bluuebunny/crossref_metadata_2025 huggingface dataset:
Clients' Experience of Partnership with Occupational Therapists in Community Mental Health
Authors: Blank Alison
Published: April 2015

The occupational therapy profession is committed to providing services that are client centred. Partnership with clients is seen as central to this way of working. However, there is little published evidence about the types of service and the relationships with therapists that clients value. This qualitative study used in-depth semi-structured interviews with seven clients from three adult community mental health teams to explore the experiences of working in partnership with occupational therapists from the clients' perspective.

The interviews were audio taped and transcribed verbatim by the researcher. The data were analysed by means of content analysis. This established four factors that contributed to partnership: the therapist's personality, the therapist's behaviour, client-centred skills and boundary issues. Five factors described as barriers to partnership were also established: the lack of an individual approach, the lack of communication and knowledge, the lack of confidentiality, the directive therapist and inequality.

The personality and behaviour of the therapist emerged as important, with the participants valuing those occupational therapists whom they perceived as warm, caring, committed and hard working and who appeared to value them as individuals. It was also found that the participants used the language of original writing on client-centred practice to describe their relationships with their therapists: warmth, empathy, trust and acceptance. Further exploration of the barriers to working in partnership with clients is needed, but the implications for practice are clear. Clients wish to be valued as individuals by occupational therapists who are committed to working in partnership with them.
An Evaluation of a Chronic Fatigue Lifestyle Management Programme Focusing on the Outcome of Return to Work or Training
Authors: McDermott C , Richards S C M , Ankers S , Selby M , Harmer J , Moran C J
Published: April 2015

This article presents the results of an audit of clinical outcomes from an occupational therapist led service for patients with chronic fatigue syndrome (CFS). The service offers group outpatient lifestyle management sessions, in which patients are encouraged to restructure lifestyle patterns in order to facilitate improvements in fatigue and function.

The cohort studied consisted of 98 consecutive patients attending the service who fulfilled the 1994 Centers for Disease Control criteria for CFS. The median illness duration was 5 years. The treatment offered consisted of six group sessions in lifestyle management together with three additional review sessions. The primary outcome measure was a return by the patient to employment, voluntary work or training. The cohort was followed up at a median of 18 months using a self-report questionnaire. Among the treated patients, 42% (31/74) reported new part-time or full-time employment, voluntary work or training.

The results of this study suggest that a lifestyle management programme offered by an occupational therapist led specialist service may provide positive outcomes, in terms of a return by patients to work and training, and indicates the need for a randomised controlled trial to provide definitive evidence of this.
The Therapeutic Use of Videogames within Secure Forensic Settings: A Review of the Literature and Application to Practice
Authors: Gooch Phil , Living Ruth
Published: April 2015

Engagement in leisure pursuits that involves the use of tools and objects and the exploration of a new environment can provide a success experience that leads to increased feelings of competence and mastery. Such experiences are considered important in the rehabilitation of forensic clients.

The findings from videogame research within a general population are compared with those among mental health and forensic clients. Within the general population, videogames may provide opportunities for social interaction and the expression of creativity and humour as well as offering a graded approach to building computer skills. Within a forensic population, videogames have been found to be a normalising, age-appropriate and culturally appropriate activity, useful in engaging clients and improving self-concept and locus of control.

The findings suggest that videogame play offers access to a safe virtual environment that encourages exploration and mastery and that it may be a useful therapeutic tool in secure settings where such opportunities are often limited. The use and potential contraindications of videogames within a forensic setting, the content of certain games and their possible influence on behaviour and the implications for future research are also discussed.
Becoming a Practitioner-Researcher: A Personal Journey
Authors: Young Anita F
Published: April 2015

This opinion piece describes one occupational therapist's experience of developing research knowledge to improve quality of care. The sharing of experience is used as a means of both prompting reflection on issues relating to practice and encouraging other practitioners into research. Developing research skills while coping with heavy clinical demands can appear daunting. Learning and development are described here in practical terms and are shown to be linked to the completion of a number of practice-based projects. The challenges, gains and necessary support systems are explored. Personal, professional and service benefits are highlighted. This piece champions the place of the practitioner within the research arena and makes recommendations for promoting practitioner-researchers in the profession.
Why Collaborate when You can Cheat? Understanding Plagiarism in Occupational Therapy Education
Authors: Savin-Baden Maggi
Published: April 2015

