bluuebunny/crossref_metadata_2025 huggingface dataset:
The Care© Approach to Enabling Independence
Authors: Pool Jackie
Published: April 2015

In piloting an occupational therapy service in Hampshire Social Services' homes for elderly people, it became evident that the occupational therapy philosophy of enabling independence was perceived by the staff of the homes to be contrary to their role as carers. An approach was required which could demonstrate that the concept of care was not incompatible with that of independence and the CARE© approach was developed. This uses a mnemonic device to show that there are four factors that combine to result in the act of caring: Communicating, Assisting, Rehabilitating and Empathising. When all four factors are present, independence is promoted by enabling the elderly person to function to his/her maximum potential. The CARE approach is currently being used in Hampshire Social Services' homes for elderly people in training programmes for staff. The approach is appropriate to anyone who is involved in caring for others. It is used as a framework that assists the carer to make the transition to the role of an enabler.
A Survey of Users of Upper Limb Prostheses
Authors: Fraser Carole
Published: April 2015

This article presents the results of a survey of 48 adults with upper limb amputations registered with the Cambridge Disablement Services Centre. The survey revealed a high level of satisfaction with the service and with the prostheses supplied. Cosmesis was seen as an extremely important factor in prosthetic wear and it was concluded that this should be given a higher profile when prescribing prostheses for new patients. It was also concluded that patients should attend the clinic at intervals of no longer than 2 years to have their prostheses checked for fit, comfort and updating.
The Casson Memorial Lecture 1993: Traditions and Transitions — Issues for the Future
Authors: Correia Stephanie
Published: April 2015

This lecture was given on 25 June 1993 at the College of Occupational Therapists' 18th Annual Conference, held at the University of Manchester Institute of Science and Technology.
Reading for Pleasure: An Experiment Using Fiction With Psychiatric Patients
Authors: Inglis Jane
Published: April 2015

The concept of ‘Reading for Pleasure’ arose from work undertaken as a librarian in an educational setting. This idea was then transferred to work being undertaken in a clinical area, where clients with problems relating to mental illness formed a group who were encouraged to use literature in their care environment. The outcome of this group was a very positive one, experiences being related in the article. The selection of material for use is discussed and the criteria explained. An attempt is made to assess the therapeutic contribution of the group and the potential benefits conferred by reading fiction. Future possibilities are sketched.
Occupational Therapy Services: Awareness among Hospital Consultants and General Practitioners
Authors: Chakravorty Binoy G
Published: April 2015

This article surveys the level of awareness among hospital consultants and general practitioners with regard to the functions of a district occupational therapy service. The results of a questionnaire study undertaken during 1990/91 show that a greater level of awareness needs to be developed, for which some suggestions are made.
Aspects of Selecting Outcome Measures to Demonstrate the Effectiveness of Comprehensive Rehabilitation
Authors: Jeffrey Lily I H
Published: April 2015

To enable clinicians to make an informed choice when selecting outcome measures to demonstrate the effectiveness of comprehensive rehabilitation, what objective criteria should be examined? This article considers the importance of the purpose, content, psychometric properties and ease of administration in selecting measures. Several outcome instruments evaluating self-care and mobility, mental health interventions and comprehensive rehabilitation approaches are examined with reference to these selection criteria. Measures that evaluate physical, psychological and social functioning, taking into account the desired outcome of the patient and his/her carers, are highlighted.
Solution Focused Brief Therapy: Establishing Goals and Assessing Competence
Authors: Iveson Chris
Published: April 2015

A new approach to counselling, solution focused brief therapy, is based on assumptions of client well-being which are very close to those underlying the work of occupational therapists. Two cases, one of memory loss and one of suicide risk assessment, are used to illustrate the principles of brief therapy translated into everyday practice.
High-Risk Elderly Patients in Acute Care Institutions: A Canadian Perspective
Authors: Beckingham Ann C , Westmorland Muriel G
Published: April 2015

Hospitalised elderly patients institutionalised for prolonged periods present a significant challenge to health professionals, but relatively few acute care hospitals provide specialised programmes designed to address their unique and individual needs. This article presents a review of relevant from 1978 to the present related to the needs of high-risk elderly patients in acute care institutions and comments on hypothesis versus reality. The literature indicates that when an active team approach is used with the elderly patient, focusing on rehabilitation and activities of daily living, a decreased length of stay can result. However, no studies were found that tested the results of a dynamic ‘enriched programme of care’.

