bluuebunny/crossref_metadata_2025 huggingface dataset:
A Review of the Initial Outcomes of a Return-to-Work Programme for Police Officers following Injury or Illness
Authors: Pratt Joanne , McFadyen Angus , Hall Gillian , Campbell Margaret , McLay David
Published: April 2015

Industrial injury and, conversely, chronic illness have well-described consequences on work performance, including the individual's ability to maintain paid employment and the necessity for medical retirement and/or benefits payments. Return to work following prolonged illness has long been valued as a goal and an outcome measure of varied models of rehabilitation, including back schools, work hardening, work conditioning and pain management programmes. Age, gender, length of sickness time, psychological factors, and type and duration of rehabilitation programme, among others, have all been presented as predictors of outcome and continue to be debated in the literature.

This article describes the initial outcomes of a return-to-work programme established specifically to address the development of chronicity following injury or illness in police officers. Early findings, that is, return-to-work rate, increases in lifting capacity and grip strength, appear positive. No correlation was found between length of time since diagnosis, age or number of sessions attended. The limitations of these findings are also discussed.
Using the Delphi Technique in Planning a Research Project on the Occupational Therapist's Role in Enabling People to Make Vocational Choices following Illness or Injury
Authors: Stokes Fran
Published: April 2015

While planning a research project intended to examine the role of the occupational therapist in enabling people to make vocational choices following illness or injury, it was decided to use the Delphi technique in order to ascertain the views of stakeholders in this field. Panellists were asked about the types of problem encountered when people are considering their future occupation after a long period of sick leave, and to identify the services that might be expected to assist with such problems. Although the response from selected panellists was initially poor, those who responded to the first round generally continued to respond to further rounds until a consensus was formed of stakeholder opinions.

The survey showed that financial problems, loss of confidence, coping with the effects of permanent disability, employers' attitudes and the need for training or retraining were considered to be the main problems facing people in this situation. Despite the low response, the Delphi technique proved itself to be a flexible and valuable tool for gathering data when planning services. This article aims to describe and evaluate the Delphi method, and to summarise the information gathered through its use on this occasion.
Employment in the Next Millennium: The Impact of Changes in Work on Health and Rehabilitation
Authors: Steward Barbara
Published: April 2015

The world of work is changing with the increasing number of flexible employers, who use casual labour, and of flexible workers, who are engaged in flexitime or home-based work. Predictions for the impact of such changes are both optimistic and pessimistic, but it is clear that there will be implications for rehabilitation from the growth of flexible work. Flexible work, with greater job insecurity and need for occupational health protection, may increase instances of ill-health and loss of wellbeing. At the same time, computer-based and home-based work may open up new opportunities for chronically sick and disabled people to compete as teleworkers in the open labour market. This article offers a sociological examination of the effects of flexible work and suggests areas of importance to occupational therapists.
Voluntary Work in the Lives of Post-Retirement Adults
Authors: Oakley Crispin , Pratt Joanne
Published: April 2015

The ability of an individual to adapt to either role loss or role gain when he or she enters a period of retirement is influenced by many factors and several attempts have been made to describe both successful and unsuccessful role adaptation. This study aimed to examine the relationship between leisure activities and life satisfaction in a sample of 40 retired adults, aged 60–83 years. The difference in life satisfaction and leisure activities in one group of 20 subjects who undertook volunteer work was compared with a second group of 20 subjects who did not undertake volunteer work. Three data collection instruments were used: a demographic questionnaire, a leisure activity questionnaire and a life satisfaction questionnaire.

When Spearman's rank order correlation coefficient was applied to the data to examine the relationship between leisure activities and life satisfaction levels for the full sample of subjects, a positive correlation was found at the 5% level. However, when the groups were examined separately, only the non-volunteer group scores showed a positive relationship. In order to compare life satisfaction levels and leisure activity patterns of those subjects who participated in voluntary work with those who did not, the Mann Whitney test was applied to the data. The results for both groups were not significant at the 5% level.
The Development of Insight following Severe Traumatic Brain Injury: Three Case Studies
Authors: Fleming J M , Strong J
Published: April 2015

A longitudinal study of 55 adults with severe traumatic brain injury was conducted to investigate the development of self-awareness, emotional distress and motivation during the first year after injury. Cluster analysis was performed on data gathered at one year post-Injury. Three clusters labelled ‘high self-awareness’, ‘low self-awareness’ and ‘good recovery’ were retrieved. A case study is presented from each cluster, contrasting the stages in the development of self-awareness of deficits over the year. This research suggests that clients with acquired brain injury can be classified on the basis of level of self-awareness. Issues for the rehabilitation of and occupational therapy with clients from the three groups are raised.
Bridging the Gap — Employment and Education, Part 1: An Evaluation of an In-Service Course
Authors: Ilott Irene , Kenyon Joan
Published: April 2015

