bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational Science: Bridging Occupation and Health
Authors: Wilcock Ann A.
Published: March 2013

Background. The paper is based on a keynote address delivered at the 2004 CAOT Conference in Charlottetown, Prince Edward Island Occupational therapists are widely associated with a medical model of health care in which recognition of how engagement in occupation contributes to health status is poorly understood. Occupational science as the study of people as occupational beings has the potential to increase such understanding. Purpose. This paper considers some aspects of the relationship between health and the occupations of older people to highlight avenues for change and the research required to support them. Method. The paper is structured around a simple verse of dialogue between a healthy old man and an occupational therapist. Explanation of the dialogue draws upon historical and current literature as well as occupational science research to provide a rationale for future practice based on broader concepts of occupation for health. Results and Practice Suggestions. The dialogue promotes the need for discussion about health and about the health notion of Active Ageing. It highlights professional language as one impediment to change and suggests that research concerning occupation as it relates to population health is a primary requirement for the future of occupational therapy.
Best Practice in Occupational Therapy: Program Characteristics that Influence Vocational Outcomes for People with Serious Mental Illnesses
Authors: Kirsh Bonnie , Cockburn Lynn , Gewurtz Rebecca
Published: March 2013

Background. Despite the known benefits of work for people with mental illnesses, vocational outcomes of this group remain poor. Attempts at comparing the efficacy of various models of service delivery have met with limited success due to variations across studies. Purpose. The purpose of this paper is to provide information about key characteristics related to outcomes in the field of vocational rehabilitation for people with serious mental illnesses. Method. A comprehensive review of literature published between 1990 and 2003 was conducted, resulting in 39 articles for analysis. Results. A set of twelve characteristics was identified that appear to influence vocational outcomes across models. These characteristics relate to the types of services offered, the manner in which services are delivered, and the work environment. Practice Implications. The authors suggest these characteristics can be incorporated across models and practice settings. The findings are discussed in terms of implications for best practice in occupational therapy.
Occupational Therapy Research on Assistive Technology and Physical Environmental Issues: A Literature Review
Authors: Ivanoff Synneve Dahlin , Iwarsson Susanne , Sonn Ulla
Published: March 2013

Background. To determine future directions for research in the area of assistive technology and physical environmental issues, it is important to have an understanding of prior research. Purpose. This literature review examined how assistive technology and physical environmental issues have been studied in the research published in international peer-reviewed occupational therapy journals. Method. Five recent volumes of nine journals were manually searched utilizing specific criteria. The publications were classified according to their perspective, application of the Person-Environment-Occupation (PEO) model, and the research design. Results. Both research fields demonstrated use of different research methods and they displayed equal needs with regard to improved research methodologies. Practice Implications. There are a lack of studies involving all three PEO components indicating a lack of research in occupational performance issues. Further research on occupational performance is important for developing occupational therapy practice in the area of assistive technology and physical environmental issues. Furthermore, study designs reflecting the societal level in all three PEO components are required. Finally, there is a strong need for conceptual and theoretical development in both fields.
A Review of Evidence on the Conceptual Elements Informing Client-Centred Practice
Authors: Sumsion Thelma , Law Mary
Published: March 2013

Background. Client-centred practice is a central concept in occupational therapy in Canada. Since 1980, Canadian occupational therapy publications have discussed the elements of a client-centred practice approach. Purpose. The purpose of this paper is to enhance the understanding of key elements of a client-centred approach and to highlight the implications for practice that arise from this discussion. Method. Literature about client-centred practice in health care from 1990–2005 was reviewed regarding thoughts and ideas about client-centred practice. The content was analyzed for thematic focus about client-centred practice conceptual ideas and their influence on practice. Results. Thematic conceptual elements emerging from the review include an overarching theme of power, with important underpinning themes of listening and communicating, partnership, choice, and hope. Selected definitions of client-centred practice and the link to best practice provide the context for the presentation of the concepts and recommendations for the implementation of client-centred practice. Practice Implications. The paper concludes with a discussion of practice implications through the presentation of questions for therapists to consider as a quick reference tool and suggestions for further research and dialogue concerning client-centred practice.
Outcomes of an Occupational Therapy School-Based Consultation Service for Students with Fine Motor Difficulties
Authors: Reid Denise , Chiu Teresa , Sinclair Gerry , Wehrmann Susan , Naseer Zahid
Published: March 2013