After a review of inpatient data on two acute orthopaedic wards at two Ontario medical centres, the authors set out to establish if it was feasible to conduct a pilot study. The proposed study included a detailed outline of an enriched programme of care utilising the resources of occupational therapists, ward nursing staff and volunteers. Over a period of 6 months there were several multidisciplinary of health professionals and volunteers, who reviewed the demographics of this population which indicated that acute elderly orthopaedic patients over 65 are being discharged fairty quickly from hospital. This reality appears to contradict the literature which suggests that this group of patients are hospitalised for long periods and therefore require more functionally focused physical rehabilitation orientated programmes. It also begs the important question regarding adequate preparation of this population for return home and continuity of care between hospital and community.
Technology for People with Tetraplegia, Part 2: Environmental Control Units
Authors: Curtin Michael
Published: April 2015

A description of the range of environmental control units (ECUs) available in the United Kingdom is presented. The ECUs discussed include the Steeper SEC1B, the Possum PSU6 and Home Control range, the GEWA range, the James, the TASH Relax, the Tetravox, and Ridley's Switch-a-Switch System. Studies indicate that people with high tetraplegia who use an ECU maintain a more independent level of activity and show an improved relationship with their family, personal assistants and other people. Points to consider when assisting a person in selecting an ECU are listed. Objective assessments and demonstrations are essential if patients with a tetraplegic spinal cord injury are to achieve the maximum benefit of technical equipment, such as computers and ECUs.
Wheelchair Referrals in England
Authors: White Elizabeth A
Published: April 2015

A survey was carried out into the processes developed for dealing with wheelchair referrals in England following the devolution of the wheelchair service to the NHS. It was found that a large number of therapists were employed within wheelchair services, over two-thirds of them on a part-time basis. The survey identified the declining role of doctors in making wheelchair referrals, and highlighted discrepancies in the level of assessment offered, the provision to temporary users and the residency criteria.
An Investigation of Vocational Programmes and Services in North America
Authors: Creegan Shelagh
Published: April 2015

This article offers an overview of the psychiatric vocational rehabilitation system studied by the author under the auspices of the Winston Churchill Memorial Trust Travelling Fellowships. Brief accounts of Canadian and American programme models are used to describe employment preparation services and vocational programmes. The visits clearly demonstrate that people with psychiatric disabilities are potentially employable if they are provided with appropriate services, employment programmes and support. Although vocational programmes are evolving throughout the United Kingdom, there are strong indications that more programming and funding are urgently needed.
The Community Dependency Index: A Standardised Assessment of Need and Occupational Therapy
Authors: Eakin Pamela , Baird Helen
Published: April 2015

Key elements of the Government's community care policy are the assessment of disabled people's needs and the measurement of the outcome of any services provided. This article describes the development of a standardised assessment which could be used by community occupational therapists both to assess the level of need and to measure outcome in relation to occupational therapy.
Is Assessment of Function the Core of Occupational Therapy?
Authors: Phillips Nicola , Renton Linda
Published: April 2015

The focus of this article is to discuss whether or not assessment of function is the core of occupational therapy. This is primarily undertaken through examining the analysis and debate surrounding the literature related to this area. Evidence suggests that the concept of function is interpreted in diverse ways and the need for commonly accepted definitions is highlighted. The nature of assessment in relation to core skills is examined, together with the potential for assessment of function to assist in defining occupational therapy. It is concluded that assessment of function cannot be isolated as the singular core of occupational therapy.
Community Mental Health: The Development of the CCOPII, a Client-Centred, Occupational Performance Initial Interview
Authors: Orford Judith E
Published: April 2015

The blurring of professional roles in community mental health teams has prevented occupational therapists from developing their specialist role fully, including standardising assessments for use in community mental health settings. The aim of this study was to start to fill this gap by designing and piloting an initial Interview proforma. Nine experienced occupational therapists used the proforma with 23 people who were referred to them specifically for occupational therapy. The results of their evaluation of the proforma were analysed and used to create the Client-Centred Community Occupational Performance Initial Interview, Version 2 (CCOPII).
Trends in Forensic Psychiatry
Authors: Lloyd Chris
Published: April 2015

Forensic psychiatry is a specialty area of psychiatry. A review of the occupational therapy literature was conducted to examine occupational therapy practice in this area. The implications for developing opportunities for occupational therapists are then discussed.
Learning in Context: Perceived Benefits of Fieldwork Education within Community Mental Health Settings
Authors: Lyons Michael
Published: April 2015

The emphasis on community-based services for people with psychiatric disorders requires a concerted response from occupational therapists, if we are to assist people to live meaningful lives in their own communities. This article draws on the fieldwork experiences of 16 Australian and American occupational therapy students, to reflect on fieldwork education and how it may be preparing students to meet the demands of proactive practice in psychiatry. Attention is drawn to the Importance of fieldwork education in community contexts for occupational therapy students, if these future therapists are to be adequately prepared for the demands of community mental health practice.
Minority Ethnic Groups and Occupational Therapy, Part 1: Recruitment of Students
Authors: Rowe Nick , MacDonald Ruth
Published: April 2015