Although there is a growing literature and numerous web sites on plagiarism, there has been little examination of it in the context of teaching occupational therapy students. However, it is important to understand what is meant by plagiarism and other related terms. This article explores the current understandings of plagiarism and examines the research findings to date. It suggests that plagiarism is affected by disciplinary differences and argues that punishing and deterring plagiarism in both universities and practice are still areas that need thoughtful consideration and implementation. The article further suggests that lecturers and practitioners need to be aware of the plagiarism policies whilst also understanding that there is a range of cheating behaviours and that, therefore, fair and consistent practices need to be adopted across health and social care education and practice.
A Description of a Functional Screening Assessment Developed for the Acute Physical Setting
Authors: Wilby Helen J
Published: April 2015

This article provides a description of the development, process and introduction of the Structured Anchored Approach to Functional Assessment (SAAFA).1 The approach was designed to include a person-centred and time-efficient occupational therapy functional screening assessment that would meet the needs of patients and be appropriate for use in an acute physical inpatient setting. SAAFA assessments were developed to incorporate the strengths of both quantitative and qualitative occupational therapy assessments and research methods. Taken in the round, SAAFA assessments follow a process that corresponds with the four processes of qualitative research: data gathering, analysis, interpretation and reflexivity (Miller and Crabtree 2003).

The SAAFA is a dynamic approach that continues to evolve in response to developments in theory and practice. Information from occupational therapists' reports of their day-to-day practice indicate that SAAFA assessments reflect the complexity of individual patients' functioning and lead to the development of recommendations based on pragmatic consideration of a wide range of contextual influences. Research on the SAAFA commenced in 2002.
Study at Master's Level: A Qualitative Study Exploring the Experience of Students
Authors: Conneeley Anne Louise
Published: April 2015

The aim of this qualitative study was to explore the experience of students engaged in Master's level study. Six students who had completed the taught component of their degree programme before embarking on their dissertation took part in a focus group.

The themes that emerged included the costs involved, perceived benefits, impact on practice and course-specific comments. The costs were seen in terms of stress related to course work and a lack of support. The perceived benefits included an increase in personal and professional confidence and growth, the development of critical and analytical skills, more career options and enthusiasm for practice. The impact on practice involved changes in relationships within the workplace, expectations of others and workload responsibilities.

The findings could enable future students to make an informed choice in their decision to embark on study at Master's level and could further inform managers of services and educators involved in programme development and delivery.
An Introduction to the Selection of Outcome Measures
Authors: Corr Susan , Siddons Leonie
Published: April 2015

This paper introduces the key issues that occupational therapists need to cover when selecting outcome measures for their workplace. It indicates the properties required for a standardised tool and describes how data are usually collected and analysed. Consideration is given to the advantages and disadvantages of using a standardised tool to measure the outcome of occupational therapy.
Ethical Issues as an Occupational Therapist and Epidemiological Researcher
Authors: Atkinson Jo Copley
Published: April 2015

There can be role conflicts for allied health professionals working in health care research that involves direct contact with study participants, particularly in relation to maintaining a duty of care. This opinion piece, drawn from the experience of working on an observational study, highlights the need for researchers to clarify their intent and purpose; to be aware of ethical demands; to have an established protocol to deal with the needs of participants arising through the course of the research; and to consider how the process of the study may affect the findings. Ultimately, the individual welfare of study participants should prevail over the aims of the study.
The Journal Club: A Method for Occupational Therapists to Bridge the Theory-Practice Gap
Authors: Sherratt Charles
Published: April 2015

There are still major problems being encountered by occupational therapists when they attempt to access relevant research material. One of the main reasons for this is that there are currently relatively few occupational therapists who are involved in any form of research on a regular basis.

This article highlights the potential of the journal club as a means of introducing occupational therapists to research that will both be relevant to their work area and form a substantial part of their continuing professional development. A brief overview of the format and content of journal clubs both in occupational therapy and in other health care professions is intended to encourage occupational therapists to initiate their own journal clubs as a method of bridging the theory-practice gap that still exists in their profession.
Sexual Expression and Occupational Therapy
Authors: Couldrick Lorna
Published: April 2015

Little is written in the occupational therapy literature about sexual expression and professional practice. This opinion piece presents two opposing opinions. One argues for its inclusion as part of an holistic approach. The other, developed from published emails, argues for its exclusion, because sexual expression is not seen as an occupational activity. These professional perspectives are set against the lived experiences of physically disabled people. From this consumer perspective, the omission of sexual expression from practice can be viewed as potentially damaging. A proposed way forward is to increase the awareness and skills of occupational therapists in this domain of practice.
Occupational Therapy for Children with Acquired Brain Injury: A Review of the Literature
Authors: Jones Pru , Drummond Avril
Published: April 2015

The aim of this literature review was to examine occupational therapy input for children with acquired brain injury (ABI). Although 3,462 citations were identified by the literature search, only 10 articles met the criteria and were relevant to the review. The studies found that children with ABI had continuing difficulties, post-injury and postdischarge, with motor skills, self-care skills, cognition and behaviour. However, substantial numbers of children with continuing problems did not access therapy, particularly in the year postdischarge.

