bluuebunny/crossref_metadata_2025 huggingface dataset:
Accommodation Needs and Student-Environment Fit in Upper Secondary Schools for Students with Severe Physical Disabilities
Authors: Hemmingsson Helena , Borell Lena
Published: March 2013

The purpose of this study was to identify, from the personal perspective of students with disability, their needs for physical and social accommodations in upper secondary schools specially adapted for students with severe physical disabilities. The study also aimed to identify those areas of student-environment fit which were most often achieved.

Forty-eight students in four schools in Sweden were assessed by occupational therapists using the School Setting Interview. Forty-seven students reported needs for accommodations in the school setting. The study indicates that schools generally were able to meet the students' accommodation needs in the physical environment. The schools also met students' accommodation needs for field trips, sport activities and assistance. Student-environment fit in occupations requiring reading, remembering and speaking was unsatisfactory. Accommodations on a general, group and individual level are highlighted and discussed. The study recommends that occupational therapists become more involved and offer society their expertise in barrier removal to a greater extent.
Reliability and Validity of a Simple Measure for Assessing the Social Skills of People with Schizophrenia Necessary for Seeking and Securing a Job
Authors: Tsang Hector , Pearson Veronica
Published: March 2013

The literature shows that social and vocational impairments are common problems among people with schizophrenia. However, assessment instruments available for measuring social competence of people with schizophrenia in the workplace are limited. This article describes a two-part measure developed and validated based on a model (Tsang & Pearson, 1996) for assessing social skills necessary for seeking and maintaining a job for people with schizophrenia. The measure consists of a 10 item self-administered checklist and a role-play exercise. The self-administered checklist measures clients' perceived competence in handling work-related social situations. The role-play exercise assesses the social skills necessary for job acquisition and maintenance in two simulated situations (participating in a simulated job interview and requesting urgent leave from work). Cronbach alpha coefficients (self-administered checklist: .80 (n=140); role-play test: .96 (n=60)) show that both parts had good internal consistency. In addition, correlation coefficients show that the self-administered checklist has acceptable test-retest reliability (.35 to .78), and the role-play exercise has good interrater reliability (.77 to .90). The concurrent validity is also shown to be good for both parts of the measure using the method of contrasted groups. It is suggested that this measure is suitable for use by clinicians, rehabilitation administrators and researchers. Application of the instrument in other countries is discussed. Finally, further research is suggested.
Utilisation du temps: réalité des parents vivant avec un enfant ayant une déficience motrice
Authors: Tétreault Sylvie , Beaulieu Johanne , Martin Geneviève , Bédard Julie , Laurion Sylvie
Published: March 2013

Une recherche quantitative portant sur le fonctionnement des familles a été réalisée auprès de 244 familles provenant de trois régions socio-sanitaires du Québec. De ce groupe, quatorze familles ont accepté de collaborer au volet qualitatif de cette étude. Vingt-huit parents ont participé à des entrevues en profondeur. Au cours de ces rencontres, l'impact de la présence d'un enfant ayant une incapacité motrice sur l'utilisation du temps a été abordée avec eux. Une analyse de contenu thématique et catégoriel a permis de ressortir les différentes facettes de l'impact de l'enfant handicapé sur le temps parental en fonction de quatre sphères de vie. En fait, les parents rencontrés indiquent que la présence de leur enfant influence grandement le temps disponible pour leur vie personnelle, conjugale, familiale ainsi que pour le travail rémunéré. De façon générale, les mères consacrent plus de temps que les pères aux soins de l'enfant. Cette situation a un impact direct sur la gestion du temps maternel. À la lumière des commentaires des répondants, des recommandations émergent afin d'accompagner les parents vers l'atteinte d'une meilleure organisation de leur temps.
Cultural Relativism: Occupation and Independence Reconsidered
Authors: Whiteford Gail Elizabeth , Wilcock Ann Allart
Published: March 2013

In this article, findings from a qualitative study of a cohort of occupational therapy students in Auckland, New Zealand are presented. The study focussed on the experiences of students as they learned to work with people from different social and cultural backgrounds over a 3-year period. As well as identifying curriculum and teaching/learning processes that enhance intercultural competence development, the data that emerged from the study also highlight important issues about how occupation and independence are conceptualised across cultures. A review of the trans-disciplinary and occupational therapy literature dealing with theoretical, conceptual and educational issues relating to cross-cultural practice is followed by a presentation of narrative extracts that address the key concepts of occupation and independence. These are then discussed with reference to relevant occupational therapy literature. In conclusion, implications for future research and practice are explored focussing on a need for occupation and independence to be reconsidered as culturally relative constructions.
Women with Multiple Sclerosis and Employment Issues: A Focus on Social and Institutional Environments
Authors: Dyck Isabel , Jongbloed Lyn
Published: March 2013