This article Is the first 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 1 deals with the first two concerns and part 2 will address Issues of course curriculum and the support that may be required for students from minority ethnic groups. The authors strongly advocate that these three issues cannot be treated in Isolation but must be dealt with simultaneously.
The Magic of Mentoring with Part-Time Students
Authors: Ilott Irene , Allen Sarah
Published: April 2015

Mentorship was an intrinsic part of the South Trent In-Service Diploma Course. The scheme was intended to optimise experiential learning and provide an outreach support network for students undertaking the 4-year part-time course.

This article describes the evolvement of mentorship as a new concept for occupational therapists. The process culminated in the production of specific guidelines which clarified the role and set an agreed minimum standard without prescribing what is essentially a personal relationship. At the end of the first and final years, the scheme was evaluated using questionnaires to ascertain the views of both mentors and students. The results identified the benefits and the problems associated with such a scheme. Although costly in terms of commitment and time, the benefits derived from support for individuals and the encouragement of a learning culture within sponsoring organisations.
Snoezelen: Its Effects on Concentration and Responsiveness in People with Profound Multiple Handicaps
Authors: Ashby Mark , Lindsay William R , Pitcaithly Deborah , Broxholme Sarah , Geelen Nicola
Published: April 2015

This article is an initial investigation into the effects of Snoezelen on concentration and responsiveness in people who have profound and multiple handicaps. Eight subjects with profound learning disabilities took part. Ratings of concentration were recorded at each session using a simple task. The subjects were also assessed at every fifth session for responsiveness to the Snoezelen environment.

The results suggest that all the subjects except one, who failed to score, responded In some way with improvements in scores. The improvements in concentration were significant for two subjects, moderate for four and minimal for one. The changes in concentration were not always related to the responsiveness/enjoyment in the Snoezelen environment. However, the two subjects who, in general, showed significant improvements in concentration were also rated as being the most responsive to the Snoezelen environment.
Learning Disability: An Alternative Frame of Reference
Authors: Jones Derek
Published: April 2015

This article outlines some of the criticisms of traditional ways of working in services to people with learning disabilities and presents some alternatives. It suggests that occupational therapists adopt a frame of reference which combines a competency-based model of occupational therapy with a redefinition of independence. O'Brien's Five Accomplishments are used to provide a service quality monitoring tool and a values base for practice. The principle of partial participation is utilised and an emphasis is placed on the value of employment and the use of systematic instruction to achieve it.
Occupational Therapy for Fatigue in Patients with Multiple Sclerosis
Authors: Welham Lynne
Published: April 2015

Fatigue is a common but poorly understood symptom which affects a majority of patients with multiple sclerosis (MS). A questionnaire was used to study current occupational therapy intervention for fatigue in MS patients. The results showed that occupational therapists appear to focus on assisting their patients in managing their fatigue within the context of their daily lives. The majority of interventions could be described under the heading ‘energy conservation’.
Feminist or Feminine? The Feminine Principle in Occupational Therapy
Authors: Kelly Greg
Published: April 2015

Recently, there has been renewed interest in the relationship between feminism and occupational therapy, but does occupational therapy continue to operate on the feminine principle which underlies the philosophical basis of the profession? There is a strong tendency by some occupational therapists to emulate the masculine principle which drives the medical model but this, in fact, places occupational therapy at a disadvantage in the prevailing male culture. Drawing on a wide range of recent literature related to education, professionalism, management, research, clinical reasoning and complementary therapies, this article argues that the feminine principle is very much alive in the theory and practice of occupational therapy today.
The Essential Elements of Professional Motivation
Authors: Creek Jennifer , Ormston Cathy
Published: April 2015

This article explores how the continuing development of occupational therapy has been fuelled by three essential elements: philosophy, theory and practice. It examines how the interplay between these elements maintains and drives the profession and discusses the part that individual therapists play in sustaining the progress of the whole.

The profession is vulnerable. Philosophy, theory and practice are becoming disconnected, leading to dampening of energy and distraction from our professional purpose. Possible explanations are suggested, including internal factors, such as the widening split between academics and clinicians, and external factors, such as changes in health policy.