Purpose. This paper reports on a study that was conducted to address the perceived occupational performance changes among school-aged children who received occupational therapy services for fine motor difficulties. It also addressed teacher awareness and the degree of implementation of occupational therapy recommendations by teachers. Methods. The study sample included 91 school-aged children referred for occupational therapy services for fine motor difficulties. The children were assessed, before and after intervention. Outcome measures used were the Canadian Occupational Performance Measure (COPM) and the Teacher Awareness Scale (TAS). Results. Significant change scores in both scales of the COPM were (Performance = 1.50, p < 0.001; Satisfaction = 1.92, p < 0.001). Regression analyses showed that lower teacher ratings of the students' performance and satisfaction of performance on the initial COPM resulted in significantly greater COPM change scores in the students' performance and satisfaction of performance at reassessment. The greater the degree of implementation of occupational therapy strategies by the teacher, the greater the COPM performance and satisfaction change scores. The greater the degree of teacher awareness of students' special needs resulted in greater COPM performance change scores. Practice Implications. Teachers may benefit from more education regarding fine motor difficulties in children and how the implementation of occupational therapy strategies are helpful to improve children's fine motor difficulties.
Discharge Decision-Making, Enabling Occupations, and Client-Centred Practice
Authors: Moats Gillian
Published: March 2013

Background. Occupational therapists working in hospitals are confronted with increasingly complex discharge decisions. However, the relationship of discharge-planning strategies to the professional concepts of client-centred practice and enabling occupations has been unclear.Purpose. This study explored the relationship between the models of decision-making used by occupational therapists, and the professional issues of enabling occupation and client-centred practice.Methods. Qualitative interviews were conducted with 10 occupational therapists. Data were analyzed for the presence and emergence of themes.Results. Therapists try to balance the sometimes competing issues of safety and autonomy. Therapists often engage in negotiated decision-making. However, clients are sometimes excluded, despite therapists' commitment to client-centred processes. Consideration of occupations is often neglected.Practice Implications. Client-defined models of decision-making are insufficient for frail, cognitively- impaired people. A new, client-centred Negotiated Model of Decision-Making is proposed, which facilitates decisions to enable older people with their occupations.
A Modified Constraint-Induced Movement Therapy Regimen for Individuals with Upper Extremity Hemiplegia
Authors: Stevenson Ted , Thalman Leyda
Published: March 2013

Background. The Constraint-Induced Movement Therapy approach has been identified as a promising method to address deficits in upper limb function experienced by some stroke survivors. There is some question regarding whether the intervention administered in the research setting could be translated into clinical practice.Purpose. This paper describes the modified version of Constraint-Induced Movement Therapy developed at St. Boniface General Hospital, Winnipeg, Canada.Method. This modified regimen involves practice of upper limb tasks for four hours per day for 10 weekdays over two weeks, concurrent with participants attempting to wear a restraint mitten on the less involved hand for 90% of their waking hours.Results. The primary outcome measure was the Canadian Occupational Performance Measure. Two case reports illustrate how the regimen is administered.Implications. The need for further research of this regimen in terms of the selection of participants, the measurement tools, and the effectiveness is discussed.
Occupational Therapy Students' and Graduates' Satisfaction with Professional Education and Preparedness for Practice
Authors: Hodgetts Sandra , Hollis Vivien , Triska Ollie , Dennis Steven , Madill Helen , Taylor Elizabeth
Published: March 2013

Background. Occupational therapy students' and graduates' perceptions of their professional education have received limited attention. Purpose. This paper presents the perspectives of occupational therapy students and graduates regarding satisfaction with their professional education and preparedness for practice. Methods. Students and graduates provided feedback as part of an occupational therapy educational program evaluation at the University of Alberta, Edmonton, Canada. Data were collected through surveys, focus groups, and telephone interviews. Results. Both students and recent graduates reported that they felt they lacked technical, intervention skills. Longer-term graduates were comfortable with their knowledge and skills, especially their ability to provide individualized intervention. Overall, students and graduates were satisfied with their education; however, it appeared to take between six months and two years of clinical practice for therapists to feel clinically competent. Implications. The results of this evaluation may have important implications for educational programs, students, graduates, fieldwork supervisors, and employers.
Environmental Factors and Their Role in Community Integration after Spinal Cord Injury
Authors: Lysack Cathy , Komanecky Marie , Kabel Allison , Cross Katherine , Neufeld Stewart
Published: March 2013