The first part of this article describes and evaluates a part-time diploma course in occupational therapy. It was instigated by a consortium of health and local authorities, using a contractual process that predated current educational purchasing arrangements. The course achieved a pass rate of 92% and nil voluntary attrition, much to the satisfaction of all the stakeholders. This was due to the students' intrinsic motivation, the partnership between the providers, purchasers and workplaces, an andragogical approach that optimised work-based learning and extensive support networks. The principle of placing the needs of part-time adult learners at the centre of the educational process is relevant for those involved with similar routes. Part 2 will report on the results of a one-year follow-up destination survey.
Homelessness: A Review of the Social Policy Background and the Role of Occupational Therapy
Authors: Mitchell Hazel , Jones Derek
Published: April 2015

This article introduces occupational therapists to some of the legislation regarding homelessness and to the research that has been conducted into current trends and the causes of the problem. Health-related issues and the help available for homeless people are highlighted. Finally, the role of occupational therapy as described in the literature is outlined.
A Longitudinal Study of Occupational Therapy New Practitioners in Their First Years of Professional Practice: Preliminary Findings
Authors: Atkinson Kim , Steward Barbara
Published: April 2015

There is limited information in the public domain about the experiences of newly qualified occupational therapists during the early years of professional practice. This article presents the preliminary findings of a longitudinal study following the experiences of the first cohort of occupational therapy graduates from the School of Occupational Therapy and Physiotherapy at the University of East Anglia over the first 3 years of their professional practice. It addresses factors related to the graduates' choice of first post, their perceived level of preparation for practice and their involvement in continuing education.
Bridging the Gap — Employment and Education, Part 2: Education into Practice
Authors: Kenyon Joan , Ilott Irene
Published: April 2015

The second part of the article evaluating the South Trent In-Service Diploma Course in Occupational Therapy contains the results of a one-year follow-up destination survey of the ex-students, their then line managers and the representatives of the sponsoring authorities. There was a high retention level, with 18 of the 19 respondents still working for their sponsoring authority. A majority agreed that the course had provided value for money, producing competent entry-level therapists as defined by the College of Occupational Therapists. The ex-students perceived themselves to be more confident when compared with peers who had undertaken a full-time route. This difference was attributed to their previous life and work experience. These outcomes provide evidence for the effectiveness of a course grounded in the practice context.
Assessments of Activities of Daily Living and Instrumental Activities of Daily Living: Their Use by Community-Based Health Service Occupational Therapists Working in Physical Disability
Authors: Wolf Helen
Published: April 2015

A preliminary study was carried out to evaluate the appropriateness of activities of dally living (ADL) scales as outcome measures for a community-based multidiscipilnary service to physically disabled young people. A literature search was undertaken which raised several questions and concerns. To find out how other teams addressed these issues, telephone interviews were conducted with occupational therapists working in similar NHS teams. They were asked about the nature of their services, their use of ADL and ADL scales and whether these were administered as outcome measures.
An Evaluation of the Occupational Therapy for Spinal Fusion Hip Spica Patients
Authors: Budge Gillian
Published: April 2015

Spinal fusions, achieved by means of Steffee plates, can be followed by the patient being encased in a hip spica jacket for 3–6 months. This is likely to create functional difficulties for the patient, which are appropriate for occupational therapy. This research aimed to evaluate a hospital occupational therapy service provided to these patients and the follow-up community occupational therapy likely to be received on discharge. All the patients underwent surgery at an elective surgical unit within a general hospital.

There were 25 patients in the study and 24 were available for interview within their own home 10 weeks postoperatively. Relevant data were collected on a number of clinical as well as functional topics. From all the sources of data it was concluded that these patients did experience difficulties postoperatively, although occupational therapy could address only some of them. In addition, it was indicated that rehabilitation was not complete once the patient's discharge package had been implemented and that, in fact, further rehabilitation was likely to be beneficial when the hip spica was gradually discarded. This article focuses on the patients' perceptions of the hospital occupational therapy service.
Openness to Group Interaction between Clients in Acute Care Psychiatric Units
Authors: Lloyd Chris , Maas Frikkie
Published: April 2015

