bluuebunny/crossref_metadata_2025 huggingface dataset:
The Definition of Disability
Authors: Eakin Pamela
Published: April 2015

Occupational therapists are heavily involved in trying to solve the problems of disabled people and meet their long-term needs in the community. However, the efficacy of occupational therapists in solving these problems is related to the definitions of disability that they use. Being defined as disabled makes a person ‘eligible’ for the receipt of various resources. Viewed objectively, are the definitions used any help in resolving the problems of a disabled person in the community? This article implies that they may not be as helpful as occupational therapists think.
The Head Injuries Rehabilitation Centre
Authors: Harris Jill , Simon Jane
Published: April 2015

This article describes the treatment methods being used at the Head Injuries Rehabilitation Centre, Birmingham. The setting and the weekly timetable are explained, along with the use of behaviour modification.
Arthritis Self-Management — American Style
Authors: Wathen Gillian
Published: April 2015

Arthritis education programmes have become an important component in the treatment of arthritis in America. This article describes an arthritis self-management course which has an approach that is different from traditional methods of patient education and is regarded as highly successful in the USA.
The Use of Games in Occupational Therapy
Authors: Burton Carole
Published: April 2015

This article examines how games can be used to assist in making the learning process more effective. It looks at guidelines for devising therapeutic games and then goes on to provide an example of a game that has been devised for use in a community rehabilitation programme for psychiatric patients.
Lourdes Pilgrimage from Burton House, 1984
Authors: Parker Jean
Published: April 2015

Burton House is a geriatric unit with a purpose-built recreation unit, providing adult education facilities and daily time-tabled recreational facilities for long-stay patients. The recreation unit is an offshoot of the occupational therapy department with an activities organizer, a music therapist and an occupational therapy helper who work, along with others, to extend the role of diversional therapy with the elderly. This article is an example of the work that is being achieved to improve the quality of life for long-stay patients.
Dipping into Community Mental Health: An Aspect of the Occupational Therapist's Role
Authors: Westland Gill
Published: April 2015

This article describes the setting up of a relaxation group by an occupational therapist working in mental health at a health centre, which encourages patient participation. Observations about the occupational therapist's role in this context and the contribution of the relaxation groups are discussed.
The Design of Viable Software for Use in Occupational Therapy
Authors: Smart Steve , MacKenzie Loreen , Richards Dave
Published: April 2015

This article discusses the process of computer program design for occupational therapy. It attempts to demonstrate the roles of the therapist and the programmer in this process. The article has largely assumed that program designers are not clinicians, but it is appreciated that this may not always be the case. Special considerations that the software designer can take into account are described, as are ways in which the therapist can help the designer to produce programs that are as useful as possible.
Occupational Therapy and the Role of Leisure
Authors: Trevan-Hawke Judith
Published: April 2015

The role of leisure and its relevance to occupational therapy are discussed in the light of its historical context and economics. Implications for occupational therapy practice are considered in relation to leisure rehabilitation, using Herzburg's job satisfaction model and Parker's model of leisure as a guide. The focus is on the western way of life.
A Self-Medication Survey of Elderly Patients in Hospital
Authors: Benson Sandra
Published: April 2015

This survey has sought to identify some of the practical handling difficulties that many old people may experience with their drugs on discharge from hospital. Most of the findings in the survey are predictable, and are related to lack of manual skills or failing vision. Highlighting these problems has led to a greater awareness among medical and pharmaceutical staff, who are now seeking ways to overcome the problem areas.
Occupational Therapy in the Treatment of the Patient with Chronic Pain
Authors: Giles Gordon Muir , Allen Mary Elizabeth
Published: April 2015

This paper discusses the role of the occupational therapist in the treatment of chronic pain. It begins with a critical evaluation of our current theoretical understanding of pain, concentrating on the link between physical and psychological factors. A unit for the treatment of patients with chronic pain is described and assessment and practical treatment approaches are outlined. Emphasis is placed on a functional approach which maximizes the individual's control over his own pain.
What Makes a Good Manager?
Authors: Haylock Sally
Published: April 2015

What is required for successful management? Are people born with management ability or can the skills be learnt? Are there particular characteristics which are more commonly found in successful managers? This paper looks at what managers actually do and at management theory related to these questions. It gives some suggestions as to how management performance can be improved. It provides a framework within which occupational therapists can question their own methods and style of management, an exercise which can only be carried out individually in relation to personal approach, the environment and tasks to be achieved.
Using Aims and Objectives in a Multidisciplinary Team
Authors: Hong Chia Swee , Hill Janet , Blundy Claire
Published: April 2015

