expand occupational therapy services is on the Increase. Kuwait is one of them and, under the auspices of the World Health Organisation, consultancy reports on occupational therapy in the mental health field have been commissioned. This article Is based on the experiences of two visits to Kuwait In the last quarter of 1994.
Making a Cup of Tea as an Honours Degree Subject
Authors: Creek Jennifer
Published: April 2015

This article discusses some of the factors that make activity an effective and versatile treatment tool. It looks at the theories and techniques underpinning the use of activity as a therapeutic medium. It considers the challenge involved in teaching therapeutic activity to occupational therapy students. Finally, the article draws conclusions about the danger of teaching staff allowing themselves to focus on outcomes at the expense of process and of failing to teach the use of activity effectively to the occupational therapists of the future.
Contemporary Issues in Cardiac Rehabilitation: Implications for Occupational Therapists
Authors: Tooth Leigh , McKenna Kryss
Published: April 2015

Since the acceptance of the beneficial effects of early mobilisation for patients after myocardial infarction, cardiac rehabilitation has undergone dramatic change. Highly structured and inflexible exercise programmes have given way to flexible and comprehensive modern programmes, which embrace the use of education, counselling and risk factor modification principles. Contemporary skills required by occupational therapists include being able to adapt services to a vast array of cardiac conditions, foster risk factor modification, enhance compliance, tailor education to learning and coping styles, assess the patient's level of risk and need for rehabilitation, and provide accelerated and alternate programmes. This article discusses the principles, directions and benefits of modern cardiac rehabilitation and the implications for occupational therapists.
Clinical Reasoning, Part 2: Novice/Expert Differences
Authors: Robertson Linda J
Published: April 2015

In part 1, a model of problem solving in occupational therapy was presented; the problem-representation component of this has now been developed to depict the differences between student and clinician in problem representation. This new model illustrates that both students and clinicians have access to the same information but that this is more clearly defined and organised in the clinician. The abstract, unlinked data of the student are ultimately transformed by concrete experience to a rich supply of schemata, which then become the basis for further development of problem representations in a particular area of practice. Clinicians frequently weave a human perspective into their understanding of the client whereas students, although able to note the client's concerns, are more likely to treat this information as another piece of data than to integrate it into treatment planning. A number of educational strategies are discussed.
The Theory/Practice Divide: Bridging the Gap in Occupational Therapy
Authors: Steward Barbara
Published: April 2015

Recent research has highlighted students' and new practitioners' perceptions of a theory/practice divide. In reviewing the literature on types of knowledge and their use in different contexts, a number of possible explanations for the divide emerge concerning the relationship of theory to practice. The extent to which changing patterns of fieldwork practice and clinical reasoning strategies are bridging the divide is explored. This suggests that emancipatory knowledge is possible by these educational routes but has yet to fulfil its full potential because of historical, professional and institutional constraints.
Body Scheme Disorders following Stroke and Assessment in Occupational Therapy
Authors: Corbett Alexandra , Shah Surya
Published: April 2015

Disorders of neural body scheme are common perceptual sequelae following hemiplegia. Such disorders affect performance of voluntary movements and quality of functional performance adversely. This article provides a comprehensive definition of body scheme and explains its development, maintenance and newel basis. It further explains the distortions of body scheme and classifies the syndromes following hemiplegia, with implications for occupational therapy. Based on published evidence, the article discusses the strengths and limitations of various body scheme measurements and concludes with recommendations that, first, further studies are required to establish the validity of existing body scheme assessments and, secondly, there is a need for a study comparing neurologically unimpaired adults with neurologically impaired adults to determine the impact of body scheme on functional performance.
Effectiveness of an Occupational Therapy Programme Based on Sensory Integration Theory for Adults with Severe Learning Disabilities
Authors: Soper Gill , Thorley Cathy R
Published: April 2015

The purpose of this 2-year research project was to seek an effective intervention to address the needs of adults with severe learning disabilities. The authors, funded by the North Thames Regional Health Authority, drew on sensory integrative (SI) theory and practice to carry out this work. This article details the first year of research.