The aim of this exploratory study was to determine the relationships between elements of group interaction in an acute psychiatric setting. The subjects were 204 adults with a major mental illness who attended a lower-level psychotherapy group. A questionnaire containing seven therapeutic elements was administered to the subjects at the end of one of the group sessions. Only one factor emerged, labelled ‘Openness to group interaction’, which explained 59.3% of the variance. Apart from the unknown percentage of error variance, the remaining 40.7% of the variance indicated that the seven elements were unique, separate processes to some extent. They should, therefore, be considered individually when monitoring changes in group interactive processes of acute psychiatric clients.
A Review of the Literature in the British Journal of Occupational Therapy, 1989–1996
Authors: Mountain Gail A
Published: April 2015

This article describes an analysis of the content of papers in the British Journal of Occupational Therapy over an 8-year period, from 1989 to 1996. The analysis is underpinned by research questions concerned with extent of published research, evidence of responsiveness to recent health and social care policy implementation and demonstrations of clinical effectiveness.

The results of the analysis show that the majority of published papers over the 8 years were descriptive in nature. Of the papers with a research orientation, the most reported area of interest was physical disability. However, much of this research was small scale and there was a notable absence of funded projects. Nevertheless, the number of papers describing research activity increased markedly during the latter years, as did the application of evidence-based material. Policy-related material was poorly represented overall, as were papers concerned with evidence of effectiveness.

These results suggest that occupational therapists are developing a research base. However, this needs to extend across a range of clinical interests. There is also a need to demonstrate a greater understanding of roles and responsibilities within the current policy framework.
Problem-Based Learning, Part 1: An Innovation Whose Time Has Come?
Authors: Savin-Baden Maggi
Published: April 2015

This is the first of three papers which explores the growing influence of problem-based learning (PBL) within professional curricula. A qualitative study was undertaken to examine the expectations and experiences of staff and students in different professional and educational environments who were involved in using PBL (Savin-Baden, 1996). What emerged from this work was a new model -Dimensions of Learner Experience – for understanding the nature of learner experience on PBL programmes, characterised by significant diversity between espoused aims and values, and what happened in practice and in relationships between staff and students. Part 1 documents the emergence of PBL in the climate of worldwide change in order to contextualise the growing influence of PBL within professional curricula.
Intervention Effectiveness: Evidence from a Case Study of Ideomotor and Ideational Apraxia
Authors: Butler Jenny
Published: April 2015

This paper considers the characteristics of apraxia and presents a case study which explores the effectiveness of tactile and kinaesthetic stimulation as an intervention strategy, in addition to visual and verbal mediation input, in the rehabilitation of a man with ideomotor and ideational apraxia following a head injury. Using an ABA design, quantitative measures were used to monitor change in motor performance. The results indicated some significant differences in measured performances between baseline and intervention phases and provided limited evidence of the effectiveness of additional sensory input. The implications for occupational therapy are discussed as are the limitations of the study.
An Investigation of Stroke Patients Resuming Sexual Activity
Authors: Edmans Judi
Published: April 2015

An area often neglected in stroke rehabilitation is patients returning to their normal sexual activity. Generally, this is not discussed routinely with patients as part of their rehabilitation, even though for many it plays an important role in their lives.

An investigation was carried out on the Nottingham Stroke Unit to identify whether stroke patients had been able to resume their sexual activity, what information they would find useful and when this should be given. The results showed that sexual activity generally deteriorated after a stroke and that patients and partners wanted relevant information when the patient started spending time at home or just before discharge. There was variation regardinthe need for private consultation and most patients and partners felt that returning to sexual activity should be considered as part of stroke rehabilitation.
Distinguishing between Occupation, Purposeful Activity and Activity, Part 1: Review and Explanation
Authors: Golledge Janet
Published: April 2015

Part 1 of this article explores how occupational therapists use the terms occupation, purposeful activity and activity. A literature review of the topic is presented, followed by a personal reflection and definition. It is hoped that this will provide an illustrative example of how the terms could be used and may assist occupational therapy students and occupational therapists to appreciate the potential differences. It is suggested that the terms occupation and purposeful activity should be used to reflect more accurately what occupational therapists do in their professional practice.
The Use of Photographs as a Means of Obtaining Views of Occupational Therapy Held by Children with Learning Disabilities: A Pilot Study
Authors: Joy Debbie , Young Anita , Harvais Val , Chesson Rosemary
Published: April 2015

As an adjunct to a pilot project on the use of Goal Attainment Scaling in occupational therapy for children with learning disabilities, children's views of therapeutic intervention were explored. These were investigated by means of interviews held at the residential special school that the children attended and were carried out by a therapist who was unknown to them.