There is a considerable interest in the use of aims and objectives with mentally and multiply handicapped people. This article describes how a multidisciplinary team sets and implements aims and objectives for mentally handicapped children who live in a hospital. It also includes examples of recording a team meeting, an individual activity and a small group activity.
Brachial Plexus Lesions Part I: Management
Authors: Robinson C
Published: April 2015

Traction lesions of the brachial plexus which occur as a result of motorcycle accidents are unfortunately on the increase. The implications of these injuries are considerable when one considers that young men in the prime of life make up the majority of this category. Early assessment, diagnosis, treatment and rehabilitation, which are best carried out by a multidisciplinary team, lead to these patients being better equipped to return as functioning members of their communities at the earliest opportunity.
The Development of the Cambridge Apraxia Battery
Authors: Fraser Carole M , Turton Ailie
Published: April 2015

This paper describes an attempt to develop a battery of tests for use when assessing stroke patients for the presence of apraxia. The authors had found that existing studies of apraxia produced little information that was of practical use to therapists. Using an information-processing approach, the present study provides a test battery that yields useful information to a therapist treating patients with apraxia. Construction of the test battery is described, followed by a discussion of the application of the information gained from administering the battery to 27 stroke patients.
Both Sides of the Table (3): How to Interview: The Appraisal Interview
Authors: Pinder T H
Published: April 2015

This is the third of a series of four articles on interviewing with the general title of ‘Both Sides of the Table’.* Three kinds of appraisal interview are described — The inform and sell method, the inform and listen method, and the problem solving method — and their favourable and unfavourable aspects discussed.
We Can Use Computers Too! The Setting up of a Project for Mentally Handicapped Residents
Authors: Armstrong Jane , Rennie Jane
Published: April 2015

This article explores the setting up of a scheme to use microcomputers in the training of mentally handicapped residents living in a hospital. Computers are used at Brentry Hospital as an integral part of the overall programme for training and independence, and the authors feel that they have been a useful addition to other teaching methods. The article tells of their experiences in setting up the use of the computer and how they have progressed over a period of 2 years.
A Review of Home Visits by Occupational Therapists in a Geriatric Assessment Unit
Authors: Whitaker John J , Hornby Jane
Published: April 2015

A review of occupational therapy home visits carried out from a geriatric assessment unit over a 6-month period is reported. There were 179 non-respite admissions of patients previously living at home and 33% of these patients had a pre-discharge occupational therapy home visit. Almost 90% of visits led to discharge home, with the provision of additional aids in 63% and the recommendation of other additional support arrangements in almost 80%. Only one of the 54 patients discharged home was considered to have had a failed discharge.
Women as Managers: Implications for Occupational Therapy
Authors: Gill Thelma
Published: April 2015

This paper reviews some factors affecting the role of women as managers in the health care system. Issues such as selection and the importance of role models are discussed. A survey of existing management selection practices in the province of Ontario, Canada, reveals relevant information for consideration by women hoping to attain management positions.
Working with the Female Offender: A Case Study
Authors: Lloyd Chris
Published: April 2015

The crime rate for women has been increasing. This has been found for each criminal code offence, including sexual offences. Occupational therapy is able to play a significant role in the rehabilitation of the female offender. The assessment and treatment of a female incest offender is described in this article.
BJOT: What Next?
Authors: Hopson Sybil E
Published: April 2015

Readers make positive and negative comments about the journal. This article aims to explain some of the mysteries and to respond to comments made by readers recently.
‘Oh, No … Not Another Quiz!’
Authors: Gunter Jess
Published: April 2015

Whatever field of caring we are involved in, continual fresh and new ideas can bring a new dimension to the most ordinary activity. This article provides a resource of different ways to help make the humble quiz session more worthwhile and interesting.
A Review of Apraxia
Authors: Concha Marjorie E
Published: April 2015

Constructional, ideomotor and ideational apraxia are described in order to demonstrate their distinguishing characteristics. Tests were constructed to be able to distinguish between constructional apraxia and spatial problems in patients suffering from a CVA. The results of evaluating 15 right hemisphere CVA patients on the tests were analysed to determine the patient's problem. The test scores and test taking behaviour of two patients are presented to demonstrate that the difference between constructional apraxia and spatial problems cannot be diagnosed through test scores alone. Further, some of the effects of apraxia on the everyday function of the patient is described.
A Mesh Sheet Adjustable Tibial Brace with an Integral Heel Cup
Authors: Cunliffe M W
Published: April 2015

This article describes the application of a low-cost adjustable tibial brace made from a thermoplastic mesh sheet (Hexcelite), combined with a thermoplastic heel cup (Aquaplast). Since May 1985, over 100 such braces have been used satisfactorily at the Royal Preston Hospital. These have produced acceptable results, giving a well-ventilated brace of adequate rigidity with no skin/sweat rashes occurring.
Opening a Group Home
Authors: Voisey Penelope
Published: April 2015