Occupational therapy is often part of inpatient paediatric rehabilitation, but there is a lack of research investigating the effectiveness of therapy. The review notes the dearth of research and literature in this field and suggests that further research is needed to underpin practice.
Comparing an Occupational Therapy Definition and Consumers' Experiences: A Q Methodology Study
Authors: Corr Susan , Neill Gemma , Turner Annie
Published: April 2015

Occupational therapy has been defined as a complex intervention (Creek 2003), on behalf of the College of Occupational Therapists. This definition was generated from a study involving occupational therapists but not consumers of services. The aim of the present study was to explore how Creek's (2003) definition of occupational therapy compared with the experience of ex-consumers whose contact with occupational therapy had been through stroke services.

A Q methodology study was conducted with 16 participants recruited through stroke clubs in two large cities. A Q-sort pack of 32 statements was developed based upon Creek's (2003) definition of occupational therapy. Participants sorted the statements along a ‘least to most’ continuum, indicating how much each statement reflected their own experience of receiving occupational therapy.

Following analysis, six factors were identified which suggested that, for these participants, occupational therapy: facilitated and improved their sense of self; recognised the importance of being heard; provided practical assistance; assisted with maintaining autonomy; generated the desire for involvement; and had general benefits. The factors identified reflected aspects of Creek's (2003) definition of occupational therapy and suggested congruence in certain concepts between the professional body and consumers. Although limited by the fact that the participants had accessed different occupational therapy services some time ago, this study also introduces a method of obtaining consumers' views of occupational therapy.
An Evidence-Based Approach to Choosing Outcome Measures: A Checklist for the Critical Appraisal of Validity, Reliability and Responsiveness Studies
Authors: Jerosch-Herold Christina
Published: April 2015

Selecting outcome measures for clinical practice or research needs to be based on a critical evaluation of the evidence on the validity and reliability of the available measures. This paper presents both a theoretical framework based on the methodological literature of how these psychometric properties can be assessed and a checklist designed to facilitate the critical appraisal of studies on outcome measures.

Through examples drawn from the published literature, the concepts of instrument validity, reliability and responsiveness and how these can be evaluated and reported are illustrated. It is suggested that a structured checklist can facilitate a more evidence-based approach to the selection and employment of outcome measures in clinical practice and research.
Transatlantic Collaborative Teaching and Learning via Information and Communications Technology
Authors: Robertson David , McCannon Robin , Caldwell Jennifer , Juwah Charles , Elfessi Abdulaziz
Published: April 2015

The overall aim of this project was to investigate the potential of problem-based learning (PBL), supported by information and communications technology (ICT), to develop key, transferable and requisite skills and knowledge, which are critical for practice as an occupational therapist. This paper provides an evaluation of the potential of the ICT employed in the study to enhance learning and teaching.

The project entailed a transatlantic collaboration between the faculty members and students of The Robert Gordon University, Aberdeen (RGU), and the University of Wisconsin, La Crosse (UWL). Thirty students participated in the project. The ICT employed in the project included videoconferencing, email and computer-mediated conferencing (online discussion forum).

The faculty members of the participating institutions generated a PBL case. The students received the case material by staged release via the virtual community and worked on developing appropriate assessment, treatment and resettlement strategies in geographical groupings, supported by email and the online discussion forum. They met and discussed their findings via videoconferences.

The findings demonstrated that the ICT used was robust and provided a viable means of delivering the project content. The participants viewed the technology positively and their confidence and skills in using the technology progressed during the project.
Reconceptualising Occupational Therapy
Authors: Pollard Nick , Alsop Auldeen , Kronenberg Frank
Published: April 2015

This opinion piece describes central issues arising from discussions at a recent conference exploring the implications of global poverty for the occupational therapy profession. The connection between poverty, disability and the marginalisation that these problems produce presents an opportunity for occupational therapists to realise their potential for facilitating social change. To do so, however, entails some reconceptualising of the profession. In some areas of intervention, the struggle to obtain a clear definition for occupational therapy has both arisen from and contributed to a marginal status, linked to difficulties in developing capacity for research. The social questions around occupation suggest both challenges and opportunities for the profession.
The Practice Placement Education Experience: An Australian Pilot Study Exploring the Perspectives of Health Professional Students with a Disability
Authors: Brown Kate , James Carole , MacKenzie Lynette
Published: April 2015

Practice placement education is an essential component of health professional programmes. The number of students with a disability entering health professional education programmes is anticipated to rise, yet research about the perspectives of students with a disability is limited, especially related to practice placement education. Therefore, the need to investigate student experiences has intensified.