This paper examines employment issues for women diagnosed with multiple sclerosis (MS) and their workplace experiences, focusing analysis on the social and institutional dimensions of the environment. The analysis draws on data from a mixed method study using in-depth interviews and a survey. The findings indicate that although severity of symptoms affect employment status, non-medical factors, including modification of work conditions and understanding employers, and a supportive home environment with the possibility of delegating household tasks, can enhance women's ability to work. The specific focus in the paper on the experiences of women managing their disability in the workplace, from the qualitative phase of the study, acts as an analytic device to illustrate how context influences the way in which such factors play out. In highlighting the issue of disclosure of diagnosis, and associated identity and income concerns for women, the paper demonstrates the importance of the social and institutional dimensions of environment in shaping occupational performance. The findings suggest that inclusion of environmental analysis in clinical practice broadens the range of intervention strategies to be considered and raises the issue of occupational therapists' role in advocacy.
The Use of the Canadian Occupational Performance Measure as an Outcome of a Pain Management Program
Authors: Carpenter Linda , Baker Gus A. , Tyldesley Barbara
Published: March 2013

The last three decades have seen the emergence of measures to assess the efficacy of pain management programs. Recently there has been interest in measures that assess clients' perceptions of their own performance. The Canadian Occupational Performance Measure (COPM) (Law et al, 1994, 1998) is an individualized measure designed for use by occupational therapists to detect a self-perceived change in occupational performance problems over time. It may be an important extra dimension to assessing the outcomes of pain management programs. The aim of this study was to ascertain the validity of the COPM as an outcome measure for the Liverpool Pain Management Program. One hundred and six clients were recruited to the study and 87 clients completed a battery of tests including the COPM at baseline, end of program and 3 month follow-up. Results of the study demonstrated that the COPM showed good evidence of concurrent criterion validity and sensitivity to change.
Relationships among Three Clinical Measures of Muscle Tone at the Elbows of Individuals after a Stroke
Authors: Worley J. Scott
Published: March 2013

Patterns of associations among three common clinical muscle tone measures were investigated to determine their degree, and patterns of agreement. Data contributing to selection of clinical measures of muscle tone and understanding factors contributing to occupational dysfunctions were also sought.

Forty five persons who were admitted after stroke to two occupational therapy rehabilitation programs were randomly selected. Their affected elbow's resting position (EJP), resistance to passive extension (ERM) and the angle where resistance first appeared (EAR) were measured by one, then a second therapist who also measured voluntary muscle function. Correlations among the three measures were calculated for both administrations and among patient subgroups with statistical correction for multiple correlations.

Statistically significant associations appeared between ERM and EAR and between EJP and EAR. Highest statistically significant associations appeared among subjects with poor upper extremity function and those with low muscle tone. Patterns of associations were similar for the first and second administrations at both centres, though patterns among subgroups differed between centres.

Correlation patterns suggest that biomechanical factors may influence the joint's resting position (EJP) more than ERM and EAR. Measures may be used interchangeably only with selected patient subgroups, which should also be the basis of method selection.
A Functional Model of Cognitive Rehabilitation in Occupational Therapy
Authors: Lee Shirley S. , Powell Nancy J. , Esdaile Susan
Published: March 2013

Persons who sustain cerebral injuries often have cognitive impairments. Occupational therapists are active in providing cognitive rehabilitation that aims to minimize the effects of cognitive deficits in their clients' lives. This paper presents a brief review of the literature in the area of cognitive rehabilitation including major characteristics of existing occupational therapy models related to the treatment of people who need cognitive rehabilitation. A model of cognitive rehabilitation is proposed that emphasizes functional components of occupational therapy in different rehabilitation settings. This model, called the Functional Model of Cognitive Rehabilitation, supports the use of activities in naturalistic settings in treatment, in order to enable those with cognitive impairments to fulfill their occupational roles.
Implementing Client-Centred Practice: Why is it so Difficult to Do?
Authors: Wilkins Seanne , Pollock Nancy , Rochon Sarah , Law Mary
Published: March 2013

This paper explores the challenges of implementing client-centred occupational therapy practice. While many occupational therapists believe in the principles of client-centred practice and espouse them, it seems much more difficult to implement these into everyday practice. Findings from three qualitative studies with three different populations (i.e., family-centred care for children and their families, community-based home care, facility-based care for older adults) are used to illustrate the challenges which are divided into three broad categories: challenges at the level of the system, at the level of the therapist and at the level of the client. Suggestions for change at each level are addressed. Organizations, therapists and clients must work together to facilitate these changes and ensure that each occupational therapy client receives respectful, supportive, coordinated, flexible and individualized service.
Cultural Competence in New Zealand and Canada: Occupational Therapy Students' Reflections on Class and Fieldwork Curriculum
Authors: Forwell Susan J. , Whiteford Gail , Dyck Isabel
Published: March 2013