During the interview, six photographs (three therapy and three non-therapy related) were presented. Each child's response was recorded by the interviewer. Despite the seven children having emotional and behavioural difficulties, all cooperated during the interviews, looking at the photographs and not displaying any challenging behaviour. When the children's responses were categorised in terms of their unique styles of communication, more positive reactions to the photographs relating to occupational therapy than to the others were noted. It is acknowledged, however, that further development work is required in order to establish the reliability and validity of the method.
The Delphi Technique: An Adaptive Research Tool
Authors: Sumsion Thelma
Published: April 2015

The Delphi technique is one type of research methodology that is growing in popularity. This paper introduces this technique to therapists searching for a user-friendly method of conducting research. The Delphi process is explained and several issues that the researcher must consider are presented. These issues include the identification of participants and the number of questionnaires or rounds that are required to reach consensus.

A discussion of the advantages and disadvantages of the technique concludes that the argument is weighted equally on both sides. Applications to research in rehabilitation are reviewed and brief case scenarios related to the application of the technique to management issues are presented for further consideration. The Delphi technique is not a perfect tool for all situations but it can be adapted to address a variety of issues in a range of working environments.
Occupational Therapists' Perceptions of Their Undergraduate Preparation for the Workplace
Authors: Adamson Barbara J , Hunt Adrienne E , Harris Lynne M , Hummel Jill
Published: April 2015

The health care environment is undergoing rapid change. This has major implications for health science education programmes. The extent to which university education prepares graduates for the requirements of the workplace has become an important issue in the health science literature. The present study investigated the perceptions of 144 graduate occupational therapists regarding the adequacy of their undergraduate education at the University of Sydney in equipping them for the workplace.

The findings indicated that occupational therapy graduates perceived significant gaps between the knowledge and skills gained during their undergraduate course and those required in the workplace, particularly in the areas of communication with other health professionals and the general public, knowledge of the health industry and workplace management. This paper considers the implications of workplace requirements and expectations for the occupational therapy course curricula.
Efficacy and the Self
Authors: Brewer Paul
Published: April 2015

Psychoanalytic theory concerning efficacy is reviewed from a historical perspective together with the work of the more recent writers, Daniel Stern and Joseph Lichtenberg. The contribution of the early caregiver and the impact of upbringing on the experience of efficacy is considered. Some psychoanalytic ideas are applied to the practice of activity-based therapy.
Anxiety Management Groups in a Community Mental Health Team
Authors: Rosier Candida , Williams Hilary , Ryrie Iain
Published: April 2015

Just as the delivery of care to people with mental health problems has evolved, so too has the role an occupational therapist plays in the multidisciplinary mental health team. This paper highlights the valuable role of occupational therapists within a particular community mental health team by, first, acknowledging their specialist skills and then describing one component of their work: a 7-week closed group for anxiety management. Finally, it provides recommendations for others who may wish to set up a similar group, which have been drawn from the authors' own experiences.
Sources of Stress and Coping Strategies in Basic Grade Occupational Therapists
Authors: Leonard Christine , Corr Susan
Published: April 2015

Little research has been carried out investigating the sources of stress and methods of coping with them in recently qualified basic grade occupational therapists. A postal survey was conducted involving 80 basic grade occupational therapists nationwide who graduated in 1995. The results, from 62 respondents (78%), indicated that organisational issues were the most popular sources of stress, with ‘too much paperwork’, ‘limited resources for client/patient care’ and ‘staff shortages' being the top stressors. The findings suggest that many coping strategies are available to basic grades in the workplace, including formal supervision and informal support, and that they are using them.
Sexuality Education and Counselling for Individuals with a Spinal Cord Injury: Implications for Occupational Therapy
Authors: Summerville Patti , McKenna Kryss
Published: April 2015

Sexuality is an integral component of human behaviour, being the expression of an individual's personality and identity. Consequently, sexuality education and counselling, as part of the rehabilitation process for individuals with a physical disability, are considered important. Although the role of occupational therapists in facilitating sexuality as a life skill Is recognised, their participation in this component of rehabilitation is low, reportedly as a result of perceived inadequate knowledge.

This paper focuses on spinal cord injury as an example of a physical disability. To highlight the need to address sexual concerns, the physiological and psychological aspects of individuals' altered sexual status after spinal cord injury are briefly described. The limitations in the sexuality education and counselling programmes provided to date are explored, with recommendations made as to how such intervention can be improved and the role that occupational therapists may play in this service provision. The P-LI-SS-IT model is presented as an appropriate framework from which to develop and deliver an effective sexuality education and counselling programme for individuals with a spinal cord injury. It is concluded that occupational therapists, as part of a multidisciplinary team, should adopt an active role in the delivery of sexuality education and counselling programmes for individuals with a physical disability.
Occupational Therapy and the National Health Service, 1948–1998
Authors: Paterson Catherine F
Published: April 2015

Much of the history of occupational therapy is associated with the history of the National Health Service (NHS). As the nation celebrates the 50th anniversary of the founding of the NHS on 5 July 1948, it is fitting to reflect on the development of the profession over the past half century and how it has adapted to the many medical, technological, demographic and social changes.