Background. The International Classification of Functioning, Disability and Health (ICF) model presents an opportunity to better understand previously neglected longterm social outcomes after traumatic spinal cord injury (SCI), especially the experience of participation. Purpose. The study explored the relationship between perceived environmental barriers and perceived community integration (a participation proxy) in a sample of adults with traumatic SCI. Methods. The study interviewed African American and White women and men (n=136) who had lived with SCI for an average of 11.5 years. Results. Participants reported environmental barriers at twice the level indicated by previous studies; the natural environment and the policies of government were the most problematic. Levels of community integration were also high. Data suggest a significant relationship (p<.01) between perceived environmental barriers and community integration for adults with SCI, providing support for the ICF model. Implications. Improved measures and more sophisticated concepts and theories are needed to explicate the relationship between environmental factors and participation concepts in the ICF. With respect to practice, occupational therapists need to be aware that removal of environmental barriers is only a first step in the more complex effort to facilitate optimal community integration after SCI.
Validating the Potential of the International Classification of Functioning, Disability and Health to Identify Barriers to and Facilitators of Consumer Participation
Authors: Shaw Lynn , Leyshon Rhysa , Liu Margaret
Published: March 2013

Background. Occupational therapists need tools to identify barriers and facilitators to participation in societal roles. Purpose. The purpose of this study was to examine the potential of the International Classification of Functioning, Disability and Health (ICF) two-level classification for use in occupational therapy. Methods. A secondary analysis of an existing dataset was conducted to identify participation barriers and facilitators that mapped to the ICF and those that did not. Results. A broad range of factors was captured across the components of the ICF. Findings also revealed enabling and disabling factors thatwere not evident in the ICF. Practice Implications. The ICF can support the identification of a broad range of external barriers and facilitators relevant to participation and of interest to occupational therapy. However, therapists must use other strategies to gain a comprehensive understanding of the nature, extent and consequences of barriers and facilitators that may exist in a given context.
“Circle of Caring”: A First Nations Worldview of Child Rearing
Authors: Gerlach Alison
Published: March 2013

Background. For occupational therapy to be meaningful for all families who have a child with a developmental disability, the profession needs to consider and integrate into practice alternative and more inclusive epistemologies. A greater understanding and respect of a First Nations worldview may help reduce the risk of inadvertently perpetuating oppression and assimilation.Purpose. To describe raising a child with a developmental disability from the perspective of five members of the Lil'wat Nation.Methods. Data were obtained from in-depth interviews and analysed using a constant comparative approach.Findings. Within the category of family the subcategories identified were extensive support network, intergenerational learning and doing, and influence of the residential school system. Within the category of raising a child the subcategories identified were health and spirituality, causation beliefs, and a sense of knowing.Implications. Occupational therapists need to be cognizant of alternative worldviews on child rearing, family, and health that may differ significantly from their own personal and professional beliefs and practices.
Factors Influencing Therapists' Interventions for Children with Learning Difficulties
Authors: Copley Jodie , Nelson Alison , Turpin Merrill , Underwood Katherine , Flanigan Kerry
Published: March 2013

Background. Occupational therapists use a range of intervention approaches with children with learning difficulties.Purpose. This study aimed to identify factors influencing therapists' clinical decisions when choosing and combining these interventions.Methods. Seven occupational therapists participated. Data were collected through in-depth interviews, short questionnaires, and therapy observations and analysed thematically.Findings. Therapists used a combination of child, therapist, and service-related factors to individually tailor a combination of intervention techniques drawn from different theoretical approaches. Therapists also used embedded practices with all children to engage and motivate them, promote task mastery, encourage application of strategies at home and school, and evolve intervention through ongoing evaluation.Implications. The child and family's home and school context and, to a lesser extent, the therapist's past experience and service context are primary factors considered when choosing interventions. Therapists continually move between theoretical and practical levels of thinking to best meet each child's needs.
Living with Parental Multiple Sclerosis: Children's Experiences and Clinical Implications
Authors: Turpin Merrill , Leech Christine , Hackenberg Louisa
Published: March 2013