The first year of a twin study undertaken between two occupational therapy programs in Canada and New Zealand is described. The primary aims of the study were to illuminate the lived experiences of students as they learn about cultural difference and had contact with clients of differing cultural backgrounds to themselves during fieldwork placements. While there are similarities between educational programs and the demographic profiles of the two cohorts of students, there are curricular differences primarily based on the described socio-political content of the two countries; Aotearoa/New Zealand as a bicultural society and Canada as multicultural. The paper discusses how these cultural differences interweave with other aspects of the students' educational program, as perceived and experienced by the students. Narrative data was thematically analyzed to reflect the experiences and the attendant thoughts and feelings of the participants.
Clinical Outcome and Client Satisfaction of an Anger Management Group Program
Authors: Tang Mary
Published: March 2013

This retrospective quasi-experimental study evaluated the effectiveness of an anger management group program for clients with mental health problems. The program, based on the cognitive-behavioral approach, was offered by outpatient mental health occupational therapy services of a community general hospital. Sixty-four clients, about 59% diagnosed with depressive disorder, enrolled in the program and participated in the study. The pre-treatment and post-treatment scores of the participants on the Anger Control Inventory and the State-Trait Anger Expression Inventory were compared. The results indicated significant reduction in the overall experience of intense anger, improvement in cognitive and behavioural coping mechanisms, and significant improvement in anger control after treatment. Most respondents (90%) found the program definitely helpful. The pace of the program and the variety of learning activities were identified as areas for improvement. The results showed the program had positive impact on anger management. Useful suggestions were identified for continuous quality improvements of the program.
Effects of Cognitive Processes and Task Complexity on Acquisition, Retention, and Transfer of Motor Skills
Authors: Jarus Tal , Gutman Tzipi
Published: March 2013

This experiment was designed to investigate the effect of cognitive problem-solving operations (termed contextual interference) and complexity of tasks on the acquisition retention and transfer of motor skills. Ninety-six children, ages 7.5-9.5 practised the task of throwing beanbags under either low contextual interference (blocked practice), high contextual interference (random practice) or medium contextual interference (combined practice). Half of the participants acquired a complex task and the other half a simple task. All participants performed 30 acquisition trials, 9 retention trials and 4 transfer trials. Results indicated that participants who practised in the blocked practice group did not differ in their performance whether they acquired complex or simple tasks. On the other hand, participants from the random and combined practice groups who acquired simple tasks performed better than those who acquired complex tasks. These findings support the hypothesis that there is a limit to the interference during practice that will benefit retention and transfer, thus creating the contextual interference effect. It seems that the complex-task condition combined with random or combined practice schedule increased the difficulty of acquisition, possibly impeding the cognitive processing during acquisition, thus impairing the learning process.
Involvement of Occupational Therapy Departments in Research: A Provincial Survey
Authors: Majnemer Annette , Desrosiers Johanne , Gauthier Jacques , Dutil Elisabeth , Robichaud Line , Rousseau Jacqueline , Hébert Lucie
Published: March 2013

It is increasingly recognized that research is necessary to advance the practice of occupational therapy. The objective of this study was to determine whether occupational therapy departments in Quebec were commonly involved in research, and whether participation varied with the size of department and type of work setting. Secondly, enablers and barriers to participation in research were identified. A random sample of occupational therapy departments, stratified by size, were surveyed by mail. Participation rate was 74.8% (107/143). Participation in research was noted in half of the departments surveyed (51/107), most frequently as collaborator. Involvement in research was associated (p<.001) with a greater number of therapists in the department. Furthermore, occupational therapy departments in rehabilitation centres and in university hospitals were more likely to participate in research (79% and 90% respectively), whereas participation was lower for long-term care facilities (29%) and community health clinics (38%). When asked to rank factors that may facilitate participation in research, the highest rankings were given to: time allotted to research, research as a priority for administration, adequate financial support, and presence of an occpational therapy researcher and a research centre on site. This survey demonstrates that a number of factors can promote or prevent the realization of research activities within the clinical setting. Strategies are proposed to enhance the integration of research into clinical practice.
Les qualités psychométriques d'un instrument de mesure du bien-être psychologique utilisé auprès des personnes ayant une déficience physique
Authors: Dumont Claire , Gervais Marie , Pépin Michel , Fougeyrollas Patrick , Loranger Michel
Published: March 2013