In 1948, the profession comprised a small band of mainly middle-class women, who worked under medical direction with long-stay patients in a hospital setting. In 1998, over 18,000 occupational therapists are state-registered. Having gained degree-entry status practitioners are increasingly self-directed and research-focused, and they work in a wide range of settings with all age-groups: a profession reflecting the ideals of the NHS to provide a service from ‘the cradle to the grave’.
An Evaluation of the Use of the Mayers' Lifestyle Questionnaire
Authors: Mayers Christine A
Published: April 2015

This article describes two studies that evaluated the use of two tools of a client-centred approach for use in community occupational therapy, namely the contact letter and the Mayers' Lifestyle Questionnaire. The first study involved community occupational therapists, mainly working in social services. They used the contact letter and the Lifestyle Questionnaire with their clients who had problems caused mainly by physical disability. The second study used an adapted Delphi technique in order to involve a Disability Action Group in the evaluation process. Finally, the article brings the reader up to date with the present use of the Lifestyle Questionnaire and related research being undertaken with clients with mental health problems.
Risk in Dementia – Assessment and Management: A Literature Review
Authors: Thom Karen M , Blair Sheena E E
Published: April 2015

Dementia affects a person's ability to undertake previously achievable tasks which can present risks. The assessment and management of risk can differ and inclusion of the person's view is not always apparent.

This literature review aimed to explore current knowledge concerning key areas relevant to risk assessment and management. This included the contribution of occupational therapy functional assessment. It revealed that knowledge tended to be practice based, rather than research based, and that there was no specific research on functional assessment of risk. Issues of how risk was established by those involved and consideration of the person's view were raised.
Single-System Methodology: A Way Forward in Dementia Care?
Authors: Perrin Tessa
Published: April 2015

Owing to the cognitive disability of people with dementia, the direct observation of behaviour is often the only means of evaluating the impact of therapeutic interventions. A number of standardised instruments of direct observation have been developed in recent years, but none offering the occupational therapist the flexibility with which to evaluate the diversity of physical, emotional, cognitive and behavioural variables encountered in dementia care. Conventional group-comparison methodology is inadequate in the clinical setting. Single-system evaluation is able to address the highly individualised needs of people with dementia. This paper describes how an evaluation may be custom-built to identify the specific changes elicited in a specific individual by a specific intervention under specific conditions.
Reflexivity: An Essential Component for All Research?
Authors: Finlay Linda
Published: April 2015

This article explains how reflexivity offers us a way to turn the problem of subjectivity in research into an opportunity. Examples of personal reflexivity, in the form of subjective analysis of some research encounters which have occurred during my own research, are presented to illustrate how the reflexive process can unfold new understandings. The discussion argues that personal and methodological reflexivity should be included as an element of every investigation (qualitative or quantitative) and that without it the validity of the research could be undermined.
Screening for Neurological Dysfunction in the Specific Learning Difficulty Child
Authors: Blythe Sally Goddard , Hyland David
Published: April 2015

A developmental questionnaire was given to the parents of 140 children. Seventy of the children had a history of specific learning difficulties which had not responded to normal remedial education. The remaining 70 had no history of specific learning difficulties. The research was undertaken to ascertain whether the developmental questionnaire could be used as a reliable instrument to detect the neuro-developmental delay underlying the specific learning difficulties and preventing remedial intervention from being effective.

The results revealed that the screening questionnaire did discriminate between the two populations. At a 98% confidence level, a child with a score of 7 or more belonged to the specific learning difficulty group and a child scoring 2 or less did not. A score of 7 or more is therefore necessary to identify a neuro-developmentally based specific learning difficulty. The two populations were also compared on individual questions to identify which early developmental factors were significant in predicting later learning difficulties when viewed as part of a developmental profile.
Promoting Staff Development in Occupational Therapy: A Reflective Group Approach
Authors: Errington Edward , Robertson Linda
Published: April 2015

Staff development is a vital aspect of professional practice. It enables occupational therapists to observe latest practice and upgrade standards appropriately. Staff development opportunities often ensure that practitioners have access to theoretical knowledge as the basis for improving practice. This approach may be ineffective or minimally effective if it provides only theoretical professional knowledge and is not integrated into everyday practice. A more productive staff development procedure involves an exploration of practical knowledge. This is not theoretical knowledge about practice, but the kind embedded in practice. Such practical theories gained through reflective processes may be discussed informally during workplace interactions but rarely are opportunities available for therapists to articulate these in a systematic way.