This article describes the setting up of a group home in Guildford to accommodate, in two flats, 13 medium-stay patients from Brookwood Hospital. The acquisition of the property, the selection of suitable patients, the initiation of a support group and the activities involved are discussed, as well as the moving arrangements, follow-up and support. Finally, some preliminary suggestions regarding possible improvements for a similar venture in the future are given.
Survey of Rancho Flexor Hinge Splint Users
Authors: Lee Anita C
Published: April 2015

In the Welsh Spinal Injury Unit, wrist-driven Rancho flexor hinge splints are fitted for patients who have suffered a spinal cord injury at C6 level. Twenty patients responded to a questionnaire to determine the significance of early fitting, types of activities performed and reasons for discarding the splint. The article concludes that patients should be encouraged to gain the maximum potential of the splint.
Associate Members: Thumbnail Sketches of Disabling Diseases Encountered by Community Staff
Authors: Sutcliffe Pip
Published: April 2015

The articles in this short series for associate members sketch the major features of some long-term diseases commonly encountered by health and social service workers helping people in their own homes. They provide a starting point for understanding the problems of sufferers and their carers in adjusting their lives to these disabling conditions, particularly as they affect family life. Health and social service workers will develop their own sensitivity to life issues raised by these illnesses through further reading and experience.
Thumbnail Sketches of Disabling Diseases Encountered by Community Staff: Part 2
Authors: Sutcliffe Pip
Published: April 2015

The articles in this short series for associate members sketch the major features of some long-term diseases commonly encountered by health and social service workers helping people in their own homes.
Investigation into Telephone Enquiries Made to the Leeds Disabled Living Center
Authors: Stowe Janet
Published: April 2015

Disabled Living Centres (DLCs), of which there are 23 in the UK, provide a valuable service of information for those involved in all aspects of life of disabled people. Most initial contact with the Leeds DLC is made by telephone. All incoming telephone calls were monitored over a 3-month period during 1986–87, with the aim of discovering who was telephoning the centre, for what purpose and from where they had heard of the centre. 145 calls were received: 33 from disabled people, 25 from their carers, 60 from medical and paramedical staff and 27 from others. The source of information covered a wide range, including hospitals (17), occupational therapists and physiotherapists (17), and social services (11). Nearly half of the reasons for calling were for information about equipment. Few (8%) disabled callers and their carers had discussed their problem with their GP. Information about such resource centres must be readily available to both disabled people and those involved in their care.
How to Improve Your Management Skills without Going on a Course
Authors: Craik Christine
Published: April 2015

This article identifies which management development activities head occupational therapists employed by the Health Service in Scotland found to be most helpful in, first, preparing them to become managers and, secondly, fulfilling their role as head occupational therapists.
The Malta Occupational Therapy Course: The Final Year
Authors: Busuttil Joseph
Published: April 2015

The first occupational therapy course in Malta came to an end in October 1987. This article reviews the developments in the third year, prior to the emergence, in the island's health field, of the pioneer group of locally qualified occupational therapists.
Microwave Cookers: Their Value for People with Disabilities
Authors: Whiteman Elaine
Published: April 2015

This study describes the advantages and disadvantages experienced by a small sample of people with disabilities using microwave cookers. The subjects had a range of disabilities, including visual handicap. Useful features on these cookers, and aids and adaptations for use in conjunction with them, are also discussed. Although not found to be a complete replacement for conventional cookers, for most subjects microwave cookers were helpful in overcoming many physical difficulties involved in cooking.
Occupational Therapist: Marketing Manager?
Authors: Bailey Eileen A
Published: April 2015

This article aims to define marketing, to introduce various marketing functions and to encourage the development of marketing skills amongst occupational therapists.
Occupational Therapy with Cardiothoracic Patients: An Evaluative Study
Authors: Cox Diane
Published: April 2015

A research project was carried out at St George's Hospital to look at the role and effectiveness of occupational therapy with cardiothoracic patients. It was found that, once the service was in operation, a high demand existed and appropriate referrals were seen. The results indicate that treatment was effective.
The Application of Contemporary Treatment Approaches in Occupational Therapy for Children with Cerebral Palsy
Authors: Chu Sidney K H
Published: April 2015

The focus of this article is the application of three commonly used approaches — neurodevelopmental treatment, sensory integrative therapy and conductive education — in occupational therapy for children with cerebral palsy. The three approaches are compared to give an overview of the differences and similarities.
Playgroup Therapy with Deprived Children: Community-Based Early Secondary Prevention
Authors: Bell Veronica , Lyne Sarah , Kolvin Israel
Published: April 2015