Mesurer le bien-être psychologique des personnes ayant des incapacités physiques peut apporter de l'information probante aux ergothérapeutes. Cette étude a pour but de vérifier certaines qualités psychométriques d'un instrument de mesure du bien-être psychologique appelé Test de personnalité PER (PER). Ce test a été administré à deux échantillons de personnes ayant des incapacités physiques. Deux temps de mesure ont été obtenus auprès de 36 personnes ainsi qu'une mesure unique auprès de 79 autres. Des comparaisons entre les temps de mesure, entre les groupes ainsi qu'avec les normes du PER ont été effectuées, dans le but de vérifier la sensibilité, la capacité de discriminer les groupes connus et la validité de construit du PER. Une section du Sickness Impact Profile a aussi été administrée aux mêmes groupes pour vérifier la validité de critère concurrente du PER. Les résultats des analyses démontrent que le PER possède les qualités psychométriques requises.
Expanding the Boundaries of Occupational Therapy Practice through Student Fieldwork Experiences: Description of a Provincially-Funded Community Development Project
Authors: Friedland Judith , Polatajko Helene , Gage Marie
Published: March 2013

The numbers of occupational therapists in community practice are not yet large enough to provide fieldwork placements to accommodate all students. This article describes a project designed to educate community agencies that do not employ occupational therapists, about our service while at the same time securing new fieldwork placements. We used on-site different discipline and offsite same discipline supervision to provide students to selected agencies without cost. Funding for one year from the Ontario Ministry of Health to the Ontario University Programs in Rehabilitation Science enabled us to initiate and evaluate the project. Students in the project developed their ability to work independently and to see their potential role in health promotion and prevention. Despite the lack of ongoing government funding, four years later, community sites are not only being maintained, but the number of sites has increased from 28 to 39, providing a total of 75 student placements. By educating a growing number of community agencies about the work of occupational therapists, the project has also expanded the boundaries of practice.
Discharging Older Adults with a Severe and Chronic Mental Illness in the Community
Authors: Larivière Nadine , Gélinas Isabelle , Mazer Barbara , Tallant Beverlea , Paquette Isabelle
Published: March 2013

In recent years, a deinstitutionalization movement has been occurring in Canadian psychiatric institutions. Occupational therapists, experts in evaluating occupational performance, are key contributors to the selection of appropriate community housing environments. This study describes the global functioning, performance in activities of daily living, social behavior, cognitive status, and quality of life of 33 older adults with a severe and chronic mental illness, who were transferred from a psychiatric hospital to community facilities between 1995 and 1998. Evaluations were repeated five times, twice before discharge and three times after the transfer. Participants demonstrated stability in their global, social and ADL functioning over time. In general, participants required occasional intervention for management of social behaviors, moderate assistance in activities of daily living, and were highly satisfied with their community accommodation. The transfer to community settings did not lead to a significant deterioration in the participants' levels of global functioning and quality of life.
Collaborative Fieldwork Education with Student Occupational Therapists and Student Occupational Therapist Assistants
Authors: Jung Bonny , Sainsbury Sandy , Grum Rosa Maria , Wilkins Seanne , Tryssenaar Joyce
Published: March 2013

The profession of occupational therapy has a long history of working collaboratively with support personnel. This paper describes the process of a fieldwork education partnership developed between the McMaster University, BHSc (OT) Program and the Mohawk College, Occupational Therapist Assistant and Physical Therapist Assistant Program. Eight student occupational therapists and eight student occupational therapist assistants learned together in a variety of fieldwork settings, either in pairs or in groups. Both groups of students kept weekly journals of the experience and completed a post placement questionnaire. The journals were inductively analysed using a retrospective content analysis. The four emergent themes identified from the data are learning about each other's role, collaborative learning, impact on client care and future practice, and resistance to roles. Recommendations for future collaborations are discussed.
Negotiation-Centred versus Client-Centred: Which Approach Should Be Used?
Authors: Falardeau Marléne , Durand Marie José
Published: March 2013

For nearly 20 years, Canadian occupational therapists have attached great importance to the client-centred approach within their practice. Professionals have agreed to define this approach through a philosophy built around the concepts of respect, power and partnership. But no reported work has really clarified what is meant by these three fundamental concepts.