In this study, qualitative research methodology was used to investigate the perceptions, feelings and experiences of health professional students with a disability during practice placement education. Five health professional students, recruited from a regional university in New South Wales, Australia, participated in semi-structured, individual interviews. A phenomenological approach was used.

Following inductive analysis of the data, three themes reflecting the students' experience of practice placement education emerged: the impact of disability, including the barriers and the strategies used to overcome these; the experiences of practice placement education, including the feelings of the participants; and support, which came from the practice placement educator, the university staff, family and friends.

This pilot study provides valuable insight into the perspectives of these students about practice placement education. The findings reinforce the need for further exploration of the unique experiences of students with a disability to ensure success within their university programme and future profession.
Adopting the Assessment of Motor and Process Skills into Practice: Therapists' Voices
Authors: Chard Gill
Published: April 2015

A qualitative study was undertaken to explore occupational therapists' experiences following a continuing professional education course to learn how to use the Assessment of Motor and Process Skills (AMPS). This paper describes the challenges and barriers they faced when adopting it within existing professional practice. Twenty-two occupational therapists from 16 National Health Service trusts across the United Kingdom who had attended an AMPS course took part in a series of three semi-structured interviews over a 9-month period. The data were analysed inductively; six themes and a number of subthemes emerged.

Three themes are explored in this paper: adopting the AMPS into professional practice, the diffusion of innovation and the embedding of new skills in clinical teams. Using the voices of the participants in the study, the findings explore some of the barriers to learning new skills and to utilising them within workplace teams. Overall, the therapists were able to overcome these barriers if they had sufficient personal motivation and workplace support from either their manager or the clinical team.

The spread of a new idea and its adoption into current practice are complex and affected by many factors. Research evidence alone may not be enough to persuade individuals and teams to change: additional resources of leadership, skills and time also appear essential to success.
Towards a Theory of Practice
Authors: Nixon Jon , Creek Jennifer
Published: April 2015

In occupational therapy, theorising is an integral part of practice and theory is shaped by practice. This paper suggests that we do theory by developing collaborative models of thoughtful practice that work within specific contexts. It begins by looking at how the nature of professionalism is changing in response to social and political changes. It argues that any claim to professional status is based on the ability to make informed and authoritative judgements. Professional judgements are described as complex and morally purposeful and as being made within a social context. The paper then addresses how thoughtfulness relates to professional practice. Three dimensions of thoughtfulness are discussed: the deliberative, the public and the reflexive. The final section of the paper considers what theory means for professional practitioners; that is, how occupational therapists use theory in order to theorise our own practice.
Occupational Therapists' Knowledge and Practice of Infection Control Procedures: A Preliminary Study
Authors: Snaith Lucinda , Rugg Sue
Published: April 2015

Occupational therapists often meet clients with infections in the course of their work, but research into such therapists' knowledge and practice of infection control procedures is limited. This small postal survey explored the deficit, gathering data from 63/93 (68%) occupational therapists working in 12 randomly selected English health care trusts. The results showed evidence of a discrepancy between respondents' knowledge and practice of infection control procedures. The respondents acknowledged the importance of infection control but did not always take the necessary precautions, reporting some difficulty in judging the latter. The reasons for the study findings and their potential implications for occupational therapy practice, research and education are considered.
Virtual Driving Tests for Older Adult Drivers?
Authors: Lee Hoe C
Published: April 2015

Driving ability is dependent on many skills within the purview and expertise of occupational therapy. In countries such as the United States and Australia, both the assessment and the training of driving skills are the focus of occupational therapists in helping older drivers. General practitioners have high expectations of the profession regarding the assessment and training of older drivers or drivers with special needs. This opinion piece summarises recent research into the use of driving simulators to improve the road safety of older adults by occupational therapists. Research confirms the high transferability of observations of driving behaviours between simulated driving and road assessment. The question remains: can the driving simulator be a clinical tool to screen out problematic older drivers before a more detailed but expensive road test is considered?
Participation in the Prescription Process of Mobility Devices: Experiences among Older Patients
Authors: Hedberg-Kristensson Elizabeth , Ivanoff Synneve Dahlin , Iwarsson Susanne
Published: April 2015

The aim of this study was to explore older patients' experiences of participation in the prescription process of mobility devices.