A pre-test, post-test two-group experimental design was used. Thirty subjects aged from 23 to 50 years were assigned to an experimental or a control group (that is, 15 subjects in each group). The subjects lived in an institutional setting, were without speech, had minimal attention and concentration and presented with tactile defensiveness and/or aversive response to movement. Members of the experimental group received a weekly SI-based treatment session and members of the control group received weekly sensory stimulation. Sessions varied from a few minutes to one hour and generally lengthened with the subjects' increasing adjustment to the new environment.

Three types of checklist were used for assessment at the pre-test and post-test stages. Analysis of data from the 28 subjects who completed the study showed a statistically significant improvement in both groups, a statistically significant greater improvement in the experimental than in the control group in some areas only, and no negative correlation between age and improvement in either group. The research indicates that SI-based treatment can benefit this client group.
Why This Interest in Minority Ethnic Groups?
Authors: Meghani-Wise Zeenat
Published: April 2015

There has been a recent surge of interest in issues affecting minority ethnic groups in the occupational therapy profession. This article explores why there is growing concern within the profession and explains some cultural differences in the practice of activities of daily living in minority ethnic groups. The question of how to develop culturally sensitive services is discussed and some practical suggestions are made.
Community Care, Occupational Therapists and the Law
Authors: Mandelstam Michael
Published: April 2015

Occupational therapists in social services departments increasingly risk having their decisions challenged. This is due to the growing gap between people's needs for community care and available resources, and to a culture of complaint.

The work of occupational therapists is bounded by complex community care legislation, an accompanying mass of guidance, judicial review by the law courts and investigations by the local ombudsmen. Various problems flow from the clash between the day-to-day demands made on therapists and legal and administrative rules. Awareness of the law is desirable but is achieved only with difficulty, given uncertainties in the legislation. The Court of Appeal's recent ruling – that the assessment of disabled people's needs cannot be influenced by resources – might increase demands for services but might also provoke local authorities into adopting defensive practices. In any case, legally, the Judgement of professionals such as occupational therapists remains central to decisions about the needs of people with disabilities.

The article concludes that legal awareness will assist occupational therapists to achieve a balance between acting legally, carrying out their duty as employees, assisting clients, maintaining standards of professional conduct, staying within resources – and protecting themselves from unpleasant and time-consuming disputes.
A Guide to the Responsibilities of Occupational Therapists and Their Managers in regard to Homeless People Who Use Their Services
Authors: Mobsby Ian
Published: April 2015

This article has been written to act as a guide and inform therapists of the obligations of health (physical and mental health) and local authority agencies in regard to meeting some of the functional needs of homeless people.
The Introduction of a Robotic Aid to Drawing into a School for Physically Handicapped Children: A Case Study
Authors: Smith Jane , Topping Mike
Published: April 2015

The Handy Artbox is a robotic system designed to enable severely disabled children with little or no hand or arm movement to draw unaided. A prototype system was constructed at Staffordshire University and tested over a one-month period at a special school in Newcastle, Staffordshire. The aim of the study was to evaluate the Handy Artbox prototype being used in a real life situation in order to determine whether or not it could play a positive role in the education of children with special needs.

In conjunction with professionals at the school, three children with cerebral palsy were selected as possible candidates to take part in the study. These children were observed in their classroom situations for one week before they were introduced to the Artbox. From the sample of three children, an 11-year-old boy was chosen to take part in the main trial and evaluation study of the robot. A series of educationally interesting worksheets was developed specifically for use on the Artbox; this was based on exercises and worksheets from English and maths books currently being used at the school. The aim of the main trial and evaluation study was to allow the child to use the Artbox alongside his peers during his usual lesson periods, thus giving him the opportunity of completing his school work with the minimum of assistance. This article reports the observations and findings of this initial pilot study.
A Comparison of Leisure-Time Activities between Able-Bodied Children and Children with Physical Disabilities
Authors: Howard Lynne
Published: April 2015

This article reports on a survey of able-bodied and physically disabled children to investigate their out-of-school activities. It outlines the importance of play and leisure time in the child's development before considering the findings from a questionnaire given to 6–11 year olds.