This article attempts to define the concepts of respect and power in the therapist-client relationship through a review of occupational therapy and related health and social sciences literature. It raises the question: “In the professional-client relationship, should the power reside with the client or is a more balanced approach needed? ” This paper also proposes using the term negotiation instead of partnership, since negotiation seems to offer more applications for occupational therapy practice. The objective of the authors who advocate for greater negotiation between client and therapist is to stimulate analysis.
An Application of the Occupation Competence Model to Organizing Factors Associated with Return to Work
Authors: Shaw Lynn , Polatajko Helene
Published: March 2013

The variations in return to work outcomes for ill or injured persons experiencing health leaves are complex. However, it is important to comprehend these variations in order to develop evidenced-based practice in work rehabilitation. Currently, a plethora of studies exist in the literature that have attempted to explain the variations in work outcomes. A 20-year review of the literature on work outcomes has revealed several limitations in using this knowledge in occupational therapy. The study of return to work outcomes is, for the most part, atheoretical and the knowledge base is fragmented and disorganized. In addition, the literature does not reflect a consistent understanding of the multidimensional nature of either work disability or the facilitators for return to work. In this paper, the Occupational Competence Model is presented as a framework for filling this gap. This model is used here to organize and synthesize the factors previously studied on work outcomes to foster an understanding of this literature from an occupational therapy perspective and the future study of work outcomes and work rehabilitation.
Will Students Be Prepared? Current Status of Gerontological Content in Entry-Level Occupational Therapy Programs in Canada
Authors: Klein Jennifer
Published: March 2013

By the year 2020, 20% of the Canadian population is expected to be over the age of 65 (Statistics Canada, 1997). It is important that future clinicians are prepared to meet the increased demand for occupational therapy services by older adults. The purpose of this study was to examine the present status of gerontological content within Canadian occupational therapy programs. A survey was sent out to all twelve entry-level occupational therapy university programs in Canada via electronic mail. This survey asked questions about the programs' focus on gerontological content within their coursework and clinical fieldwork. All ten responding programs indicated that they had gerontological content within their curricula. However, the amount and content varied throughout the programs.
Occupational Therapy Intervention with Children Survivors of War
Authors: Simó-Algado Salvador , Mehta Nina , Kronenberg Franciscus , Cockburn Lynn , Kirsh Bonnie
Published: March 2013

A preventive occupational therapy program with children surviving the Kosovo conflict is examined. The objective of the program was to facilitate the emotional expression of traumatic experiences in order to prevent the development of future psychological problems. The intervention was based on a community-centred approach with spirituality as a central focus of the intervention. The Model of Human Occupation and the Occupational Performance Process Model were utilized to guide the identification and intervention of occupational performance issues. The children's return from a land of war to a land of children demonstrates the potential of occupational therapy intervention in this field. With increasing awareness of populations facing social and political challenges, there is a growing importance of the concept of occupational justice and the need to work against occupational apartheid.
Environmental Analysis: Insights from Sociological and Geographical Perspectives
Authors: O'Brien Patti , Dyck Isabel , Caron Staci , Mortenson Patricia
Published: March 2013

Recent conceptual models, such as the Canadian Model of Occupational Performance, emphasize the transactional relationships between individuals, their occupations, and the environments in which they live. Nevertheless, further theoretical development is necessary in order to gain a comprehensive understanding of the nature of interconnections between the environment, occupation, and disability.

This paper draws on concepts from sociology and geography that can broaden our understanding of the environment and the manner in which its different dimensions may influence individuals' experiences of disability. The paper demonstrates how theoretical ideas from these disciplines can be used to inform our understanding of the daily lives of three different individuals: a senior with Bipolar Affective Disorder, a man with HIV/AIDS, and a parent of a child with a severe disability. The paper concludes with a discussion of the implications of the analysis for occupational therapy theory and practice.
Predicting the Use of Occupational Therapy Services among People with Multiple Sclerosis in Atlantic Canada
Authors: Finlayson Marcia , DalMonte Julie
Published: March 2013

This secondary analysis examined the factors that predicted the use of occupational therapy services since diagnosis and over the past year among people with multiple sclerosis in Atlantic Canada. Data were gathered through a mail-out survey of members of the Multiple Sclerosis Society of Canada (Atlantic Division) in the winter of 1997/98. The Behavioral Model of Health Services Utilization (Andersen & Newman, 1973) was used to guide the analysis. Seeing greater numbers of health professionals, having a hospitalization in the past year, and having more functional limitations all increased the likelihood of seeing an occupational therapist, both since diagnosis and over the past year. These findings suggest that the organization and structure of the service system play a large role in the likelihood that a person with multiple sclerosis will see an occupational therapist in Atlantic Canada.
Professional Accountability in Restructured Contexts of Occupational Therapy Practice
Authors: Rappolt Susan , Mitra Aruna L. , Murphy Elise
Published: March 2013

Professional standards for accountability establish essential competencies for clinical practices and provide strategies for professional advancement. This study examines the perspectives of a sample of occupational therapists on their capacity to engage in continuing education, to provide evidence-based practices and to have confidence in the effectiveness of available quality assurance mechanisms within restructured contexts of occupational therapy practice. The analysis of in-depth interviews with participants from program management, managed competition and private practice suggested three urgent needs: the development of strategies to assist therapists' translation of research evidence into clinical practices, research to determine the effectiveness of models of professional leadership within the workplace that promote professional accountability and alliances to advance policies that eliminate workplace barriers to professional accountability.
Private Practice: Benefits, Barriers and Strategies of Providing Fieldwork Placements
Authors: Sloggett Kym , Kim Nancy , Cameron Debra
Published: March 2013