Strengthening the links between philosophy, theory and practice will ensure that occupational therapy remains healthy and progressive. The article concludes with some practical recommendations about what can be done to bring the philosophers, theorists and practitioners together, to fire individual motivations and re-energise the profession.
Client Confidentiality: Ethical Issues in Occupational Therapy
Authors: Sim Julius
Published: April 2015

Confidentiality is a central ethical concern in occupational therapy practice and one that is emphasised in professional codes of ethics. This article examines the conceptual and moral basis of confidentiality, and relates it to the fundamental ethical principles of respect for autonomy, respect for persons and non-maleficence. The moral conflicts that may arise between the requirement of confidentiality on the one hand, and the need to safeguard the interests and welfare of others on the other hand, are explored with reference to the Tarasoff case. Both consequentialist (outcome-based) and deontological (duty-based) perspectives are examined.

It is argued that confidentiality should be given a special status within the client-therapist relationship and, up to a certain critical threshold, should be protected from considerations of general welfare. It is argued that, whilst confidentiality may on occasions be breached in the interests of others, it Is rarely permissible to do so in the client's own Interest. In conclusion, occupational therapists are urged to give a high regard to confidentiality and to cultivate the virtue of discretion in their professional practice.
The Developing Role of Occupational Therapy in Psychiatric Intensive Care
Authors: Best Diana
Published: April 2015

Occupational therapy has an established role in the delivery of mental health services. Psychiatric Intensive Care Units (PICUs) are a development found in many psychiatric inpatient facilities and their numbers are increasing. The introduction of occupational therapy to a recently established PICU is examined. A comparison is made between PICU and forensic client groups, and the developing need for PICUs as a distinct service and the client group they serve are described. An example of successful service delivery of occupational therapy in a PICU is offered, and the challenges to the therapist working in this demanding and rewarding setting are outlined.
Clinical Reasoning in Local Authority Paediatric Occupational Therapy: Planning a Major Adaptation for the Child with a Degenerative Condition, Part 1
Authors: Medhurst Angela , Ryan Susan
Published: April 2015

Three-track reasoning, narratives and reflective practice frameworks form the background for examining the clinical reasoning of a social services occupational therapist during a supervision session. Telling the story of a child with a degenerative condition and the family's needs to the service manager helps to clarify the underlying meanings in the unfolding events the therapist is confronted with. Her reasoning is further challenged by presenting this work to her peers on a postgraduate course on clinical reasoning. This article provides the background and theory base for examining the use of narratives in greater depth in part 2.
Applying Clinical Reasoning: A Caseload Management System for Community Occupational Therapists
Authors: Fortune Tracy , Ryan Susan
Published: April 2015

This article presents a system of caseload management for community occupational therapists. Using the clinical reasoning work of Mattingly and Fleming as a framework, the perceived complexity of each case for a community occupational therapist was analysed and then paralleled with the type and amount of clinical reasoning required.

Following an initial occupational therapy assessment, each case is given a numerical weighting, graded at 3 for complex cases and from 1 for non-complex or simple cases. The degree of complexity or weighting is recognised to be a subjective phenomenon dependent on the experience, knowledge and skills of the therapist. The cases held by an occupational therapist are able to be mixed so that the experienced therapist holds a varied caseload of complex and simple work. Beginning therapists can follow the same measured approach thus augmenting their background experience.

This method promotes continuing education, assists experiential learning and provides variety. Using this system, it is proposed that occupational therapy services are enhanced by reducing unnecessary casework from therapists' active caseloads, allowing increased time to work on complex cases and using expertise more efficiently.
Functional and Health Assessments Used in Rheumatology Occupational Therapy: A Review and United Kingdom Survey
Authors: Hammond Alison
Published: April 2015

Functional and health status outcome measures used in rheumatology therapy research and practice were reviewed. A national survey was conducted with rheumatology occupational therapists to identify which functional assessments are most used. The majority of respondents considered standardised assessments to be valuable in clinical practice. Over half used a standardised measure, with the Hearth Assessment Questionnaire (HAQ), Modified HAQ and Barthel Index being the commonest. The reasons for non-use were mainly a lack of knowledge of assessments available or difficulty in accessing these. All departments using standardised assessments did so in conjunction with a non-standardised activities of dally living assessment, because the former were not considered to provide sufficient detail for treatment planning purposes.
The Casson Memorial Lecture 1996: Equalising Opportunities
Authors: Yates J Elizabeth
Published: April 2015

The Casson Memorial Lecture 1996, given on 19 July at the 20th Annual Conference of the College of Occupational Therapists, held at the University of Leeds.
Levels of Psychological Distress among Occupational Therapy Students
Authors: Tyrrell Jeanne , Smith Howard
Published: April 2015