The results mirror those elsewhere in the literature, mostly from the USA, that children with physical disabilities have a less rich play experience than able-bodied children, spending more time in the company of adults, watching television more and generally having less variety in their lives. The significance of the findings for occupational therapy is discussed and areas for future research are suggested.
Once is an Incident: MRSA and the Occupational Therapist
Authors: Rugg Sue , Patrick Sharon
Published: April 2015

Occupational therapists are increasingly finding themselves working in settings where they are exposed to methicillin-resistant Staphylococcus aureus (MRSA). This article explores the epidemiological and clinical background to this area, highlighting some of the most important issues.
… The Truth is No Longer Out There
Authors: Creek Jennifer
Published: April 2015

Western scientific endeavour, for the past 200 years, has been directed towards uncovering the laws that govern the physical universe. Truth has been seen as existing independently of human activity, and all that is required to discover it is to make accurate and objective observations which lead to rational conclusions. The second half of the 20th century has been characterised by an increasing awareness that knowledge can never be truly objective. With this realisation, the pursuit of truth has given way to a greater acceptance of diversity, complexity and uncertainty in a shift of perspective called postmodernism.

Occupational therapists have been traditionally concerned with the details of everyday life as lived by ordinary people. The goals of intervention are individual, contextual, discrete and diverse. Practice is based on pragmatism rather than on abstract principles. This article provides an introduction to a complex topic and argues that occupational therapy can best be understood and valued from a postmodernist perspective.
The Model of Human Occupation: An Overview of Current Concepts
Authors: Kielhofner Gary , Forsyth Kirsty
Published: April 2015

The model of human occupation has evolved since it was first published. A number of important changes and refinements have been made. These changes reflect research findings, new interdisciplinary theory and insights encountered in practice. This article provides an overview of the current theoretical arguments. These concepts attempt to offer a way of understanding how human occupation is motivated, organised, performed and influenced by the environment. This is followed by a discussion of how occupational therapists can use this framework in their clinical practice.
Computer-Assisted Cognitive Rehabilitation and Occupational Therapy
Authors: McBain Kenneth , Renton Linda B M
Published: April 2015

Occupational therapists have been exploring and debating the therapeutic use of computers for over 10 years. Much of the literature on this topic is descriptive in nature. There has, however, been some work done in the area of cognitive rehabilitation. This article reviews the literature in relation to the use of computers in occupational therapy and in computer-assisted cognitive rehabilitation (CACR). The benefits of computers and the human computer interface are explored and the restorative versus the adaptive approaches in cognitive rehabilitation are debated. The role of occupational therapy in CACR is discussed and assistive technology literature is used to expand upon this topic. The topic of the contributions of programmers and clinicians in designing software is raised. Software issues are also raised, such as the properties, limitations and development of software.

The conclusions suggest that there have been few studies that have explored the efficacy of CACR and that those that have indicate that there is limited clinical benefit. Some of the limiting factors are the hardware the programs were developed on and the lack of theoretical underpinning for using software in a rehabilitation programme. However, when an adaptive rather than a restorative approach is considered, the use of computers in this area appears more promising.
An Association of the Asymmetrical Tonic Neck Reflex (ATNR) and Agoraphobia and Panic Attacks
Authors: Morgan-Brown Mark
Published: April 2015

Eighteen people who suffered from panic attacks and/or agoraphobia were compared with 18 controls in their responses to the Schilder test for the asymmetrical tonic neck reflex. All the research individuals scored highly, compared with only a third of the control group. The result was statistically significant using the Mann-Whitney U test, suggesting a relationship between the Schilder test and panic or agoraphobic states.
The Casson Memorial Lecture 1997: Shifting the Balance — Evidence-Based Practice
Authors: Eakin Pamela
Published: April 2015