Background. Health professionals need to understand how chronic illness affects all family members. Purpose. This study explored the everyday experiences of children who have a parent with multiple sclerosis. Methods. Exploratory, semi-structured interviews were conducted with eight Queensland children, aged 7 to 14 years. Videotapes were transcribed verbatim and analysed inductively. Findings. Themes were labelled changing roles and responsibilities, emotional impact, and things that helped. Participants described taking on additional roles and responsibilities that restricted their participation in developmentally appropriate occupations, the emotional and practical impact of having aparent with MS and different methods they employed to cope with this impact. Implications. The findings emphasise the need for therapists to look beyond the diagnosed individual and see MS as a chronic illness affecting the whole family. Occupational therapists might assist parents and children to maintain their occupations through the provision of appropriate interventions and connection to referral networks.
Occupational Well-Being: Rethinking Occupational Therapy Outcomes
Authors: Doble Susan E. , Santha Josiane Caron
Published: March 2013

Background. Outcomes in occupational therapy focus largely on increasing and enhancing the quality of clients' occupational performance, and thus, the importance of clients' subjective experiences of their occupations are often overshadowed. Purpose. In this paper, the concept of occupational well-being is introduced. Our intent is to extend the focus beyond occupational performance and draw attention to individuals' subjective occupational experiences. Key Issues. We contend that occupational well-being is enhanced when individuals' occupational needs, including their needs for accomplishment, affirmation, agency, coherence, companionship, pleasure, and renewal are consistently met. Implications. Occupational therapists can play a vital role in enabling clients to compose or re-orchestrate their occupational lives so they are able to meet their occupational needs more consistently. This role may be fulfilled by intervening directly with clients or by indirectly influencing clients' occupational lives or society at large to effect changes at an environmental or organizational level.
The Importance of Parent and Child Opinion in Detecting Change in Movement Capabilities
Authors: Green Dido , Wilson Brenda N.
Published: March 2013

Background. Children and parents can make valid judgments about movement difficulties, which aids in the screening and assessment of Developmental Coordination Disorder (DCD). When considering therapy outcomes, child and family-centred practice supports the inclusion of parent and child perspectives to reflect progress made in meaningful daily contexts. Purpose. This paper describes an evaluation of the use of questionnaires for parents and children to measure change in motor performance. Methods. Questionnaires were administered to 43 children with DCD and their parents five times over two-and-a-quarter years in conjunction with other clinical measures. Findings. Parent report, using the Developmental Coordination Disorder Questionnaire, correlated significantly with clinical measures of motor skill, whilst parent and child perceptions differed. Children's confidence and resilience may influence their opinions of their ability. Implications. These results raise questions of whose perspective of progress is most valid and relevant — the therapist's, child's or parent's?
Étude rétrospective d'une pratique d'évaluation de la conduite automobile en santé mentale adulte
Authors: Rouleau Suzanne , Therriault Pierre-Yves
Published: March 2013

Contexte. En santé mentale adulte, peu de données probantes guident la pratique de l'ergothérapeute lors de l'évaluation des capacités à conduire un véhicule. Objectif. Cet article vise à décrire une pratique d'évaluation de la conduite d'un véhicule, en santé mentale adulte. Méthodologie. Une étude rétrospective a été menée à partir de dossiers de clients suivis en ergothérapie entre 1999 et 2004 à la clinique externe de psychiatrie d'un hôpital universitaire. Résultats. Les ergothérapeutes n'utilisent pas le test sur route, mais les résultats aux épreuves suivantes distinguent les conducteurs jugés sécuritaires ou non-sécuritaires: « Tracé A » (p=0,0004), « Tracé B » (p=0,0005), « Cognitive Behavioral Driver's Inventory » (p=0.006), « Continuous Performance Test » (p=0,001). Conséquences. Les résultats à certaines épreuves métrologiques guident les recommandations de l'ergothérapeute lors de l'évaluation des capacités à conduire. Cependant, d'autres études devraient inclure la performance sur route pour une clientèle en santé mentale adulte.
Qualitative Meta-Synthesis: Reflections on the Utility and Challenges in Occupational Therapy
Authors: Gewurtz Rebecca , Stergiou-Kita Mary , Shaw Lynn , Kirsh Bonnie , Rappolt Susan
Published: March 2013