Given the above, this paper reports on the procedures of a staff development research project which engaged a sample of practising occupational therapists from the Dunedin community in a process of reflective group practice. The project focused on two main questions: what are the issues that influence practice? And are the uses of reflective peer groups an effective staff development strategy?

Two themes emerged from the investigation, the first being that practice is fraught with uncertainties and the second that the aims of occupational therapists are not necessarily supported by other health team members. These two themes highlight the notion that occupational therapists cannot rely on theoretical knowledge alone prior to graduation and that practical knowledge plays a substantial part in their learning. The use of reflective groups was endorsed by all participants as a viable method of staff development. The reported effectiveness was in facilitating change at various levels: simple raising of awareness; encounters with ideas of others different from one's own; stated intention to change practice in light of new insights; and reports of actual changes because of group insights.
Sexual Issues within Occupational Therapy, Part 1: Attitudes and Practice
Authors: Couldrick Lorna
Published: April 2015

This article describes a qualitative study which considered if a client's sexual expression was a legitimate domain of concern of the occupational therapist. The research used an inductive strategy of depth interviews with 10 practitioners who represented a breadth of practice (children, adults and elderly people; acute and community settings; and physical and psychosocial conditions, learning disabilities, alcohol abuse, HIV and AIDS). The focus of the study was to discover the attitudes, practice and confidence of occupational therapists to address sexual issues.

Part 1 reviews relevant literature, outlines the methodology and briefly reports the results. Part 2 will discuss the results, especially their implications for professional education and practice, and the need for further research.
Male Occupational Therapists in Canada: A Demographic Profile
Authors: Brown G Ted
Published: April 2015

Occupational therapy is a predominantly female profession with, for example, only 5.8% of the occupational therapists in Canada being men. Traditionally, there has been limited success in recruiting men into occupational therapy education programmes and those men who do qualify as occupational therapists tend to work in the profession for only short periods of time. The purpose of this study was to examine the demographic characteristics of a group of male occupational therapists. 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 results indicated several significant findings. Seventy-four per cent of the respondents said that they would end up leaving the profession within 10 years. The top four features of the profession that influenced respondents' choice of an occupational therapy career were the opportunity to work with people, job security and availability, feelings of accomplishment and diversity. On the other hand, the top four factors that contributed to respondents' feelings of job dissatisfaction were limited earning potential, limited upward mobility and opportunities for advancement, lack of awareness by other professionals of occupational therapy's role in health care and the lack of understanding the general public have about occupational therapy.

In terms of demographics, the majority of male occupational therapists were around 33 years old, worked with an adult client caseload in a general hospital setting and spent 50% of their work time in direct client care. Overall, the male occupational therapists in this study were job dissatisfied. If means are not implemented to address this issue, many male clinicians are likely to leave the occupational therapy profession at some point.
Rising from Sitting in Elderly People, Part 1: Implications of Biomechanics and Physiology
Authors: Laporte Diane M , Chan Donna , Sveistrup Heidi
Published: April 2015

Rising from a sitting position is arguably the most frequently performed component of activities of daily living and is a prerequisite to functional mobility and subsequent meaningful activity. A difficulty with rising, commonly observed in elderly people, may either be a nuisance factor or have a serious impact on independence and quality of life; thus the occupational therapist seeks to maintain and improve this function.

This literature review is in two parts. Part 1 discusses the functional implications and importance of rising from sitting and provides a biomechanical analysis of sit-to-stand that focuses on balance and momentum. It considers the dynamic relationship between the centre of mass and the centre of pressure, the phases of rising and the factors that affect ease of rising, such as initial body position, speed of rising and age-related physiological changes. Part 2 will offer movement, environmental and motivational strategies based on the findings presented in part 1. These strategies are designed to help elderly people to compensate for difficulties in rising. The analysis and strategies proposed are also applicable to younger clients with balance or muscle strength impairments.
A Study to Determine a British Occupational Therapy Definition of Client-Centred Practice
Authors: Sumsion Thelma
Published: April 2015

This paper presents the results of a study that used the Delphi technique to create a draft definition of client-centred practice in occupational therapy. A brief literature review of the issues related to the Delphi technique is followed by details about the 64 therapists who participated in the four rounds of this study. They represented a range of geographical areas and areas of practice.