The Casson Memorial Lecture 1997, given on 27 June at the 21st Annual Conference of the College of Occupational Therapists, held at the University of Southampton.
Moving to Trust Status: The Experiences of Staff of Occupational Therapy Departments
Authors: Lloyd-Smith Walter
Published: April 2015

There has been much discussion of the NHS and Community Care Act 1990 and the changes it has brought to the delivery of health and social care. The introduction of self-governing trust status for hospitals as part of an internal market for the NHS has played a significant role both in the lives of occupational therapy staff and in the services that they provide. This article describes a qualitative research study into how occupational therapy staff (n=15) from both a trust and a non-trust unit have perceived and experienced these developments.

The findings are considered under four key themes: the need to justify and market the role of occupational therapy; how trust status has affected staffs roles and relationships; how staff understood trust status to have affected the departmental identity, and concepts of leadership, power and autonomy; and in what ways trust status has shaped staff attitudes and opinions. The findings highlight the important role played by departmental leadership during moves to trust status and the interest now shown in measures of outcome to demonstrate the effectiveness of interventions. A range of perspectives on trust status is then discussed.
Mental Health and Student Health Professionals: A Literature Review
Authors: Tyrrell Jeanne
Published: April 2015

This article discusses the mental health problems of students, based on a review of previous research studies. Although a university education is regarded as a privilege, studying for a degree can be a demanding and stressful experience. Many students experience episodes of psychological distress during their college years. Professional degree programmes (such as occupational therapy or medicine) are particularly stressful relative to some other courses, because students face both academic and clinical demands.

The prevalence and causes of psychological distress among trainee health professionals are reviewed. Both institutional and individual factors affecting mental health are explored and some issues about student selection are discussed. The final section suggests how the institution and academic staff can address the issue of student mental health in a proactive and constructive manner. There are over 3000 occupational therapy students in the United Kingdom and Ireland, and the topic of student mental health should be of interest to academic staff and clinical supervisors.
Evolving Health Environments and Occupational Therapy: Definitions, Descriptions and Opportunities
Authors: Finlayson Marcia , Edwards Jeanette
Published: April 2015

Over the past 20 years, the world has seen a slow but steady shift in thinking about illness and wellness and about what constitutes health and health care. Concepts such as primary health care, disease and injury prevention, disability postponement, health promotion and population health are the focal points of this shift. In order to contribute in this evolving health environment, occupational therapists need to understand this terminology and make the link between these concepts and their philosophy and skills in enabling health through occupation. To contribute to this understanding, the objectives of this paper are to review the history of occupational therapy as it relates to recent shifts in thinking about health and health care, to define and describe briefly the relevant health and health care terms and concepts, and to illustrate the existing and potential links between the practice of occupational therapy and these health and health care concepts.
Evidence-Based Practice and Continuing Professional Development
Authors: Alsop Auldeen
Published: April 2015

This article discusses how evidence-based practice informs the process of contracting for health and social care services and explores the difficulties that practitioners seem to have in integrating research into their work. It addresses the need for practitioners to develop appropriate skills to seek, develop and use evidence to underpin their practice and so demonstrate the effectiveness of the work they do. Strategies for skill development through continuing professional development are outlined.
Rhyme and Reason: The Relationship between Creative Writing and Mental Wellbeing
Authors: Jensen Christine M , Blair Sheena E E
Published: April 2015

The relationship between creative writing and mental wellbeing is the subject of much debate and is often founded on conjecture and supposition. The aim of this small study was to explore the relationship between creative writing and mental wellbeing, with the cooperation of 14 adults who had all been users of mental health services and were involved in a creative writing group in the community. Qualitative data were collected from an interview (with the group facilitator), observation (of the group over a period of four group sessions) and the nominal group technique (to elicit the beliefs and opinions of the group itself).