The study was conducted in two Swedish municipalities and was a qualitative study, based on the focus group interview methodology of Merton et al (1990). In order to recruit a sample fulfilling both homogeneity and heterogeneity criteria, occupational therapists and physiotherapists in the municipalities identified potential participants, all aged 65 years or older. Twenty-two patients participated in focus group interviews. Each patient participated once in the seven focus group interviews that were arranged.

The participants reported passive participation in the prescription process of mobility devices as the most frequently occurring experience. They also reported non-participation, for example, in discussion about alternative solutions to activity problems.

The study concluded that it was necessary to develop a more client-centred approach in community-based rehabilitation, challenging occupational therapists and physiotherapists to encourage patient participation in the prescription process of mobility devices. The study also highlighted the importance of inviting the patient to discuss alternative solutions to activity problems.
Outdoor Recreation as an Occupation to Improve Quality of Life for People with Enduring Mental Health Problems
Authors: Frances Katy
Published: April 2015

This report reviews available evidence to illustrate that outdoor recreation can be used as a viable therapeutic medium for people with enduring mental health problems. It illustrates how outdoor recreation is in keeping with government mental health promotion strategies and that, if outdoor recreation is considered as an occupational role, it can facilitate positive self-identity and enhance quality of life for people with enduring mental health problems.

The term ‘outdoor recreation’ encompasses activities that take place in an outdoor environment, including walking, hiking, orienteering and cycling, and more adventurous activities such as climbing, kayaking, canoeing and sailing.
Randomised Controlled Trials: Part 1, Design
Authors: Deane Katherine H O
Published: April 2015

Occupational therapists need to be able to evaluate the profession's interventions critically: to stop the ineffective, to reduce the hazardous and to promote the effective. Randomised controlled trials are a research tool for testing the efficacy of interventions with small to moderate effects. This review aims to cover the issues to be considered when designing a randomised controlled trial of complex interventions, such as occupational therapy.
Moving from Student to New Practitioner: The Transitional Experience
Authors: Morley Mary
Published: April 2015

Preceptorship is now a requirement for all newly qualified occupational therapists joining the National Health Service (Department of Health 2005). This is intended to ameliorate the difficulties experienced by new practitioners when moving from the role of student into clinical work. A number of studies confirm the importance of providing both support and challenge in the first year of practice.

This opinion piece presents the case for the introduction of preceptorship, building on the expertise of clinical supervisors. This role of preceptor could improve the transitional experience of new practitioners and support the development of their skills and their confidence.
Mental Health Vocational Rehabilitation: An Overview of Occupational Therapy Service Provision in Northern Ireland
Authors: Devlin Ciara , Burnside Lesley , Akroyd Lorna
Published: April 2015

The job clinic model was established in Northern Ireland in 1992. It was initiated by mental health occupational therapists and represented an interagency model of vocational rehabilitation (McCrum et al 1997). Occupational therapy vocational practice has evolved significantly since then, with a regional variation in service delivery, which necessitated review. There was a recognition that practice needed to be examined to develop services in a unified professional way.

This paper gives an overview of occupational therapy mental health vocational service provision in Northern Ireland. The authors sought information from 13 regional trusts, which demonstrated that vocational work is a very active part of occupational therapy provision but that there are also opportunities to develop services based on current evidence. This paper makes recommendations and highlights the action required to take forward occupational therapy vocational rehabilitation in Northern Ireland.
Exploring Changes in Occupational Therapy Students' Approaches to Learning during Pre-Registration Education
Authors: Chapman Judith , Watson Jo , Adams Jo
Published: April 2015

This article describes a longitudinal cohort study, which examined the preferred approaches to learning of pre-registration occupational therapy students (N = 55) as they progressed through the 3 years of an undergraduate BSc(Hons) programme. The students' orientations to learning were measured using the short Approaches to Studying Inventory (ASI) (Entwistle 1981) and the results were compared descriptively across repeat measures undertaken during each year of study. Inferential statistics were used to examine whether there were any statistically significant differences in preferred learning approaches throughout the 3 years of study.

The results showed moderate changes in learning approaches, which were associated with more successful outcomes of learning. The evidence of the use of these deeper approaches to learning was accompanied by statistically significant decreases in the less desirable, superficial approaches, with reductions in the mean scores between year one and year three for Operation Learning (p < 0.005) and Learning Pathologies (p < 0.05).