This article describes research into a method of intervention in and prevention of the effects of multiple deprivation on inner-city infant schoolchildren and discusses some short-term effects. It covers the research background preceding the project and its aims to evaluate the impact of playgroup therapy on this section of the population. The methodology of setting up and assessing the study is explained, including the monitoring of play used during therapy. The therapeutic model — Developmental Play Therapy — is described, with attention given to the therapeutic relationship, the non-directive play setting and the use of various developmental frameworks. The article also describes how this technique can be used in a small group setting. A profile of the children included in the study is given and some short-term outcomes as seen through changes in play.
The Use of Disabled Living Centres by Disabled People
Authors: Gallop Julia F , Chamberlain M Anne
Published: April 2015

Disabled Living Centres are generally accepted as performing a useful service yet there are few data in the literature as to how they do this. The present study used an independent researcher who gained information about 75 consecutive non-professional visitors to one DLC. Visitors were questioned at the end of their visit to the centre and up to 6 months later. Most were significantly disabled with considerable locomotor difficulties. Most came to resolve specific problems and occupational therapists were the most important source of referral. A total of 95 items of equipment was suggested for 48 visitors. By the end of the study, 22 visitors had received all suggested items and most were highly satisfied. The situation was similar for adaptations but the time to deliver these was longer. DLCs were shown to be a most useful and effective resource for those seeking solutions to practical problems arising from disability. This self-help approach in which the disabled person takes the initiative in the rehabilitation process is to be encouraged and makes good use of occupational therapy expertise.
Committees: For Better or Worse
Authors: Barnitt Rosemary E
Published: April 2015

This article raises some of the issues which occupational therapists face when they chair or sit on committees set up by the professional body. It deals with both the structure and the process of committee systems. A check list is provided for therapists who wish to be involved in the committee system.
The Application of Perry's Model of Intellectual Development to Teaching a Course in Access and Design
Authors: Cobb Siobhan Mac
Published: April 2015

The skills of an occupational therapist require the ability to adopt a mature view to complex issues, where knowledge and value systems are appreciated as contextual and relativistic. The course in access and design is planned to develop such professional and intellectual skills by the application of Perry's Model of Intellectual Development.
The Relation between Perceptual Deficits after Stroke and Independence in Activities of Daily Living
Authors: Edmans J A , Lincoln N B
Published: April 2015

The impact of perceptual difficulties on daily life was evaluated using standardised procedures. One hundred and fifty stroke patients (75 right hemiplegic and 75 left hemiplegic) of all ages, admitted consecutively to two general hospitals, were assessed one month after stroke. They were assessed on the Rivermead Perceptual Assessment Battery to identify perceptual difficulties and on an activities of daily living (ADL) scale. Patients without perceptual deficits were more often independent than those with perceptual deficits. On simple ADL tasks, left hemiplegic patients were more often independent than right hemiplegic patients, but not on more complex ones. There was a significant correlation between perceptual abilities and independence in all ADL scales. There was no correlation between visual neglect and independence in ADL in left hemiplegic patients.
Corset Supply and the Hastings Corset Shop
Authors: Markley V J , Shepperd J A N
Published: April 2015

This article compares traditional made-to-measure corset prescription with the provision of ready-made corsets by self-selection under the guidance of an occupational therapist. A survey of 100 patients suggested that the ready-made versions are preferred by patients and also carry substantial cost advantages.
Solid Wood: A New Furniture Renovation Project for Psychiatric Patients in the Community
Authors: Cramer William
Published: April 2015

This article is about a community work project for psychiatric patients run largely by volunteers. It is hoped that it will encourage staff working in the community by demonstrating that work projects can be started by therapists or other workers who are not in senior management positions; and that through cooperation and planning, these projects can exist with the minimum of NHS funding alongside other rehabilitation schemes. The article describes how the project ‘Solid Wood’ began and the successes and difficulties that it encountered. It describes the basic ingredients of this work project as well as showing that dedication and enthusiasm for an idea are as important as planning and budgeting.
The Disabled Persons Act 1986: The Need for Counselling
Authors: Etherington Kim
Published: April 2015

This article examines the Disabled Persons (Services, Consultation and Representation) Act 1986 and, in particular, Section 3 which deals with the assessment of need. The particular emphasis is concerned with emotional need and counselling as a means of helping. There has been no specific statutory provision or recognition in the Act of the possible usefulness of a service to meet the emotional aspect of coping with and adjustment to disability. A second article will consider the occupational therapist as a counsellor towards attitude change in disability.
The Use of Home Therapy Programmes for Improving Recovery of the Upper Limb following Stroke
Authors: Turton Ailie , Fraser Carole
Published: April 2015