Background. A qualitative meta-synthesis is an approach to synthesizing relevant findings from across qualitative studies on a particular topic using methods consistent with qualitative research.Purpose. Using examples of recently completed qualitative meta-synthesis projects, the purpose of this paper is to present the meta-synthesis approach; highlight the key steps, processes, and issues involved; and demonstrate its potential to advance knowledge about occupation and occupation-based practice.Key Issues. The qualitative meta-synthesis approach allows us to take stock of the current state of knowledge in a given area in order to ensure that we have explored the phenomenon from different perspectives and to begin to push the field forward by allowing us to develop deeper insights and understandings.Implications. Despite certain limitations and challenges associated with the approach, qualitative meta-syntheses can provide new knowledge through critical analysis and interpretation to inform client, practitioner, and policy audiences.
A Reflection on Motor Learning Theory in Pediatric Occupational Therapy Practice
Authors: Zwicker Jill G. , Harris Susan R.
Published: March 2013

Background. Theory provides a guide to clinical practice. To date, the most prevalent theories in pediatric occupational therapy practice are sensory integration and neurodevelopmental treatment. Purpose. The purpose of this paper is to present a brief overview and reflection on motor learning theories as well as a summary of motor learning principles that can be used in pediatric practice. Key Issues. Over the past two decades, motor learning theory has been applied in adult occupational therapy practice, but it has been slow to gain popularity in pediatrics. Implications. Although therapists may be tacitly applying motor learning principles in practice, conscious and deliberate application of these principles to a variety of pediatric populations is required to determine if motor learning theory provides a viable and effective contribution to evidence-based, occupational therapy pediatric practice. Further research comparing motor learning interventions to other dominant interventions in pediatric occupational therapy is warranted.
Factors Predicting Applicant Outcomes in Occupational Therapy Education
Authors: Lysaght Rosemary , Donnelly Catherine , Villeneuve Michelle
Published: March 2013

Background. Student selection for health science programs is a complex process designed to identify individuals who are most likely to succeed academically and professionally. There is limited evidence supporting specific admission criteria beyond the pre-admission GPA, and no strong evidence substantiating the need for specific academic prerequisites. Purpose. This study examined the predictive value of selected pre-admissions criteria relative to student outcomes in a master of occupational therapy program. Methods. The study involved analysis of data for 129 students admitted to a new master in occupational therapy program. Findings. Results show strong support for the pre-admission academic average as a selection criterion and limited support for referee ratings. No evidence was found linking pre-admission coursework to subsequent performance in courses of similar content. Implications. Results provide evidence upon which to ground admissions decisions, and point to the need for further examination of the value of extensive pre-admission course requirements.
Using the Cognitive Orientation to Occupational Performance (CO-OP) with Adults with Executive Dysfunction following Traumatic Brain Injury
Authors: Dawson Deirdre R. , Gaya Arvinder , Hunt Anne , Levine Brian , Lemsky Carolyn , Polatajko Helene J.
Published: March 2013

Background. Meta-cognitive strategies have a positive effect on the rehabilitation of executive dysfunction. However, achieving generalization to daily life remains a challenge. We believe that providing rehabilitation in the person's own physical environment and using self-identified tasks will enhance the benefits of meta-cognitive training and promote generalization. Purpose. This pilot study tested the applicability of the Cognitive Orientation to Occupational Performance (CO-OP) approach for use with adults with executive dysfunction arising from traumatic brain injury (TBI). Methods. A single-case design was used with 3 adults, 5 to 20 years post-TBI and their self-identified significant others. Assessments included neuropsychological tests and the Canadian Occupational Performance Measure. The intervention entailed guiding participants to use a meta-cognitive problem-solving strategy to perform self-identified daily tasks that they needed and wanted to do and with which they were having difficulties. The intervention occurred over 20 one-hour sessions in participants' environments. Findings. Performance improved to criterion (2-point positive change) on 7 of 9 trained goals and on 4 of 7 untrained goals (self-report). Improvement was maintained at a 3-month follow-up assessment. Implications. The CO-OP approach has the potential to improve performance in daily functioning for adults with executive dysfunction following TBI.
Children with Disabilities' Perceptions of Activity Participation and Environments: A Pilot Study
Authors: Harding Johanna , Harding Kimberly , Jamieson Patricia , Mullally Maria , Politi Carolyn , Wong-Sing Erline , Law Mary , Petrenchik Theresa M.
Published: March 2013