Background. Occupational therapists are entering private practice in ever increasing numbers. In order to gain the skills to practice in this area, students should have the opportunity to experience private practice fieldwork placements. However, the number offered in private practice settings continues to be limited. The purpose of this exploratory qualitative study was to identify the benefits, the barriers, and the strategies associated with providing fieldwork opportunities in private practice. Methods. Data were obtained through semi-structured interviews with six occupational therapists in private practice. Results. Results indicated that participating in fieldwork education affords benefits to the profession of occupational therapy, to the clinician, and to the facility. Potential barriers included student characteristics, cost, time, travel and legalities. Involvement from the university and the private setting were considered necessary for providing and implementing strategies. Clinical Implications. The findings have implications for increasing private practice placements for future students in occupational therapy and other health care professions offering clinical placements as a component of their formal education.
Pre-Arthroplasty Rehabilitation is Effective in Reducing Hospital Stay
Authors: Crowe Jean , Henderson Jennifer
Published: March 2013

Backround. The purpose of the trial was to evaluate the effect on length of stay of individually tailored rehabilitation for clients who were undergoing hip or knee arthroplasty. Method. Clients (n = 133) with complex needs (comorbid conditions or limited social support) were randomly assigned to receive preoperative usual care (UC) or rehabilitation (R). Usual care clients received a single preoperative clinic visit. Rehabilitation clients were individually assessed and received multi disciplinary rehabilitation to optimize functional capacity, education about the in-hospital phase and early discharge planning. All rehabilitation subjects received interdisciplinary counseling/education focused on preparation for discharge home. The intervention for approximately half the rehabilitation clients was a single, cost-effective session, while others received physical conditioning. Results. Clients receiving rehabilitation achieved discharge criteria earlier (R = 5.4, UC = 8 days) and had a shorter actual length of stay (R = 6.5, UC = 10.5 days). Clinical Implications. This preoperative, individually tailored, rehabilitation program reduced length of stay.
A Secondary Guy: Physically Disabled Teenagers in Secondary Schools
Authors: Doubt Lorna , McColl Mary Ann
Published: March 2013

Background. This study explored the perceptions and experiences of teenagers with physical disabilities attending regular secondary schools. In particular, the study focused on social integration and the factors that influenced it. Social integration was defined as a sense of belonging in the school community. Methods. A phenomenological approach was used to explore the viewpoint of physically disabled young people themselves. Seven secondary school students with ambulation disabilities were interviewed using a semi-structured interview guide. Results. The findings identified both factors that facilitated and those that limited integration. Extrinsic factors included peer and staff support, negative reactions and inaccessible activities. Intrinsic factors included the disability itself, as well as strategies of self-exclusion, masking the disability, finding a niche, making fun of the disability, and educating peers. Interpretation of the findings suggested that the participants occupied a secondary place in their schools, as opposed to being fully integrated. Practice Implications. Occupational therapists have the opportunity, expertise and responsibility to be instrumental in the process of ensuring that schools are inclusive and that their young clients are capable of participating fully.
An Occupational Therapy Work Skills Assessment for Individuals with Head Injury
Authors: Chappell Irene , Higham Julie , McLean Alison M.
Published: March 2013

Background. Comprehensive and accurate evaluation is a critical step in the return-to-work process for individuals with head injury. Research findings have been reported on the barriers for a successful return to work. Assessment frameworks have been published, but they do not include a protocol that contains each component for the assessment. Method. This paper describes an occupational therapy assessment protocol developed and used in the evaluation of the work skills of individuals with head injury. This protocol focuses on assessment of physical, cognitive and behavioural abilities in relation to the demands of the workplace and measures these within the framework of productivity, interpersonal skills and safety. Practice Implications. The functional approach inherent in this protocol provides information to complement the findings of other interdisciplinary team members. This paper also explores the strengths and limitations of this protocol.
The Time of Our Lives: The Experience of Temporality in Occupation
Authors: Larson Elizabeth A.
Published: March 2013