The implications of the findings are discussed in relation to learning and teaching and assessment methods in undergraduate health professional education. Students may be encouraged to become more independent and to develop deeper approaches to learning by reducing formal contact time and developing assessment strategies that emphasise the exploration and application of knowledge.
Outcome Measures for People with Scleroderma: Relationships between Measures of Impairment and Activity Limitation
Authors: Poole Janet L
Published: April 2015

This study examined the relationships between impairment and activity limitation outcome measures in people with scleroderma. Forty people with scleroderma received evaluations of body structure and function variables: grip and pinch strength (Arthritis Hand Function Test), dexterity (nine-hole pegboard), joint motion (Hand Mobility in Scleroderma and Keital Function Test) and skin thickness. The participants also completed self-report questionnaires regarding activity limitations (Health Assessment Questionnaire, Hand Functional Disability Scale and Scleroderma Functional Assessment Questionnaire).

All grip and pinch strength and dexterity measures correlated significantly but moderately with the activity limitation measures (r = 0.34 to 0.62). The Keital Function Test correlated with the activity limitation measures (r = 0.43 to 0.49) whereas the Hand Mobility in Scleroderma test and skin thickness did not. The results demonstrated that the activity limitations reported by the participants were only partly associated with the impairment variables. The findings from this study might help occupational therapists to decide where to focus intervention and which measures to use when assessing the effectiveness of occupational therapy for people with scleroderma.
The Prevocational and Early Employment Needs of Adolescents with Juvenile Idiopathic Arthritis: The Occupational Therapy Perspective
Authors: Shaw K L , Hackett J L , Southwood T R , McDonagh J E
Published: April 2015

The purpose of the study was to explore the prevocational needs of adolescents with juvenile idiopathic arthritis (JIA) from the perspective of occupational therapists and to examine the role of occupational therapy in addressing these. A questionnaire was distributed to members of occupational therapy organisations (n = 494) to assess the perceived importance of addressing prevocational issues for adolescents with JIA and the respondents' knowledge, confidence and perceived role. The questionnaire was completed by 175 (35.4%) individuals.

The results showed that although the occupational therapists felt that they were an appropriate profession to address the vocational needs of adolescents, they reported limited knowledge and confidence to do so. Significant unmet training needs were highlighted. This study echoes previous calls for vocational issues to be addressed within adolescent rheumatology and provides evidence that occupational therapy is well placed to coordinate this area of need.
New Graduates' Experiences of Learning to Practise Occupational Therapy
Authors: Toal-Sullivan Darene
Published: April 2015

This article presents findings from a qualitative study of six occupational therapists in the first year of their career, with a focus on the experience of transition and how beginning practitioners learn about doing practice. An initial interview was conducted with each participant in the third to fifth months of practice. The participants then maintained a journal for one month. A second interview was held with each participant in the eighth to tenth months of practice, which explored the learning experiences documented in the journals and changes in knowledge and skills since beginning practice.

The transitional experiences of the participants revealed that they were challenged by their limited practical experience, the responsibilities of client care, system issues and role uncertainty. The support of colleagues and peers was critical to their learning and eased their adjustment from student to occupational therapist. The relationship with clients was particularly valuable to the participants' learning and professional identity. Recommendations to bridge academic and clinical settings and ease the transition from student to therapist are proposed.
Is Big Brother Watching You? Responding to Tagging and Tracking in Dementia Care
Authors: Plastow Nicola Ann
Published: April 2015

The increased availability of electronic assistive technologies, particularly tagging and tracking technology, raises questions for occupational therapists working in dementia care. As experts in environmental adaptation to support participation, occupational therapists need to be clear about what technologies are available to address wandering behaviour, how emerging technologies could be used in their practice and how they will respond proactively to the ethical issues involved in these technologies. Occupational therapists need to join the national debate in order to ensure that ethical, person-centred practice is used to reduce the risk of big brother style monitoring and to support the independent functioning of their service users.
Cognitive Stimulation Therapy versus Acetyl Cholinesterase Inhibitors for Mild to Moderate Dementia: A latter-day David and Goliath?
Authors: Salmon Niall
Published: April 2015

The pharmaceutical industry was first licensed to produce acetyl cholinesterase inhibitors (ACIs) in April 1997. The current popularity of this intervention is due to its key aim to treat the symptoms of early to moderate stage dementia. Recent evidence has shown that the therapeutic intervention cognitive stimulation therapy (CST) is comparable to intervention with ACIs. The results of a randomised controlled trial of a CST programme allowed the size of its effects to be compared with published data from trials of the major dementia drugs. This opinion piece directs the spotlight onto CST, describing it and its recent clinical evidence, and asks the question: why have occupational therapists not been more engaged in developing and using such interventions?
Occupational Therapy Students' Approaches to Learning: Considering the Impact of Culture
Authors: Watson Jo , Chapman Judith , Adams Jo , Nila Ummey Hamida
Published: April 2015

Learning approaches describe the way that individuals approach tasks or learning situations and are influenced by individual characteristics and specific learning contexts. Cultural factors are likely to have an impact on various aspects of learning, yet the literature disagrees over the extent to which culture influences approaches to learning. With increasing cultural diversity in student cohorts and the contributions of culturally Western therapists to occupational therapy programmes in developing nations, this issue is worthy of exploration within the context of pre-registration education.