This study measured levels of psychological distress among a sample of Irish occupational therapy students. Students from all four undergraduate classes (n=102) were surveyed, using the General Health Questionnaire (GHQ-28). Over 40% of the students scored as having a ‘just significant clinical disturbance’ on the GHQ-28. Mean GHQ scores (or symptom levels) varied throughout the 4-year course and were highest just before examinations and during fieldwork placements. Students who had unhealthy diets or who smoked had significantly higher levels of psychiatric symptomatology. The prevalence of psychological distress among occupational therapy students was similar to that found in students from four other disciplines; however, the university students had much higher levels of symptomatology than the non-university peer group. The article concludes with some suggestions for dealing with stressful aspects of professional education and some recommendations for further research.
Practical Ways of Improving Memory Storage and Retrieval Problems in Patients with Head Injuries
Authors: Thompson Simon B N
Published: April 2015

Memory disorders resulting from head injuries can be very distressing to both patients and carers. Understanding memory processes can be helpful in selecting the best memory strategies for particular patients. These strategies are discussed together with definitions of amnesic conditions and memory aids. The important message from using such memory strategies is that patients learning how to improve their poor memory have a far greater chance of improvement in the long term than those who simply rehearse items to be memorised.
Taking Stock and Taking Chances: Creating New Opportunities for Fieldwork Education
Authors: Alsop Auldeen , Donald Mary
Published: April 2015

This article stems from, and builds on, a workshop presented at the College of Occupational Therapists' Annual Conference held in Edinburgh in July 1995. It examines current issues for the profession which impinge on fieldwork education; it challenges some of the myths surrounding fieldwork education and its delivery; and it explores how creative thinking might promote new ventures and enable alternative strategies for fieldwork education to be adopted. Some of the principles believed to be fundamental to the future provision of fieldwork are presented.
In-Service Students Undertaking Fieldwork Education: Strengths, Expectations and Needs
Authors: Alsop Auldeen
Published: April 2015

This article discusses the particular needs of in-service students in relation to their fieldwork education. The experience that occupational therapy assistants and technical instructors bring to fieldwork, the areas of responsibility with which they must be concerned in the transition between the workplace and the fieldwork setting, and the role conflicts that might arise during their professional education are explored. Some ways in which line managers and fieldwork educators might assist in the process prior to, during and following fieldwork education are discussed.
Fieldwork Educator Training: Design and Evaluation of an Educational Package
Authors: Seale Jane , Gallagher Crissi , Grisbrooke Jani
Published: April 2015

This article describes and evaluates an educational package consisting of five hypothetical case studies. The case studies were designed by the School of Occupational Therapy and Physiotherapy, University of Southampton, and used during briefing sessions with fieldwork educators in order to introduce the fieldwork assessment form and discuss grading issues. A questionnaire survey of 70 fieldwork educators who had attended a briefing session and used the five hypothetical case studies revealed that, generally, the fieldwork educators found the briefing session, including the grading exercise with the case studies, useful. The fieldwork educators indicated a commitment to the principles of being reliable assessors but felt that certain areas needed more consideration, such as the implications of giving grades to real as opposed to hypothetical students. The implications of these results are discussed in relation to literature regarding assessment issues and fieldwork educator training.
A Survival Guide to Paper Presentation
Authors: Walker Marion
Published: April 2015

This article provides guidelines and practical advice for those wishing to present a paper in a scientific forum. The content gives some pointers to a successful presentation. The article was written on behalf of the Research and Development Committee of the College of Occupational Therapists.
Environmental Challenges and Opportunities of Client-Centred Practice
Authors: Sumsion Thelma
Published: April 2015

Environmental considerations are important aspects of client-centred practice. The cultural, economic, legal, physical, political and social environments must all be considered individually and as entitles that interact with each other and with the client. This article presents a brief discussion of client-centred practice, reviews the literature related to each of the six environments and discusses the impact of each environment on a client with AIDS.

It is clear from the discussion of the case that all environments must be considered if the focus is to be truly client centred. There is frequently overlap between the environments and the focus shifts to meet the evolving needs of the client. The environment is not static and the skills of the therapist are required to ensure that the appropriate focus is maintained at all times.
Goal Attainment Scaling as a Method of Measuring Clinical Outcome for Children with Learning Disabilities
Authors: Young Anita , Chesson Rosemary
Published: April 2015

In this article, one approach to measuring therapeutic impact — Goal Attainment Scaling (GAS) — is discussed. The authors forward the case for GAS based on their own research regarding occupational therapy with children with learning disabilities. GAS is described and the factors relating to the setting of goals are examined. The main advantages are identified and GAS is seen to have benefits beyond those relating specifically to occupational therapy. The implications for multidisciplinary teamworking are examined and, in particular, it is asserted that co-workers may acquire, through the goal-setting process, realistic expectations of clients. The audit of therapeutic goals is seen to have the potential to inform decision making regarding treatment options. In conclusion, GAS is advocated as a particularly appropriate evaluative tool for the 1990s.
‘Until Disabled People Get Consulted …’: The Role of Occupational Therapy in Meeting Housing Needs
Authors: Nocon Andrew , Pleace Nicholas
Published: April 2015