Background. Children with disabilities are particularly vulnerable to participation restrictions resulting from the interactions between children and their physical and social environments. Purpose. The purpose of this study was to gain a better understanding of how children with disabilities view their participation in out-of-school-time (OST) activities in a range of environmental settings. Methods. A case-study design was used to examine six children's views on their OST activities using the Children's Assessment of Participation and Enjoyment (CAPE), photographs of their OST activity settings, and semi-structured interviews. Findings. CAPE results indicated that the children participated most often in recreational activities. Through the use of photographs and interviews, four major themes emerged that emphasized a deep interconnection between childhood activities and settings. Implications. This unique pilot study contributes to developing an understanding for occupational therapists about how children with disabilities view their participation, their activity environments, and how photographs can be used to engage children in research.
Friendship Experiences among Children with Disabilities Who Attend Mainstream Australian Schools
Authors: Morrison Rachel , Burgman Imelda
Published: March 2013

Purpose. To explore the experiences of friendship for children with disabilities who attend mainstream Australian schools. Background. Being a friend is an important occupational role for all children. However, the literature suggests that physical inclusion of children with disabilities in mainstream schools does not necessarily develop social inclusion. Methods. Phenomenology was used to explore friendship experiences of 10 primary school children with disabilities. Findings. Five themes emerged from the data: (1) self-identity; (2) meaning of friendship; (3) classroom experiences; (4) playing together; (5) longing for friendship. These themes reflected the importance of friendship in the children's lives, the influence of the children's beliefs and values, and the impact of the attitudes and actions of educational staff and other students. Implications. Occupational therapists need to work collaboratively with educational staff, students, and their peers to create inclusive school settings that facilitate positive friendship experiences for children with disabilities.
An Analysis of Constraints on Access to Augmentative Communication in Cerebral Palsy
Authors: Costigan F. Aileen , Newell Karl M.
Published: March 2013

Background. Effective use of augmentative communication requires an individual to manage its technical aspects. Motor-skill limitations in cerebral palsy (i.e., individual constraints) can influence this ability as can demands imposed by communication devices (i.e., task constraints). Purpose. This paper emphasizes the importance of analyzing the confluence of task and individual constraints in promoting a functional fit between the individual with cerebral palsy and the communication device. We demonstrate the utility of current principles of motor control in analyzing this confluence. Key Issues. Task constraints imposed by target selection and individual constraints imposed by cerebral palsy are introduced prior to an analysis of their confluence using the degrees of freedom of the potential planes of limb motion. Implications. Occupational therapists should look beyond motor-skill assessment to the confluence of task and individual constraints when customizing target selection in augmentative communication.
Contributing to Operations of Community Agencies through Integrated Fieldwork Experiences
Authors: Klinger Lisa , Bossers Ann
Published: March 2013

Background. Occupational therapists are change agents who are well equipped to participate in community development. Community development projects can help agencies in many ways, including determining needs, educating stakeholders, developing novel programs, finding and creating resources, marketing the agency, and creating or implementing policy. In order for service agencies to profit, they need an understanding of the skills occupational therapists can offer. The best way to gain that knowledge may be through direct experience. Purpose. This paper describes the benefits that flow to community agency partners and to occupational therapy students from an innovative, integrated fieldwork model that links students with service agencies. Key Issues. This approach has demonstrated many benefits to community partners, while allowing all students in an occupational therapy program to have community development experience. Implications. This is a cost-effective way to demonstrate the value of occupational therapy and to deliver multiple community development projects.
The Impact of Everyday Racism on the Occupations of African Canadian Women
Authors: Beagan Brenda L. , Etowa Josephine
Published: March 2013

Background. Occupational therapy has increasingly explored the impact of cultural differences on occupations but has not yet begun to explore the impact of racism on human occupation. Purpose. This study with 50 African Canadian women used mixed methods to explore the effects of racism on their occupational experiences. Methods. Women aged 40–65 were interviewed in-depth about everyday experiences with racism and overall well-being. Three standardized instruments assessed frequency and stressfulness of race-related experiences. Findings. Everyday racism had subtle, almost intangible, impacts, shaping women's engagement with and the meaning of leisure, productive, and caring occupations. Implications. As occupational therapy increasingly attends to issues of cultural difference, it is critical to also attend to racism. This means learning to ask thoughtful questions about how racism may shape clients' occupations. Attention to this aspect of the social environment will enhance practice with African-heritage clients and clients from other racial minority groups.
Lessons in Living and Dying from My First Patient: An Autoethnography
Authors: Warne Katie E. , Hoppes Steve
Published: March 2013