The effectiveness of home therapy programmes for facilitating recovery of stroke patients' reaching movements was tested. Twenty-two patients were visited regularly at home for approximately 9 weeks following their discharge from a rehabilitation unit. Twelve patients were assessed and provided with a programme of exercises, while 10 were visited for assessment only. The home therapy group's performance on a peg transfer test improved significantly more than that of the control group. Compliance rates with the programmes were high. These results lead to suggestions for further evaluation of home therapy.
Government Policy into Action: Good Discharge of Patients Leaving General Hospitals, Part 2
Authors: Sutcliffe Pip
Published: April 2015

This article describes a general hospitals unit's response to the Department of Health Circular (89)5 which requires general hospitals to make arrangements for patients' discharges which ensure satisfaction for all concerned. Theoretical models of implementation provide some insight into the problems of implementing policies, and into the range of actions which arise from the use of different models of hospital care. Some conclusions are drawn, showing impediments to implementation of the circular due to competing priorities.
To Bath or Not to Bath? A Joint Initiative to Resolve the Problem of Increasing Demand for Bath Assessments, Part 1
Authors: Porter Joyce , James Fiona
Published: April 2015

This article presents a possible solution to dealing with increasinǵ demand on social services occupational therapists for general assessments and examines, in particular, ways of reducing bath assessments as a method of decreasing caseloads. It demonstrates the practicalities of health and social services working together to solve problems and, by using a centralised base for bath assessments which in itself depends on the user group's commitment and motivation, to provide an improved overall service and a more efficient bath assessment. A second article will examine the findings and modifications and suggest ways forward.
‘Well, What is Occupational Therapy?’ An Examination of the Definitions Given by Occupational Therapists
Authors: Lycett Rachel
Published: April 2015

This article examines the spontaneous definitions of occupational therapy given by occupational therapists and relates the definitions to their current work setting. Data were collected by interviewing 46 occupational therapists working in East Dorset. The results showed that a wide range of words and phrases were used inconsistently to describe occupational therapy. The words and phrases were directly linked to the work setting. Recommendations are made to suggest that an improved definition of occupational therapy should be related to the work areas of occupational therapists. Also, a stronger professional identity should be established by examining the core elements of occupational therapy and including these in the definition.
Setting up an Occupational Therapy College in the Middle East
Authors: Busuttil Joseph
Published: April 2015

The first occupational therapy college in the Arab Middle East opened its doors in September 1989. Situated at the Farah Royal Jordanian Rehabilitation Centre within the King Hussein Medical Centre in Amman, Jordan, this educational establishment is a joint project between the General Union of Voluntary Societies and the National Medical institution. This article reviews the background to the project and the first year of the occupational therapy course, A later article will deal with the second and third years of the course and associated developments.
Stress Management for Carers
Authors: Gregory Susan
Published: April 2015

This article describes the setting up and running of a stress management group designed for people who are caring for an elderly person with confusion at home. It also outlines some of the issues raised during the course of the group about the reality of caring at home.
The Initiation and Evaluation of a Rheumatoid Arthritis Self-Help Group (RASH)
Authors: Bowell Catherine , Ashmore Alison
Published: April 2015

This article discusses the need for and importance of a self-help group in the treatment programme of patients with rheumatoid arthritis. It describes the aims, format and content of the group and analyses the results of two questionnaires. It is hoped that it will encourage workers elsewhere within the field of rheumatology to develop a similar group.
Are Norms the Key to Manpower Planning?
Authors: Crawford Gail , Johnson Sybil , Morris Shelagh , Steeples Sheila
Published: April 2015

Occupational therapy managers have relied on the College's document entitled Recommended Minimum Standards for Occupational Therapy Staff: Patient Ratios for more than a decade. Trent Region District Occupational Therapists' Group reviewed this document and agreed to formulate proposals for its update. This article describes the work of a project team who collaborated with regional manpower colleagues and the region's mental health occupational therapy services staff in an endeavour to establish norms, formulae or other means of manpower planning.
The Effect of Nutritional Education on the Shopping and Eating Habits of a Small Group of Chronic Schizophrenic Patients Living in the Community
Authors: McDougall Shelagh
Published: April 2015

Eleven people with chronic schizophrenia were the subjects of an 8-week study which asked three research questions. How did these individuals with a chronic mental illness function as deinstitutionalised persons? Did participation in a 6-week nutritional education programme affect cognitive performance and behaviour? And did the nutritional education package require further refinement? This experiment produced qualitative data which were analysed using descriptive statistics and evaluation of questionnaires. The pre-test and post-test scores of the subjects suggested that improved nutritional knowledge did not relate to attitudes or to the shopping and eating behaviour of people with chronic schizophrenia living in the community. A future need to address this lack of generalisation of skills was identified.
A Survey of Transport for Children in Wheelchairs
Authors: McMillen Pauline H
Published: April 2015