This article reports oh a study of the housing needs of people with disabilities (aged 16 to 65) in Shropshire. The study included interviews with disabled people and with frontline and managerial staff in several agencies, a survey of disabled people, and the analysis of quantitative data. The findings highlight the high level of need for adaptations and more appropriate housing for disabled people; the importance of greater user involvement in the way needs are identified and services provided; the need for reform of the Disabled Facilities Grant system; and the need for an integrated inter-agency approach to meeting disabled people's housing needs.
A Comparison of the Snoezelen Environment and a Music Relaxation Group on the Mood and Behaviour of Patients with Senile Dementia
Authors: Pinkney Lesley
Published: April 2015

Relaxation for elderly people is one of the more complicated activities to achieve with a client group who have limited cognitive abilities, particularly those with senile dementia. The deterioration in cognitive function and orientation may lead to agitation and frustration with their perceived situation. Consequently, this makes directed relaxation a difficult activity to facilitate.

Following research of Snoezelen carried out at the King's Park Community Hospital, Bournemouth, the need to test the effectiveness of Snoezelen in manipulating mood had been identified. It was further identified that comparisons should be made between more conventional relaxation groups and Snoezelen.

Three moderately demented female subjects were studied during a 9-week period. Observations were made on their behaviour and affect. The results indicated that the principles of Snoezelen could be used in many settings, making it a versatile medium. However, its effectiveness was dependent on the patient's cognitive skill level.
Joint Protection Education: What are We Doing?
Authors: Hammond Alison
Published: April 2015

Joint protection (JP) education is a standard part of rheumatology occupational therapy services. This survey was conducted to identify the duration, teaching methods and content of JP education. Over half of therapists responding (55%, n=86) provided education for less than one hour during one treatment session. Eighty-six per cent supported education with written information; 66% demonstrated JP methods to patients, commonly methods for opening Jars, chair transfers and tap turning; and 50% also asked patients to practise these under supervision. The SPIRE arthritis education programme seemed a common influence on the JP education provided. Previous research suggests that educational-behavioural approach based patient education programmes (of 8–12 hours' duration) facilitate health behavioural change. It would appear that much of the current JP education provided in the United Kingdom may not be achieving this goal.
A Strategy to Improve Nurse/Occupational Therapist Communication for Managing Patients with Splints
Authors: Batteson Rachel
Published: April 2015

This article explores the reasons for the observation that nurses and occupational therapists managed the aftercare of patients with splints differently. An action research stance was adopted, which enabled the two professions to identify several problems collaboratively and to develop a strategy for change that was mutually beneficial. As a result of the study, a training programme in the aftercare of splints was implemented for nurses, increasing their involvement in caring for splints. In addition, ward-based resources were produced to supplement information regarding the aftercare of splints given by occupational therapists to nurses. An evaluation of the programme encouraged further discussion between the two professions, whose members were then able to move forward and work more collaboratively.
What is Evidence-Based Practice?
Authors: Taylor M Clare
Published: April 2015

Evidence-based practice are the buzz words of current health care. This article explores what evidence-based practice actually means for occupational therapists. Evidence-based practice has two strands. The first strand involves using the best available evidence as part of the clinical decision-making process. The second strand involves drawing the evidence together in the form of systematic reviews. These reviews may then be used to help inform the development of clinical guidelines.

This article outlines and discusses both strands of evidence-based practice and the relevance of each strand to practising occupational therapists. It explores how therapists can locate, evaluate and use evidence to inform their practice. The article focuses particularly on the development of critical appraisal skills. The role of systematic reviews and the relevance of clinical guidelines for occupational therapy are discussed.
Clinical Effectiveness: Systematic Reviews and Evidence-Based Practice in Occupational Therapy
Authors: Bannigan Katrina
Published: April 2015

Evidence-based health care can be defined as an approach to health care that involves finding and using up-to-date research into the effectiveness of health care interventions to inform decision making (Entwistle et al, 1996). For many occupational therapists, the practicalities of keeping up to date with the best research evidence is difficult; however, through the National Health Service Centre for Reviews and Dissemination (NHS CRD), the NHS Research and Development (R&D) Programme is aiming to improve the availability of high quality research evidence to all health care professionals.