Background. This study examines the challenges and rewards of a fieldwork student's first encounter with death in a clinical setting and describes occupational interventions that affirm the life of a client preparing for death. Purpose. To explore meanings, challenges, and lessons of end-of-life care for an occupational therapy fieldwork student. Methods. A qualitative format, autoethnography, was used to develop a narrative that reveals the lived experience of a fieldwork student. Findings. Findings include a description of what a fieldwork student was and was not able to accomplish in end-of-life care. The paper describes using self-care activities to normalize and cede control of end-of-life care to the client and developing a vision of how to help clients find closure. Implications. The study carries implications for students and therapists working in end-of-life care. Therapists and educators can draw from this study to better understand and support new therapists when patients die.
Sensory Processing Patterns and Daily Activity Preferences of Israeli Children
Authors: Engel-Yeger Batya
Published: March 2013

Background. One determinant of participation is activity preferences, which may be influenced by sensory processing patterns. Purpose. To compare daily activity preferences of Israeli children who have typical versus atypical sensory processing patterns, according to age and gender. Methods. Twenty-five children with atypical sensory processing patterns and 109 typical peers aged 6 – 10.75 years completed the Preference for Activities of Children (PAC) questionnaire. Sensory processing patterns were determined according to the Short Sensory Profile (SSP). Results. Children with atypical sensory processing patterns showed greater preference for active physical activities. Lower energy level was correlated with greater preference for self-improvement activities. Practice implications. Activity preferences may be affected by children's sensory processing patterns. These effects are minimal among children with atypical sensory processing but no other co-morbidities. Evaluating these effects may assist in establishing occupational therapy interventions, facilitate children's engagement in the intervention, and enhance their participation in daily living.
Exploring the integration of internationally educated occupational therapists into the workforce
Authors: Mulholland Susan J. , Dietrich Tracy A. , Bressler Sandra I. , Corbett Kathy G.
Published: March 2013

Background.

British Columbia (BC) is a popular Canadian work destination for occupational therapists from around the world.

Purpose.

This study explored the experiences of stakeholders involved in the integration of internationally educated occupational therapists (IEOTs) into the BC workforce.

Method.

Semi-structured interviews were conducted with the three primary stakeholder groups (40 IEOTs, 12 supervising occupational therapists, seven managers), as well as with seven key informants. Participants were purposively sampled and thematic analysis was applied to the data.

Findings.

Three themes were identified that fit sequentially along a workforce-integration continuum: “coming to Canada,” “registering with the college,” and “integrating into the workplace.” Within those themes, findings were organized into two categories, “ingredients for success” and “stumbling block,” and multiple subcategories.

Implications.

The findings suggest that hiring IEOTs can bring benefits to the workplace and clients. However, changes made along the continuum would facilitate workforce integration, ultimately benefiting all stakeholders. These findings may be of interest to IEOTs, occupational therapists, and managers as well as individuals working in regulation and policy.
Community integration outcomes after traumatic brain injury due to physical assault
Authors: Kim Hwan , Colantonio Angela , Dawson Deirdre R. , Bayley Mark T.
Published: March 2013

Background.

Community integration is considered an ultimate goal for rehabilitation after traumatic brain injury (TBI).

Purpose.

To determine (a) whether differences exist in rehabilitation outcomes between intentional and unintentional TBI populations and (b) whether TBI from assault is a predictor of community integration following inpatient rehabilitation.

Method.

Retrospective cohort study using population-based data from Canadian hospital administration records, 2001 to 2006. Outcome measure was the Reintegration to Normal Living Index (RNLI).

Findings.

From a sample of 243 persons, 24 (9.9%) had sustained TBI from physical assault. Persons with TBI from physical assault reported significantly lower scores on two items on the RNLI’s Daily Functioning subscale: “recreation” and “family role.”

Implications.

These findings suggest that targeted intervention in these specific areas could be beneficial, which are often primarily addressed by occupational therapists in both inpatient rehabilitation and community settings.
Teaching mindfulness to occupational therapy students: Pilot evaluation of an online curriculum
Authors: Reid Denise T.
Published: March 2013

Background.

How mindfulness can be learned by occupational therapy students to manage their own self-care processes has not been fully examined as yet.

Purpose.

This article describes an online curriculum approach for teaching a general introductory mindfulness course and examines outcomes with master’s entry-level occupational therapy students.

Method.

Fifteen students participated in an 8-week online mindfulness curriculum and completed a pre- and post-training survey. The Mindfulness Attention and Awareness Scale (MAAS) was used to measure mindfulness. Demographic, MAAS-scored mindfulness, and clinical utility data were collected.