The findings of the study were two-fold. Firstly, there was a tension between the cathartic expression of thoughts and feelings and the production of quality writings and, secondly, the notion of stigmatisation as a result of being a user of mental health services emerged. This explorative study, carried out in an urban Scottish context, indicated a covert relationship between creative writing as a product (rhyme) and its therapeutic by-products which affect an individual's mental wellbeing (reason).
Problem-Based Learning, Part 3: Making Sense of and Managing Disjunction
Authors: Savin-Baden Maggi
Published: April 2015

This is the third of three papers which explores the growing influence of problem-based learning (PBL) within professional curricula. Part 1 documented the emergence of PBL in a climate of world-wide change. Part 2 presented the model of Dimensions of Learner Experience and argued that it offers a framework for broadening current understandings of learner experience on diverse PBL programmes. Part 3 discusses the findings of the study, which extend earlier work around the concept of disjunction in learning, and the notion of enabling and disabling forms in relation to three different understandings of learner stance.

Disjunction is a concept seen by many as a starting point for learning and, in this study, particular issues appeared to arise from PBL, often in the form of paradoxes, which prompted different forms of disjunction. The study concludes by suggesting that the concept of learner stances offers a framework that challenges current understandings of learner experience on programmes that adopt PBL. It argues that PBL may prompt new forms of transition in relation to students' past, present and future constructions of learning and of themselves as learners.
Occupational Therapy in Community Mental Health, Part 2: Factors Influencing Intervention Choice
Authors: Meeson Beverley
Published: April 2015

Part 1 of this article examined how frequently various intervention media were chosen by 12 occupational therapists working in community mental health. An emphasis on anxiety management, problem solving and supportive counselling techniques was evident. In part 2, these therapists' rationale for therapy choices is explored.

The influence of personal perspective and context, that is, policy, organisation of services, division of labour within the team and resources at their disposal, set the boundaries for the therapists' intervention repertoire. Individual interventions were chosen on the basis of utility and client-centred values. The therapists expressed a preference for instigating activity participation by their clients in their locality and homes rather than doing activities with them in a contrived simulation of daily life. These influences are discussed and the extent to which activity-centred analysis or client-centred problem solving is dominant in this setting is questioned. It is clear that some therapists would see certain elements to be important to enable good practice in this working context. These and further implications for educators and practitioners are explored.
An Evaluation of Staff Attitudes towards the Sexual Activity of People with Learning Disabilities
Authors: Holmes Maria
Published: April 2015

This article presents part of a study which aimed to evaluate staff attitudes towards the sexual activity of people with learning disabilities. The need for such a study is clarified, drawing upon the development of societal attitude change, normalisation and community care. Previous research in this area is reviewed and the potential change in hospital policy at the research site, which is a medium secure unit, is considered. The first part of the research is presented, which involved 69 questionnaires containing a 20-item attitude rating scale and open and closed questions being sent to both clinical and non-clinical staff. The data from the 46 (67%) returned questionnaires are analysed. Although some conservative attitudes remain, the results highlight a liberal trend in attitudes. Many staff identified a need to change hospital policy, provide more staff training and improve condom availability. Methodological issues are also discussed.
Pain and Multiple Sclerosis
Authors: Gilmore Rosemary , Strong Jenny
Published: April 2015

This study investigated the prevalence of pain and its pattern in multiple sclerosis and examined whether pain as a symptom of multiple sclerosis has an effect upon an individual's quality of life. It also examined the effects of coping strategies on such quality of life.