The Approaches to Study Inventory was used to explore differences in the approaches to learning of United Kingdom and Bangladeshi occupational therapy students studying in their home countries. Significant differences between the groups revealed that the Bangladeshi students displayed both stronger tendencies for deep approaches to learning (p<0.05) and for less integrated superficial approaches to learning (p< 0.05). This apparent contradiction required careful consideration.

There is no single correct way to learn. This study's results reinforce the need for cultural sensitivity in not only clinical but also educational contexts. The cultural biases underpinning the constructs of deep and superficial learning approaches are explored. Educators are encouraged to recognise the potential for culture to influence how students engage within the learning environment and how they themselves construct learning opportunities.
An Example of Occupational Coherence: The Story of Dian Fossey, Occupational Therapist and Primatologist
Authors: Cara Elizabeth
Published: April 2015

Dr Dian Fossey was the primatologist and occupational therapist who is famous worldwide for saving the highland mountain gorillas from extinction. She sustained her research centre successfully for 18 years in an inhospitable physical and political climate before her murder in 1985.

Prior to moving to Africa, Dr Fossey enjoyed a successful 10-year career as a paediatric occupational therapist. After graduating from San José State College (now university) in California, she moved to Louisville, Kentucky, to lead a one-woman department at a well-known hospital where she treated orthopaedic clients, including children from the Appalachian Mountains.

Yet, in spite of her considerable accomplishments and successful early career, Fossey is not well known in today's occupational therapy profession and there is little information about her occupational therapy career. This paucity prevents a complete analysis of her life.

This paper presents an alternative narrative, which identifies connections between her early lives as an occupational therapist working with children and a primatologist studying the highland mountain gorilla culture. These connections suggest that there is an occupational coherence throughout life that may occur in spite of the pursuit of apparently different careers in very different contexts. The links also imply that certain values and motivations may contribute to this occupational coherence throughout one's lifespan.
Pressure to Lead: What Can We Learn from the Theory?
Authors: Stewart Lisa S P
Published: April 2015

Older people are major users of health and social services and, in the United Kingdom, the proportion of the population over 65 years is set to rise in the coming decades (Audit Commission 2000) with growing numbers of long-term conditions. In response, the National Health Service (NHS) must also change if it is to meet the needs of the nation. Whether in the public or the private sector, organisations must have leaders with the skills necessary to implement change if the organisation is to be successful (Landrum et al 2000). In the health care environment, leaders with the capacity to influence, shape and deliver services will enable the NHS to realise its organisational vision (Scottish Executive 2006).

Partnership for Care (Scottish Executive 2003) provides direction to achieve this goal by devolving power to frontline staff and promoting a culture of continuous improvement in the NHS. Occupational therapists form part of the frontline power responsible for implementing change and are in an ideal position to do so (Grady 1991). The author describes four theories of leadership — trait theory, motivational theories, transformational leadership and emotional intelligence — and reflects on their strengths and weaknesses and their relevance to occupational therapists currently working in the NHS.
Interprofessional Learning in Practice: The Student Experience
Authors: Mackenzie Alice , Craik Christine , Tempest Stephanie , Cordingley Kevin , Buckingham Ian , Hale Sally
Published: April 2015

Interprofessional learning and the development of teamworking skills are recognised as essential for patient care and are also a government priority for undergraduate education. Sixteen occupational therapy students worked on an interprofessional training ward as part of their practice placement and three of them participated in an evaluation using the nominal group technique. Despite this small number, the evaluation identifies the value of this learning experience in giving the students an opportunity to appreciate the importance of interpersonal skills; to learn about other team members' roles; and to experience the challenges of working on a busy rehabilitation ward for older people.
Occupation, Mental Illness and Medium Security: Exploring Time-Use in Forensic Regional Secure Units
Authors: Stewart Paul , Craik Christine
Published: April 2015

Research investigating occupational experience among people with mental illness has highlighted their difficulties in selecting, organising, valuing, enjoying and competently performing occupations. Although occupational therapy literature consistently identifies environmental factors as key in facilitating successful and valued engagement, few authors have studied the implications of detention in secure mental health settings for this population.