This article is the result of an investigation carried out during 1988/1989 into the way in which local education authorities transport children in wheelchairs to and from school. It covers areas such as the number of children with special needs transported on a daily basis, the ownership of the vehicles used to transport them, the use of tail gate lift vehicles and the details of any accidents that had happened during the previous 5 years. There did seem to be a wide variation across the country in the suitability of transport provided for the children. In general, Northern Ireland and the metropolitan areas of England provided more appropriate transport.
General Practitioners and Wheelchair Prescribing
Authors: McMahon Martin , Dudley N J
Published: April 2015

A random sample of general practitioners was surveyed by postal questionnaire to determine their knowledge of wheelchairs and wheelchair prescribing, and their opinion of the usefulness of the A0F5G for wheelchair prescribing. Seventy-four per cent considered their knowledge of wheelchairs to be ‘not very good’ or worse, and one-third found the A0F5G to be inadequate for prescribing and difficult to complete. Inadequacy of training was identified as the likely cause of these findings. Improved educational programmes for doctors at both an undergraduate and a postgraduate level would raise the standards of wheelchair prescribing.
An Introduction to Occupational Therapy for High Risk Infants on Special Care Baby Units
Authors: Warren Inga
Published: April 2015

This article introduces a role for occupational therapy in Special Care Baby Units (SCBUs). The relevance of occupational therapy is discussed, a potential client group is identified and effective intervention studies are briefly described. Skills and training needs are reviewed and suggestions given for occupational therapy. Some likely problems are discussed.
Occupational Therapy Core Skills in Mental Handicap: A Review of the Literature
Authors: Renton Linda B M
Published: April 2015

This article attempts to explore the core skills in occupational therapy by reviewing the relevant literature and then to relate the findings to the field of mental handicap. It should be read in conjunction with recently published and accepted work on occupational therapy core skills and skill mix. A brief overview of the rote of occupational therapy in mental handicap is given and the concept of core skills is defined and discussed with reference to competence, skill mix and teamwork.
Handing over the Controls: Alternative Controls for Wheelchairs in Cambridge
Authors: Greenfield Eve , Lachmann Sylvia , Wrench Alan
Published: April 2015

There are people who, despite being perfectly able mentally and visually, are unable to use a powered wheelchair because they cannot manage any of the standard controls due to their physical disability. An initial study had been undertaken partly to establish how many people were involved and to see if it was viable to invest money into developing more sophisticated controls. Before this stage was reached, it was important to make sure that all the controls currently available had been tried. Alternative controls clinics were therefore set up to fulfil this need. It was found that not all but most problems could be solved by adapting standard equipment or perhaps using it in a different way. Two case histories are used to demonstrate some of the problems encountered in the alternative controls clinic.
Experience of Community Physiotherapy for People with HIV Infection
Authors: Lang Cherry
Published: April 2015

This article discusses the setting up of a community physiotherapy service for people infected by HIV (human immunodeficiency virus). It looks briefly at the rationale for the practice of relaxation and of exercise to promote health for people with HIV infection, and discusses some of the clinical experiences during the first year of the service. Many aspects will be of interest to occupational therapists.
Establishing Objectives in Occupational Therapy Practice, Part 2
Authors: Hammell Karen R Whalley
Published: April 2015

Part 1 of this study examined the range of objectives that must be included in a personal rehabilitation plan, in order to ensure compatibility with clients' goals, values and aspirations. In Part 2, examination is made of the importance of identifying when objectives have been reached and what characteristics these objectives should have for it to be possible to recognise that they have been achieved. This is placed in the context of accountability and the use of outcome measures. Spinal cord injury is again used for illustration. Consideration is given to the possible barriers to active patient participation in the rehabilitation process.
Problem-Based Learning in the Development of an Occupational Therapy Curriculum, Part 1: The Process of Problem-Based Learning
Authors: Sadlo Gaynor , Piper David Warren , Agnew Patricia
Published: April 2015

‘Problem-based learning’ is a concept of learning in which students focus from the beginning of their course on a series of real professional issues, where the knowledge of the various academic disciplines that relate to these issues is integrated. The process evolved from dissatisfaction with the usual teaching methods in higher education, particularly in medicine. It seems eminently applicable to the education of occupational therapists, and its wider adoption is advocated. Part 1 of this article outlines the development of problem-based learning, describes its rationale, and discusses some of the evidence of its effectiveness. Part 2 will describe its implementation in the new BSc course at the London School of Occupational Therapy, West London Institute, College of Brunel University.
Phantom Pain: A Critical Review of the Proposed Mechanisms
Authors: Hodges Craig , Bender Louise
Published: April 2015