Thirty-seven subjects, all with a definite diagnosis of multiple sclerosis and with varying experiences of pain, participated in the study. The Psychosocial Adjustment to Illness Scale was administered to all subjects. The McGill Pain Questionnaire and the Coping Strategies Questionnaire were administered to those subjects who experienced pain. Sixty-eight per cent of the subjects in this sample experienced pain associated with multiple sclerosis. A higher intensity of pain and the use of behavioural, catastrophising and praying coping strategies were significantly related to a poorer quality of life.
Occupational Therapy in Mental Health: A Review of the Literature
Authors: Craik Christine
Published: April 2015

This review of the literature was conducted as part of the development of a position paper on the way ahead for research, education and practice in occupational therapy in mental health. It included publications over the past decade and concentrated on the British Journal of Occupational Therapy. Recognising that experience from other countries would be beneficial, aspects of the literature from the national journals in the USA, Canada and Australia which were most relevant to practice in the United Kingdom were included.

The shortage of articles on mental health was conspicuous and their diverse topics and descriptive nature were notable. In the United Kingdom literature, the clinical subjects featured most often were dementia, work rehabilitation, community mental health and forensic psychiatry, with other subjects either appearing infrequently or not included. The literature from the other countries also explored new roles for occupational therapy, reflecting the changes in the delivery of mental health services. In the American Journal of Occupational Therapy, there was concern about the declining number of occupational therapists working in mental health. The review identified major themes in the literature, posed questions for research, education and practice in occupational therapy and formed the foundation for the position paper.
A Two-Year BSc(Hons) in Occupational Therapy: Preparing Graduates for a Demanding Profession through an Accelerated Degree
Authors: Elliott Karen , Francis Mark
Published: April 2015

The expectations, skills and demands of graduate students undertaking an undergraduate programme in occupational therapy form a unique challenge for curriculum design. Through a sound philosophical base, the emerging professional is encouraged to use existing study skills, develop professional characteristics and adapt to the ever-changing climate within occupational therapy. This article presents the issues facing a team in the development, delivery and continuous evaluation of a unique learning experience for graduates undertaking a degree in occupational therapy.
Occupational Therapy and Spirituality: Reflecting on Quality of Experience in Therapeutic Interventions
Authors: Collins Mick
Published: April 2015

Spirituality is an under-researched aspect of human functioning in occupational therapy. Because spirituality is often difficult to quantify, this article attempts to explore the conditions that enable quality of experience, which may subsequently lead to spiritual wellbeing. The article considers a process-orientated approach to spirituality in occupational therapy.
College of Occupational Therapists: Position Paper on the Way Ahead for Research, Education and Practice in Mental Health
Authors: Craik Christine , Austin Chris , Chacksfield John D , Richards Gabrielle , Schell Donna
Published: April 2015

The future of occupational therapy in mental health has been a topic of reflection and debate. The Education and Research Board (now the Education and Practice Board) of the College of Occupational Therapists created a Working Group to develop a position paper on the way ahead for research, education and practice in mental health. Following consultation, the Working Group reviewed literature, examined current research and surveyed practitioners, managers and educators. From these findings, recommendations have been made which will create a firmer evidence base for the practice of occupational therapy in mental health, leading to a more effective use of the expertise of occupational therapists and an improved service for users.
Work-Related Stress among Occupational Therapists in Sweden
Authors: Wressle Ewa , Öberg Birgitta
Published: April 2015

The purpose of this study was to describe work-related stress among occupational therapists and to identify the specific stress factors that contributed to work-related stress and their influence on the individual. Two hundred active occupational therapists in Sweden, selected at random from the membership registry of the Swedish Association of Occupational Therapists, received a postal questionnaire. One hundred and sixty-two responses were included in the study. An instrument introduced by Sweeney was used, which included 49 stressors, and a secondary aim was to conduct a factor analysis on the Swedish population of occupational therapists. In addition to this instrument there were questions about emotional and physical symptoms and discomfort, feelings about work and perceived satisfaction.

The results showed that only two of the 49 stressors were graded as high in affecting stress levels, both concerning lack of resources and lack of time. The factor analysis indicated 15 dimensions of stress relevant to the sample, and a second-order analysis gave four factors with high reliability both for the whole stress instrument and for each of the four factors. The factors were named ‘Resources and demands’, ‘Professional value’, ‘Rewards' and ‘Interaction with patients and colleagues’.