This study investigated the occupational experiences of five people with schizophrenia in two forensic regional secure units. Quantitative and qualitative methodologies were used, with semi-structured interviews adding depth and subjectivity to Occupational Questionnaire (Smith et al 1986) responses. The quantitative data were analysed using non-parametric analysis, with content analysis applied to the qualitative data.

Time-use was characterised predominantly by engagement in passive leisure and rest occupations. This reflects the findings of both inpatient and community-based studies elsewhere and suggests that mental illness is a common factor influencing time-use. The participants chose occupations based on expectations of enjoyment and success, and associations with independence and normality. Significant correlations were found between perceived competence, value and enjoyment (p<0.01), and the participants were more likely to enjoy self-chosen occupations (p<0.05).

Forensic occupational therapists must use evidence to optimise resources and deliver interventions that facilitate choice and autonomy and reflect individual needs. Further research with larger samples and longitudinal methodologies will facilitate generalisation and establish temporal perspectives.
From Graduate to Reflective Practice Scholar
Authors: Quick Laura , Forsyth Kirsty , Melton Jane
Published: April 2015

The National Health Service is currently striving to deliver evidence-based, effective and efficient services. In this climate, it is important to enable new graduates to develop their knowledge, skills and confidence to meet these exacting demands, in an effective and supportive environment. This is of particular importance because there is growing concern over the retention of new graduates. If new graduates do not receive effective support to complete the transition to a competent professional, then the concern is that they may choose to leave the profession and/or seek new roles. This opinion piece argues for an academic/practice partnership to provide the needed support structures to allow graduates to become competent professionals. Two examples are provided, which embrace such partnership working.
Should Children with ADHD be Routinely Screened for Motor Coordination Problems? The Role of the Paediatric Occupational Therapist
Authors: Kirby Amanda , Salmon Gill , Edwards Lisa
Published: April 2015

Attention deficit hyperactivity disorder (ADHD) is commonly comorbid with movement difficulties, including developmental coordination disorder (DCD). Compartmentalised service provision may result in children with ADHD not being screened, and assessed if necessary, for DCD and vice versa. In this study, 69 children attending an ADHD clinic were screened for movement problems, using the parent-completed Movement Assessment Battery for Children Checklist (Henderson and Sugden 1992). The results showed that 19% of the children with ADHD were defined as having a ‘movement problem’, with a further 16% defined as ‘at risk’. This paper discusses the results of the study and the implications for paediatric occupational therapy.
Spiritual Emergency and Occupational Identity: A Transpersonal Perspective
Authors: Collins Mick
Published: April 2015

The subject of spirituality has been developing over recent years in occupational therapy journals internationally and this article contributes to the ongoing exploration of spiritual issues in therapeutic practice. People can experience a transformational crisis through engaging in spiritual growth and development, a phenomenon that has been termed a ‘spiritual emergency’. A spiritual emergency manifests itself as a crisis within ego-identity and can include experiences of disorientation and de-adaptation, which affect a person's ability to function in daily life. Consequently, a person may be diagnosed and treated for a mental health problem; however, a spiritual emergency may present a person with opportunities to engage in a process of self-renewal rather than being considered ill.

The dichotomy of a spiritual emergency as reflecting human potential or a mental health problem is a complex issue, which underpins many of the discussions concerning health professional involvement. This article argues that there are clear therapeutic needs for people experiencing a transformational crisis, which are well suited to the skills of occupational therapists. Engaging in occupation could play an important role in the process of re-adaptation during a spiritual emergency through enabling occupational identity, which could support the process of self-renewal. A case vignette is provided to illustrate the theoretical position outlined.
Complexity, Occupational Therapy, Unpredictability and the Scientific Method: a Response to Creek et al (2005) and Duncan et al (2007)
Authors: Lambert Rod , Harrison Deborah , Watson Martin
Published: April 2015

Two recent articles in this journal have discussed complex systems and differing views of occupational therapy as a complex intervention. This opinion piece develops the discussion of complex adaptive systems and complex interventions further, concluding that all health professions can claim to be complex. Complexity implies a degree of unpredictability. Within patient-centred systems, this means not that complexity cannot and should not be studied, but merely that variability will be experienced and needs to be understood and examined. The Medical Research Council framework provides a rational way of doing so. Research by occupational therapists should grasp this nettle to develop the profession's evidence base.