Deafferentation refers to any process that results in a loss of afferent input at the peripheral or central nervous system level. Phantom pain has been demonstrated to affect a significant number of people following a range of deafferentating conditions. These conditions include amputation, spinal cord injury, brachial plexus avulsion and even congenital aplasia and local anaesthesia. Despite the prevalence of phantom pain, little is known about its cause; indeed, it remains a contentious issue. This article discusses the major theories proposed and the evidence accumulated regarding each. A mixed mechanism is mooted, which combines pertinent elements from each theory, and the implications for occupational therapy are discussed.
The Use of Spreadsheets to Aid Management in Occupational Therapy
Authors: Clark Yolande
Published: April 2015

The aim of this article is to demonstrate the flexibility of spreadsheets as an aid to management in occupational therapy. The problems of introducing this electronic tool are explored.
The Nottingham Leisure Questionnaire for Stroke Patients
Authors: Drummond A E R , Walker M F
Published: April 2015

Although leisure is now regarded as an Important aspect of life, there is no suitable instrument to measure the leisure activity of stroke patients in this country. An instrument was therefore developed and its reliability tested. The majority of results for the inter-rater reliability study were ‘excellent’, and ‘excellent’ or ‘good’ for the test re-test reliability study. It is suggested that the tool has potential for clinical use.
Multiple Sclerosis in the Community: A Selective Survey
Authors: Esgate Anthony
Published: April 2015

A survey was conducted to assess aspects of the distribution of and service provision for clients with multiple sclerosis (MS) in a South London borough known from previous research to have a prevalence that exceeds national expectations. No distinctive feature of the borough or of the MS clients sampled supported the conclusion that the borough is in any way unique. Demand for occupational therapy services from MS clients in comparable areas may, therefore, be underestimated. Quality of service provision however, as assessed by the survey, was found to be good but additional support for carers is indicated.
Service Provision to Black People: A Study of Occupational Therapy Staff in Physical Disability Teams within Social Services
Authors: David Paul A
Published: April 2015

This research derived Its Impetus from the need to recognise that we live in a multiracial and multicultural society. Thus, the responses of caring agencies to individuals must be governed by the fact that there are varying needs depending on cultural and racial backgrounds, and the services that are provided need to be geared to all sectors of the community.

The study focused on the occupational therapists and occupational therapy assistants In physical disability teams in a social services department and the service they provided to their black clients. The aim was to assess how effectively these professionals were meeting their obligations, as specified in the Race Relations Act 1976 and the city's equal opportunities policy. The article also looks at the features of policy and practice that inhibit occupational therapists and their assistants in responding to black people.
What Occupational Therapists Can Learn from Traditional Healers
Authors: Kelly Linda
Published: April 2015

Historically in Africa and throughout the world, patients with psychiatric complaints have sought out a traditional heaier for treatment. Today, to deal more effectively with patients who come for modern medical treatment, it is important for the occupational therapist to understand, reinforce and even incorporate aspects of traditional healing with patients who also seek out traditional healers. This article explores the key components of traditional healing that may be familiar to the occupational therapist, in order to create the understanding that is needed to treat appropriately those patients whose beliefs find comfort in the traditional healer. The Model of Human Occupation provides the structure to include the traditional heaier as a component of the environment from which the patient comes.
Expert Clinicians' and Students' Views on Clinical Reasoning in Occupational Therapy
Authors: Strong Jenny , Gilbert Jillian , Cassidy Susan , Bennett Sally
Published: April 2015

In this study, an examination was made of the clinical reasoning processes used by expert occupational therapists and post-clinical fourth-year occupational therapy students. Using nominal group technique, the factors involved in clinical reasoning were derived and their relative importance determined.

The most highly valued skill for the experts was good communication, while the most highly valued skill for the students was a knowledge of and understanding of disability. The experts considered a wider range of factors when making clinical decisions than did the students, and rated their level of clinical reasoning at a higher level than did the students. For the experts, the factors identified as important in clinical reasoning were concerned more with gaining an understanding of the patients both by using general principles of diagnosis and illness and by gaining an understanding of the illness as it affected the individual patient. Meanwhile, for the students, greater emphasis was placed upon the influence of pragmatic factors on treatment, such as resources, time constraints and other environmental factors.
Factitious Disorders in Occupational Therapy: Sad Cases or Incorrigible Rogues?
Authors: Barnitt Rosemary E
Published: April 2015

Inventing Illness or disability for social, emotional or financial gain has been known to occupational therapists since the early days of professional practice. Despite this, there is little literature that is relevant to therapists' practice. In medicine, the condition has attracted a number of labels from ‘polysurgical’ to ‘conversion hysteria’. More recently, the subject has received renewed popular interest because of media coverage of dramatic and newsworthy cases of Munchausen's syndrome and Munchausen's syndrome by proxy. Within the medical literature, the 1994 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) now Includes a section titled ‘Factitious disorders’. The definition of these disorders is given as ‘physical or psychological symptoms which are intentionally produced or feigned in order to assume the sick role’.