Background. This paper synthesizes research and theory on aspects of activities producing variations in perceived temporality and subjective experience. Synthesis. A proposed continuum of variations of six temporal experience are described: 1) protracted duration - elapsed time feels greater than actual elapsed clock time; 2) synchronicity - match of clock and perceived time; 3) compression - perceived time feels shorter than clock time; 4) flow - a sense of timelessness; 5) interstitial - perceived stoppage of clock time; and 6) temporal rupture - disruption of synchronicity of clock time. Five contextually situated steps that generate each of these temporal variations explain how these variations unfold in the experience of occupation. This synthesis is the basis for the Dynamic Occupation in Time (DOiT) Model which also incorporates the key occupational therapy concepts of human agency, personal engagement, context, and culture. Practice Implications. Investigating how occupations produce various temporalities and experiences will allow occupational scientists to investigate the underlying complexities of occupation-based practice. Also, by understanding more about the dynamic nature of occupations and appreciating the fluid quality of persons within their occupational context, occupational therapists can improve their design of occupation-based interventions.
Hemiplegic Shoulder Pain: Implications for Occupational Therapy Treatment
Authors: Gilmore Paula E. , Spaulding Sandi J. , Vandervoort Anthony A.
Published: March 2013

Background. Hemiplegic shoulder pain is common after stroke causing hemiplegia. It adversely affects the recovery of arm function and independence in activities of daily living. Subluxation, abnormal tone and limited range of motion or capsular constrictions have been reported as potential causes. Other factors such as rotator cuff tears, brachial plexus injury, shoulder-hand syndrome and other pre-existing pathological conditions may also be associated with hemiplegic shoulder pain. The etiology remains unclear, but hemiplegic shoulder pain may result from a combination of the above factors. Scope. This literature review examines the possible causes of hemiplegic shoulder pain and discusses the implications for occupational therapy treatment. Occupational therapy interventions include proper positioning, facilitation of movement through purposeful therapeutic activities, increasing passive range of motion, implementation of external supports and treatment of shoulder-hand syndrome. Practice Implications. Understanding the processes involved will assist with effective assessment, treatment and prevention of hemiplegic shoulder pain. This will facilitate clients' participation in rehabilitation programs and move them towards attainment of optimal function.
Life Care Plans: An Emerging Area for Occupational Therapists
Authors: Klinger Lisa , Baptiste Barbara , R.Adams James
Published: March 2013

Background. Life care plans, or cost of future care reports as they are often called in Canada, are medico-legal documents that predict probable future medical and rehabilitation needs and costs. They are used when someone has sustained a serious personal injury in an accident, as the result of medical malpractice, or due to some other unnatural cause. Life care plans are generally commissioned by third-party payers in order to set aside adequate reserves for future costs or to negotiate a settlement. Scope. Life care plans need to be grounded in knowledge of how personal injury law has been applied and interpreted. Therefore, Canadian law pertaining to the costs of future care in personal injury will be briefly reviewed. The balance of the article discusses the process used to develop a life care plan, the necessary content, and accepted formats for reports. The article concludes with a case example that demonstrates the application of life care planning skills. Practice Implications. Occupational therapists are well suited to developing these plans by virtue of their training, knowledge base, and theoretical approaches. This is an emerging consultative role for experienced therapists.
Le jeu théâtral comme médium thérapeutique en réadaptation psychosociale: Le point de vue des participants
Authors: Fleury France , Marazzani Micheline H. , Saucier Jean-François
Published: March 2013

Description générale. Une thérapie employant l'activité théâtrale est proposée à six clients présentant des troubles graves et persistants de santé mentale. Cette étude se concentre sur le sens que donnent les participants à cette expérience ainsi que sur les aspects de la thérapie qu'ils jugent influents pour leur évolution. Méthodologie. Le recours à une démarche formelle vise à optimiser la qualité de telles interventions grâce à l'avis même des acteurs. Le déroulement de la thérapie propose une application qui est la plus ressemblante possible de l'activité théâtrale elle-même. Des données qualitatives, recueillies par entrevue semi-structurée et par questionnaire auprès de trois sujets choisis par échantillonnage réfléchi, sont analysées par cycles successifs de réduction des données. Résultats et conséquences pour la pratique. Les participants mettent en valeur la souplesse et la polyvalence de l'expérience théâtrale. Ils perçoivent la présence du public comme nécessaire pour améliorer les sentiments de plaisir et de compétence personnelle. Une thérapie employant l'activité théâtrale apparaît pertinente pour la réadaptation psychosociale.
The Canadian Occupational Performance Measure: A Research and Clinical Literature Review
Authors: Carswell Anne , McColl Mary Ann , Baptiste Sue , Law Mary , Polatajko Helene , Pollock Nancy
Published: March 2013