In round one, the participants were asked to add items to or eliminate items from a list of components of client-centred practice chosen from the literature. These components related to the client, the therapist and client-centred practice in general. These items were placed in rank order in round two and further reviewed in round three. Round four provided the opportunity to comment on the first draft of the definition.

Information is provided about the analysis of the results in each round. The resulting second draft of the definition is presented in the paper along with a discussion of the limitations of the study.
Reliability of ‘The Motor Observations with regards to Sensory Integration’: A Pilot Study
Authors: Norwood Kate W
Published: April 2015

The Motor Observations (MO) with regards to Sensory Integration’ (Horowitz 1994) is based on the original Clinical Observations of Ayres (1972a). The test aims to identify children aged 5 to 12 years with a learning disorder, described in this study as a developmental coordination disorder (DCD), hypothesised by Ayres to be due to sensory integration dysfunction. This study initiated the measurement of the reliability (internal consistency and intrarater and interrater reliability) of the MO, not included in its Dutch standardisation.

An observational correlational design was employed. The subjects were 28 children aged 6 to 10 years from the Sussex Weald. The MO was administered to a random sample of 21 children without DCD and a convenience sample of 7 children with DCD. Reliability coefficienss (Cronbach's alpha and intraclass correlation [ICC] random observers) were obtained via statistical analysis of score sets generated from live testing and its video recording.

The results indicate marginal reliability of the MO. Internal consistency (N=28) at 0.62 fell below the a priori level of 0.70. Intrarater and interrater reliability for the total samples (N=28, n=15) and the DCD samples (n=7, n=5) was high, ranging from 0.98 to 0.91, above the 0.75 a priori level. However, interrater reliability for the normal sample (n=10) fell below at 0.57, which suggests a deficiency in the test to identify normal development of sensory integration reliably. As the findings are not generalisable due to small samples, further studies are recommended.
Occupational Therapy and the Self-Care Needs of Hindu Elders
Authors: Gibbs Katherine E , Barnitt Rosemary
Published: April 2015

A study was carried out to identify the self-care needs of 19 Hindu elders. With the rising number of people in this group, the occupational therapist has a responsibility to be aware of the cultural and religious practices associated with self-care for them. There is an expectation that occupational therapists will practise in a culturally sensitive way and this is stated clearly in the professional code of ethics (College of Occupational Therapists 1995). However, occupational therapists can only practise in a culturally sensitive way if they have an understanding of the culture of the client and his or her family and social group. There is, to date, little information for occupational therapists about the cultural and religious needs of Hindu elders, one of the groups they may meet during their professional practice. Thus, the purpose of this study was to explore the needs of elderly Hindus with regard to four aspects of self-care: dress, diet, bathing and toileting.

The method used for the study was the snowball technique, with an access sample comprising four Hindu university students and the main sample comprising 19 of the students' elderly relatives. Interviews were carried out with the student sample and questionnaires were sent to the elderly relatives with regard to preferences in dressing, diet, bathing and toileting. The results showed that there were common issues related to religion and culture for many of the sample but that, additionally, there were unique issues related to personal circumstances with wide variation in family structures. By asking potential clients with particular cultural or religious beliefs about their needs, occupational therapists can provide a tailored service and gain an understanding of the significance of activities of daily living to Hindu elders.
Young Occupations Unlimited: An Early Intervention Programme for Young People with Psychosis
Authors: Parlato Linda , Lloyd Chris , Bassett Jo
Published: April 2015

Early intervention and prevention in psychosis is a relatively new area of practice for clinicians working in mental health. An important task for the young person following a psychotic disorder is the redefinition of self in relation to the disorder and the development of valued social and vocational roles. Occupational therapists have developed an early psychosis intervention programme, known as the Young Occupations Unlimited programme, which aims to promote health and wellbeing by encouraging participation in a variety of self-chosen and self-satisfying occupations.
Factors Influencing Junior Occupational Therapists' Continuity of Employment: A Review of the Literature
Authors: Rugg Sue
Published: April 2015

This article explores the factors influencing junior occupational therapists' entry into, retention in and withdrawal from practice. It begins by outlining some of the influences associated with these outcomes in health and social care workers in general and then reviews the occupational therapy literature in these areas. It concludes that the factors contributing to junior occupational therapists' continuity of employment have remained largely unexplored to date and makes a case for further study of this area.
Elderly Fallers: A Baseline Audit of Admissions to a Day Hospital for Elderly People
Authors: McIntyre Anne
Published: April 2015

Falls in elderly people are a major problem for health and social services because of the incidence of injury and the fear of falling as a disabling consequence (McKee 1998). It seemed that many admissions to a South Buckinghamshire day hospital for elderly people were as a result of falls.