The Swedish study showed that lack of resources and lack of time were graded high as stress factors while the English population was concerned about patient contact to a greater extent than the Swedish. The most commonly reported symptoms were headache, poor concentration and feeling restless. There were significant correlations showing that high work satisfaction was correlated with low frequency of emotional and physical symptoms (r = 0.47–0.61). Work satisfaction was not correlated with discomfort from musculoskeletal disorders. Positive feelings about the job correlated with rare occurrence of symptoms (r = 0.17–0.51), and there were also relationships between positive feelings about work and fewer musculoskeletal problems like pain and headache.

It was concluded that a low level of stress existed among the Swedish occupational therapists. They felt that they had a strong professional role and identity but that financial conditions had not kept pace with the status of the profession. The feeling of high work satisfaction was related primarily to fewer emotional or physical discomforts or symptoms. The factor analysis indicated that the work situation in Sweden was different from the situation in England.
Occupational Therapy: Building Skills or Transforming Selves?
Authors: Crabtree Jeffrey L
Published: April 2015

This paper addresses the claim that there is increasing disparity between the profession's philosophical beliefs and core concepts and its clinical practice and research. The author of this claim, Mocellin, maintained that occupational therapy's assumptions about occupation are false and have serious consequences for the profession. He proposed that ‘occupation’ be replaced with ‘teaching skills' as the focus of intervention.

To address his criticism and solution, this paper critiques what its author understands to be Mocellin's assumptions about competence and teaching/learning skills and offers reasons why his underlying assumptions of the competence model do not work. These are that the competence model limits therapists' and patients' resources to available skills; it neglects the spiritual elements of humans; it neglects the rich and influential context of the therapeutic situation; and, contrary to Mocellin's assertions, the founders of occupational therapy placed no special value on competence over occupation.

Further, it is proposed that meaning making is the essential nature of human beings and that meaning making through occupation describes a more viable model of the ideal human condition. To support this thesis, a concise definition of occupation is offered and the therapeutic use of occupation, based on this definition, is contrasted with Mocellin's notions of teaching/learning skills.
Ergonomic Evaluation of Electric Mobile Hoists
Authors: Hignett Sue
Published: April 2015

Manual handling is known to be a major contributory factor in the high level of musculoskeletal injury among health care workers. One increasingly popular way to attempt to decrease total load handling is to use mechanical aids. There has been considerable growth in the range of moving and handling equipment being marketed to the health care industry but relatively little evaluation of its design or usability. Often purchasing decisions are made on an anecdotal basis from personal experience or recommendations and, while that information can be of considerable value, it will always be skewed by personal bias.

In order to provide robust ergonomic advice on which to base a purchasing recommendation for electric mobile hoists at a large teaching hospital, an ergonomic product evaluation was carried out consisting of both expert evaluation and user trials. The outcome is a purchasing recommendation for occasional use hoists (LIKO Uno, Oxford Major and Invacare Opale) and for frequent use hoists (LIKO Golvo and LIKO Uno). Although these are currently the recommended products, the results from the evaluation suggest that there is still room for design improvements.
A Further Validation of the Salford Objective Recognition Test in Stroke Patients
Authors: Lincoln N B , Rother L
Published: April 2015

The aim of the study was to validate the Salford Objective Recognition Test (SORT) by examining its relationship with the Rivermead Behavioural Memory Test (RBMT). Fifty stroke patients admitted to a stroke rehabilitation unit were assessed within 2 weeks of admission on the SORT and the RBMT. Correlations between the RBMT screening score and the SORT were all statistically significant. Correlations between the RBMT profile score and SORT words were statistically significant but not those between the profile score and SORT faces. The SORT has acceptable validity as a measure of memory in stroke patients and could be used as a screening test to detect memory problems.