In occupational therapy, evidence from the letters page suggests that such clients are known and talked about, but that there are few procedures or guidelines for dealing with them. A tension is apparent between therapists who view these clients as wilfully behaving badly for gain (incorrigible rogues) and therapists who view these clients as having profound psychological problems (sad cases). The differing implications for service delivery, where one or other of these beliefs is strongly held, are divisive. In this article, the nature of factitious disorders in occupational therapy is explored, using examples from research into ethical dilemmas and information from respondents to the letters page of this journal. From these it appears that therapists are skilled at identifying such clients, but how and by whom the client should be confronted and treated remains unresolved In a number of workplaces.
The Potential Benefits of ‘Clinical Induction’ in Occupational Therapy
Authors: Fleming Anne , Tullis Alison
Published: April 2015

This article explores the development of the ‘induction process’ for qualified staff and examines the purpose induction should serve within occupational therapy. Induction is defined and the benefits to new and existing staff participating in Induction programmes are highlighted. Suggestions are made as to how the process of induction might be structured, with recommendations for both clinical and educational staff.
Clinical Decision Making in Familiar Cases: A Model of the Process and Implications for Practice
Authors: Hagedorn Rosemary
Published: April 2015

This qualitative study describes the clinical reasoning and decision-making processes used by experienced occupational therapists in physical practice when deciding on the first intervention in a familiar type of case. The main finding was that therapists use schematic processing to speed the identification of problems and to indicate potential solutions and actions. Such processing is rapid and automated. Theory appears to become embedded in practice to the point where the therapist is no longer conscious of using it.

A model of the mental problem space generated by therapists during decision making is proposed and the implications for practice are discussed. This model may help to explain some of the differences observed in the reasoning of novice and experienced practitioners. The sample is too small to permit generalisation, but the findings are compatible with theories of cognition and problem solving and also with the results of studies into medical decision making.
Using the Occupational Performance History Interview (OPHI): Therapists' Reflections
Authors: Fossey Ellie
Published: April 2015

Clinical interviews provide occupational therapists with sensitive and versatile sources of information; however, reliable means to collect and interpret this information are necessary for effective clinical decision making. The Occupational Performance History Interview (OPHI) is a semi-structured interview, designed to address the need for a reliable and clinically useful interview tool in occupational therapy. This article describes a qualitative research study, in which four experienced therapists reflected on their use of the OPHI to interview people referred to a psychiatric day hospital service.

The therapists' reflections, based on listening to audiotapes of these interviews, focused on the interview procedure and on themselves as interviewers. They illustrate how the conduct and interpretation of interviews may be guided by interactive reasoning and professional values. The development of a conversational interviewing style, whilst using this semi-structured interview tool, is also described. To develop reliable interview tools that are also consistent with the particular values and perspective of occupational therapy, consideration might usefully be given to using evaluation criteria applied to qualitative research, as well as conventional scientific criteria of reliability and validity.
The Development of the Role of Access Officer in Psychological Services
Authors: Duguid Liz
Published: April 2015

This article describes the post of Access Officer as developed by the Psychological Service in Central Region, Scotland. It looks at how the needs of physically disabled children and the policy of integrating them into mainstream schools brought about the creation of the post, the initial concept of the post and how the post has broadened and developed over 4 years. It looks briefly at work still to be done and reports on some feedback from the service users.
Some of the Implications of Caring for a Child or Adult with Cerebral Palsy
Authors: Pimm Paul L
Published: April 2015

Many studies have suggested that the presence of a child or adult with a disability in a family can, and does, have a significant impact upon family members, in particular the primary caregiver. Research findings have indicated that there may be social isolation, lack of awareness of services, poor service delivery and psychiatric disorders among parents. However, there have been fewer psychosocial studies on specific conditions such as cerebral palsy and fewer still that consider objectively the impact of caring upon both mothers and fathers caring for their son or daughter throughout a life span.

This article, part of a larger research undertaking, presents some key survey findings from a study of 235 mothers and fathers of children and adults with cerebral palsy. The parents evaluated the caring process and their satisfaction with the professionals involved in service delivery. The prevalence of psychiatric morbidity among the parents is also reported. The findings indicate that the mental well-being of many fathers and even more mothers was severely affected by the caring process. High levels of parental dissatisfaction with some professionals are reported.