Backround. It has been 13 years since the Canadian Occupational Performance Measure (COPM) was published. In that time there has been a remarkable growth in its acceptance as an outcome measure within the occupational therapy practice and research. Purpose. The purpose of this paper is to review the emerging research and clinical literature related to the COPM since 1994 and to document its impact upon occupational therapy practice and research throughout the world. Method. A systematic search was conducted to the professional and research literature in English publications (primarily occupational therapy). Eighty-eight papers that met the inclusion criteria were reviewed, 86% of which examined the COPM in relation to its psychometric properties (19 papers), research outcomes (33 papers) or practice (33 papers). Results. Overall, although there are a few limitations discussed in the review, the conclusion is that the COPM is a valid, reliable, clinically useful and responsive outcome measure acceptable for occupational therapist practitioners and researchers. Practice Implications. The COPM is used with a wide variety of clients, enables client-centred practice, facilitates evidence-based practice and supports outcomes research.
Exploring What Employers Seek When Hiring Occupational Therapists
Authors: Mulholland Susan , Derdall Michele
Published: March 2013

Backround. Understanding the needs of employers is an important component of curriculum development in today's occupational therapy programs. Purpose. This exploratory, descriptive study looked at what employers seek when they hire occupational therapists, and whether they seek anything different in new graduates. Method. Surveys were mailed to sites where occupational therapists work in Alberta and Saskatchewan. Results. There was a 64% response rate and data from 128 surveys were analyzed. The results indicate that employers seek a variety of attributes in occupational therapists, the most frequently cited being experience, team skills, practice skills and abilities, communication, and interpersonal skills. Employers did not necessarily look for different attributes when hiring new graduates, however the employers' expectations were often less, or modified. Practice Implications. The results of this study can be used to guide curriculum development, to aid students making decisions regarding fieldwork, and to offer insight to new graduates or therapists seeking employment
Enhancing Research Use through Online Action Research
Authors: Egan Mary , Dubouloz Claire-Jehanne , Rappolt Susan , Polatajko Helene , von Zweck Claudia , King Judy , Vallerand Josée , Craik Janet , Davis Jane A. , Graham Ian D.
Published: March 2013

Background. Many health professionals, including occupational therapists, have difficulty utilizing research findings in daily practice. Purpose. To determine if an online action research project could enhance research use among occupational therapists working in similar practice areas. Methods. Four groups of 12–14 occupational therapists met online for approximately one year. They discussed barriers and facilitators to research utilization, defined practice questions, and attempted to search for, synthesize and apply relevant research findings. Online communications and post-group interviews were thematically analyzed. Results. Only half of the participants who began the project were still online with the research project at completion. These participants believed that their involvement in the group led to increased personal awareness, motivation and confidence regarding the use of research evidence in practice and knowledge to be used in practice. Time to review, critique and synthesize research evidence continued to be a major barrier to enhanced research utilization. Practice Implications. Online meetings designed to enhance research use among occupational therapists appear to hold some promise, but refinements are needed to ensure their ultimate success.
Effectiveness of Occupational Therapy following Organ Transplantation
Authors: Hastings Jennifer , Gowans Susan , Watson Diane E.
Published: March 2013

Background. Individuals who receive a solid organ transplant have pre-operative and post-operative impairments in physical function. Purpose. This pilot study evaluated the changes in physical function of 23 individuals with an organ transplant who received 2 or more hours of occupational therapy while inpatients in an acute care facility. These individuals also received physiotherapy treatment that was retrospectively quantified. Post-operative function was evaluated at assessment and discharge from occupational therapy with the Functional Independence Measure (FIM). Results. Significant improvements in FIM scores (mean change +22) were noted at discharge from occupational therapy and there was a positive correlation between attendances or minutes of occupational therapy and study participants' changes in function. Occupational therapy attendances or minutes were also negatively correlated with study participants' initial functional status, which suggests that individuals with lower function received more occupational therapy. Practice Implications. Notwithstanding the benefit of physiotherapy, and the methodological limits of an uncontrolled pre-test/post-test design, this study provides novel, preliminary evidence for the benefit of occupational therapy during the acute care stay of individuals with a solid organ transplant.
Orthoses as Enablers of Occupation: Client-Centred Splinting for Better Outcomes
Authors: McKee Pat , Rivard Annette
Published: March 2013

Background. Orthotic intervention (splinting) may have become an end unto itself in the minds of therapists and clients rather than the means to enable optimal occupational performance. Some policy makers and payers seem to hold the belief that orthoses/splints are mere technical aids and as such do not require professional skill and expertise. Narratives. Three client stories demonstrate how iterative collaboration and follow-up help achieve client-identified objectives. Discussion. Client input is an important component of the process and an orthosis must fit into the person's lifestyle, especially if required for long-term use. Six essential considerations when providing orthoses to meet occupational goals are emphasized: client-centredness, comfort, cosmesis, convenience, less is more and follow-up. Use of the Canadian Occupational Performance Model for intervention planning and as an outcome measure is demonstrated. Practice Implications. Orthoses that are thoughtfully designed with client input and carefully constructed can make a difference in a person's life by relieving pain, providing protection and joint stabilization and enabling valued occupations.