A retrospective and concurrent caseload audit was carried out of medical and occupational therapy notes. The aim of the audit was to establish the incidence of falls among the day hospital population, with a view to improving the quality of the service. The data collected included age, diagnosis, functional ability and consequential actions. These items were included by consensus agreement following a literature review.

Fifty-six of 196 elderly people admitted over the 12-month period had fallen at least once. Of these, 73% had no apparent predisposing factor for their fall and 39% were not carrying out any obvious activity at the time; 59% had an increase in social support due to decreased confidence and mobility after the fall. A multidisciplinary team approach was reinforced and the management of patients' problems on an individual basis was to be continued. The adoption of the audit data collection form as a checklist to facilitate future assessment was recommended.
Assistive Devices: An Audit of Waiting Times
Authors: Wilson Janet , McCracken Eva , Cummings Yvonne
Published: April 2015

People with rheumatic diseases often require an assistive device at some stage to enable them to carry out their normal activities of daily living without placing undue strain on their affected joints. Up till 1995, most assistive devices in Fife were provided through statutory provision via the Fife Social Work Service. However, the Fife Rheumatic Diseases Unit (FRDU) occupational therapists felt that the speed of the supply did not match patient need.

An 18-month audit was set up to establish the current situation and to seek an appropriate intervention which would minimise the delays in patients obtaining these devices. The first audit showed that patients waited an average of 39 days for an assistive device. The FRDU then took on the direct supply of consumables and the second audit showed that waiting times were reduced to an average of 21 days, an improvement of 18 days.
Setting Standards for Home Assessment Visiting
Authors: Dove Janet
Published: April 2015

Occupational therapists working in care of the elderly assessment units and geriatric orthopaedic rehabilitation units throughout Lothian Health devised an audit project to develop a timescale for organising home assessment visits. The aim was to formulate an achievable and realistic standard which could be adopted for use throughout the area. A steering group organised a 4-week survey of practice to determine how long it takes to organise a home assessment visit. The results showed that 86% of home assessment visits were organised within 5 working days. A standard was subsequently drafted based on these results. A 3-month audit of the standard was then carried out to determine if any exceptions were required.

Following a home assessment visit, a written report is completed and filed in the patient's medical notes. A period of 2 days between the date of the visit and filing the report is the commonly held standard throughout Lothian Health. This standard was examined concurrently with the above. The results showed that 88% of visits were organised within 5 working days and 61% of reports were filed within 2 working days. Both the standards are currently being reaudited but full results are not yet available.
Spirituality and Palliative Care: The Attitudes of Occupational Therapists
Authors: Rose Andrew
Published: April 2015

The attitudes of 44 occupational therapists on the place of spirituality within palliative care were investigated. Their responses to a postal questionnaire indicated that spirituality was an important part of life for 35 (80%) respondents, helped 33 (75%) respondents with daily job responsibilities and was viewed as an important dimension of health and rehabilitation by 39 (89%) respondents. Spiritual issues were considered to be within the scope of occupational therapy by 33 (75%) respondents. However, only 8 (18%) respondents stated that they consistently addressed spirituality within assessment.

The respondents described several activities that addressed clients' spirituality, including open-ended discussion, facilitation of activities of daily living that contribute to maximising quality of life and creative activities. Thirty-two (73%) respondents considered that their education had not prepared them to deal with clients' spiritual needs and 28 (64%) wanted further training in spiritual care.

It is proposed that there is a need for further research and refinement of the conceptual understanding of spirituality in order to provide a firm framework for its inclusion in occupational therapy.
New Graduates: Perceptions of Their First Occupational Therapy Position
Authors: Hummell Jill , Koelmeyer Louise
Published: April 2015

The study investigated the perceptions of 74 occupational therapists 6 months after graduating from the University of Sydney. Australia, regarding their first occupational therapy position, using a self-administered posted questionnaire. The findings provide a profile of these graduates, the majority of whom were female, aged between 20 and 24 years and employed in the public health system in the Sydney metropolitan area.

Over three-quarters were provided with an orientation programme at the workplace and were satisfied with their initial job, although they perceived it as stressful. Two-thirds received support and supervision from senior occupational therapists; however, one-third did not. The provision of support/supervision from a senior colleague was of critical importance to the successful transition from student to graduate. The primary recommendation is that all new graduates have access to support/supervision from skilled occupational therapists and other colleagues on a regular basis.