The NHS CRD carries out and commissions systematic reviews. Systematic reviews are a means of pulling together large quantities of research information and are considered to be one of the most reliable sources of information about effectiveness (Chalmers and Altman, 1995). The NHS CRD also disseminates the findings of systematic reviews, one method of which is through the Database of Abstracts of Reviews of Effectiveness (DARE).

The relevance of systematic reviews to the clinical practice of occupational therapists is explored in this paper using two examples: a poor quality and a high quality systematic review identified from the abstracting process for DARE. Both reviews are directly relevant to occupational therapy, being about sensory integration and falls in the elderly respectively. The implications of these reviews for evidence-based practice in occupational therapy are discussed.
College of Occupational Therapists: Research and Development Strategy
Authors: Eakin Pamela , Ballinger Claire , Nicol Margaret , Walker Marion , Alsop Auldeen , Ilott Irene
Published: April 2015

The role of research in occupational therapy has been widely debated over the last two years within the profession. The outcome has been the production, by the Research and Development Committee, of the Research and Development Strategy for the College of Occupational Therapists. The strategy addresses how the College of Occupational Therapists can help to support occupational therapists as research consumers, as participants in research and as proactive researchers.
Computer-Assisted versus Teacher-Directed Teaching of Community Living Skills in People with a Mild Learning Disability
Authors: Nicol M M , Anderson A
Published: April 2015

An experiment was carried out in which adults with a learning disability of the mild type undertook either computer-assisted or teacher-implemented instruction in community living skills, with a third group acting as a control group. All groups were pre-tested on a standardised psychometric measure of community living skills (the HANC 2 subscale of the Hampshire Assessment for Living with Others test), after which the experimental groups received one half-day per week training in such skills as money handling and budgeting for 3 months, when all groups were reassessed. It was found that both the teacher-led and computer-assisted instruction groups appeared to gain more than the control group, but only the teacher-led group differed significantly from the control group. The computer-assisted group improved in their scores by an intermediate amount, with their gains being non-significantly different from either the control or the teacher-led groups. The strengths and weaknesses of the software used in the study are discussed.
An Acute Medical Admission Unit: Is There a Place for an Occupational Therapist?
Authors: Sutton Sarah
Published: April 2015

Since the Griffiths Report (1988), the profile of community care has risen. At the same time, economic constraints imposed on the health care system have led to increased pressure on acute hospital beds. This has had an effect on the nature of the occupational therapy service. At the Royal Infirmary of Edinburgh NHS Trust, a move has been taken to address this challenge by setting up an occupational therapy service in the Acute Medical Admission Unit (AMAU). This article examines the role of occupational therapy in this setting and provides details of a 6-month audit. It was identified that occupational therapy in this area enabled people to be discharged home successfully within a 48-hour period and, as a result of the early screening in the AMAU, the assessment of patients in the medical services began on average 3 days earlier.
The Reliability of Markers
Authors: Rouse Simon J
Published: April 2015

This article examines the reliability of markers and questions the practice of double marking versus single marking of student essays. Three investigations were carried out and analysed, one with the use of descriptive statistics and two with inferential statistics. All three investigations involved two staff members assessing student essays independently and using the same general marking criteria. In addition, the first investigation used specific marking criteria drawn up by the two staff prior to marking. The results of the three investigations were that investigation one had a very high correlation and investigations two and three a high correlation. All three results showed that markers had a high degree of reliability. In addition, the higher correlations found in investigation one strongly supported the use of specific marking criteria drawn up prior to marking as a recommended assessment procedure to follow.
The Reliability and Validity of the Safety Assessment of Function and the Environment for Rehabilitation (SAFER Tool)
Authors: Letts Lori , Scott Sheri , Burtney Jill , Marshall Linda , McKean Martha
Published: April 2015

The Safety Assessment of Function and the Environment for Rehabilitation (SAFER Too)) was developed to assess people's abilities to manage functional activities safety within their homes. The results of a study to evaluate the instruments inter-rater and test-retest reliability and construct validity are reported.

Reliability was evaluated using kappa for each dichotomous item. For inter-rater reliability, 59 of 66 items had acceptable reliability. For test-retest reliability, 63 of 70 items had acceptable kappa scores. For items where kappa could not be calculated because of limited variation between raters, percentage agreement was over 80%.

For validity, higher SAFER Tool scores (that is, more safety problems) were hypothesised to be associated with less independence in activities of daily living (ADL) and instrumental activities of daily living (IADL) and more cognitive impairment. The correlation between SAFER Tool scores and cognitive impairment supported this hypothesis. The results of the correlations with ADL and IADL scores were less clear. This could be attributed to caregivers' assistance with activities which might have reduced risk, and generally limited variation in ADL scores.

The reliability results from this study are positive. Further research to assure the SAFER Tools validity and predictive ability are needed.
Distinguishing between Occupation, Purposeful Activity and Activity, Part 2: Why is the Distinction Important?
Authors: Golledge Janet
Published: April 2015

Part 2 of this article stresses the importance of noting the distinctions between the terms occupation, purposeful activity and activity. Both occupational therapists and occupational therapy students need to be able to articulate to others exactly what they do in their individual work settings. This includes acknowledging both shared core skills and unique core occupational therapy skills. It is important that occupational therapists employ these unique core skills in their day-to-day work to highlight their distinction from other health care professionals, who may legitimately use activity within their own interventions. Additionally, if purchasers are negotiating contracts for services from multidisciplinary teams, they need to be able to discern the differences between the input of the different health care professionals. In light of this, current political influences within health care and professional concerns are briefly explored.
Peer Learning on Fieldwork Placements
Authors: Martin Marion , Edwards Lyn
Published: April 2015

Placements with a ratio of one fieldwork educator to two or more students have potential benefits for students and educators as well as for placement organisers, who have difficulty finding enough fieldwork experiences for students. A questionnaire was distributed to 14 students who had been on a 1:2 placement together, in order to find out what they perceived had been the advantages and disadvantages of this experience. Their responses were largely positive, giving enhanced learning and peer support as the main advantages. The most commonly cited disadvantage was added stress, which could occur if the two students were not compatible. It is recommended that this type of placement should be used more frequently, although it is Important that strategies should be employed by fieldwork educators to exploit the full potential of the learning experience.
Effectiveness in Wheelchair Service Provision
Authors: White Elizabeth , Lemmer Bill
Published: April 2015

Services that provide wheelchairs to permanently disabled people have undergone fundamental changes following the recommendations of the McColl report in 1986. The devolution of centralised wheelchair services to the National Health Service (NHS) health districts in 1991 coincided with the implementation of the government's proposals for NHS reforms and community care initiatives. This paper describes a four-part research study, undertaken to identify and investigate key factors which propose effectiveness in the post-devolution wheelchair service.

The sample comprised 125 wheelchair therapists as service providers and a total of 130 service users. The user sample consisted of 84 people issued with NHS manual wheelchairs, 27 indoor powered wheelchair users and 19 special seating users. An integrated methodology was employed, including questionnaires, interviews, participant observation and case studies.

The research identified the development of client-centred referral and assessment procedures for wheelchairs and seating, and highlighted the need for increased therapist training. Close links between wheelchair services and local therapists were found, providing greater access to assessment for wheelchair users. An increased demand for wheelchairs outside the NHS range and a rising number of referrals for elderly people were recorded, although the management of finite resources resulted in eligibility criteria designed to control supply and provision variations between districts.
Role Strain Experienced by Male Occupational Therapists: A Descriptive Survey
Authors: Brown G Ted
Published: April 2015

Occupational therapy is a female-dominated profession with only 5.8% of all clinicians being men. Traditionally, occupational therapy education programmes have had limited success in recruiting men and those men who do become therapists tend to work in the profession for only short periods of time. The purpose of this study was to identify the factors that have an impact on male occupational therapists. Specifically, role strain due to community, colleagues and patients, three types of role stress (role ambiguity, role conflict and role overload) and the demographic characteristics of male occupational therapists in Canada were examined.

Role strain is a subjective state of emotional arousal (such as increased level of awareness, general emotional arousal, distress, anxiety or frustration) in response to the external conditions of social stress. Community role strain was considered to arise from the negative attitudes of people outside the immediate work environment. Colleague role strain was considered to arise from the attitudes and behaviours of co-workers and others employed in the work environment. Patient role strain was considered to arise from the acts and attitudes of patients and their families.

Role stress is a social structural condition in which role obligations are vague, irritating, difficult, conflicting or impossible to meet. Role ambiguity was defined as vagueness or a lack of clarity of role expectation. Role conflict was defined as role expectations that are incompatible. Role overload was defined as too much expected in the time available.

A questionnaire was posted to all male therapists who were members of the Canadian Association of Occupational Therapists (n = 199). Eighty-three per cent of the sample responded. The survey instruments consisted of a demographic questionnaire, the Egeland and Brown Rating Scale, the Rizzo, House and Lirtzman Scale and the Beehr, Walsh and Taber Scale. As a group, male occupational therapists reported a moderate level of community role strain, colleague role strain and patient role strain. Similarly, male occupational therapists also reported a moderate degree of role conflict and role overload, but had a low level of role ambiguity.