Results.

Results showed a statistically significant change ( t = –4.82, p = 0.002) in MAAS mindfulness scores from the program start to end. Informal practice exercises and guided meditations were perceived by participants as being more helpful ways for developing an understanding and approach to mindfulness than were readings about mindfulness.

Implications.

This study suggests that mindfulness can be taught using an online approach.
Research in Prosthetics in New Brunswick
Authors: O'Shea Barbara
Published: March 2013

Ce n'est qu'après la tragédie de la Thalidomide, qu'un effort poussé fut amorcé au Canada pour développer des méthodes de traitement plus efficace. Celles-ci ont pour but de développer des moyens artificiels, facilitant aux amputés l'activation de leurs prothèses. Présentement, quatre centres de recherche au Canada, travaillent sur le développement et l'amélioration des prothèses. Ceux-ci sont situés dans les villes de Winnipeg, Toronto, Montréal et Frédéricton. Voici un des trois projets du “Bio-Engineering Institute” établit à l'Université du Nouveau-Brunswick en 1965:

“L'investigation et le développement des systèmes de contrôle myoélectrique”.

Après plusieurs expériences, il semble que les amputés du membre supérieur dont le moyon est très court bénéficient davantage des prothèses à contrôle myoélectrique; étant donné que des contractions d'intensité différente d'un même muscle, produisent deux mouvements isolés (flexion et extension) de la prothèse.

Les quatre étapes du programme d'ergothérapie sont:

L'évaluation des patients afin de déterminer ceux qui bénéficient de prothèses à contrôle myo-électrique. La sélection et l'entraînement des muscles utilisés comme contrôle de la prothèse. L'entraînement fonctionnel avec prothèses après appareillage. L'évaluation du système de contrôle.

Dans la sélection des points de contrôle, il y a deux facteurs à considérer:

que le muscle soit superficiel et qu'il ait perdu sa fonction première qu'il puisse être utilisé isolément

Il semble donc qu'un muscle produisant une contraction adéquate peut être utilisé comme point de contrôle.
Spina Bifida, the Increasing Challenge
Authors: McLeod Pat
Published: March 2013

Grâce à de nouvelles techniques chirurgicales, le taux de mortalité des enfants Spina Bifida est maintenant de 45%. Dû à l'amélioration dans l'administration des soins, nous augmentons ainsi la longévité de vie; ceci crée de nouveaux besoins.

Il semble alors que l'ergothérapeute s'intéressera davantage aux processus secondaires de la maladie:

Rôle de l'Ergothérapeute dans l'administration de l'enfant Spina Bifida.

Un défi important est provoqué chez l'enfant lorsqu'il arrive tardivement au stage ambulatoire. Cette période sera donc longue et difficile et l'ergothérapeute pourra intervenir dans les aspects suivants:

Si la société partage les dépenses coûteuses d'une réhabilitation, elle doit non seulement vouloir lui donner du travail mais aussi pourvoir aux besoins de l'handicapé afin qu'il puisse vivre et circuler dans sa propre ville.

Le danger de rejet par la mère. Les problèmes chirurgicaux et l'hospitalisation trop tôt chez l'enfant. Paraplégie congénitale.

Après une évaluation complète de l'enfant par l'équipe médicale, l'ergothérapeute pourra aider les parents dans l'administration du traitement de leur enfant handicapé, par des interprétations et des suggestions:

traiter l'enfant comme les autres membres de la famille; lui donner autant d'expériences intéressantes soit en l'amenant vers l'objet ou en lui présentant celui-ci; l'encourager vers une attitude indépendante; décourager les parents de parler trop librement devant leur enfant handicapé; soutenir l'enfant en position assise, afin de lui permettre de voir le monde sous un angle différent.

l'augmentation de la tolérance debout; de pourvoir une thérapie de soutien afin qu'il puisse exprimer son aggressivité; l'aider à acquérir une apparence convenable en utilisant des vêtements appropriés; de l'introduire dans le monde adulte et de le motiver par des activités telles que l'art culinaire; explorer le terrain du foyer et de l'école ainsi que les limitations physiques de l'enfant afin d'aider à déterminer l'usage d'une chaise roulante.
Language Development and Performance
Authors: Dray Gertrude Ellis
Published: March 2013

The function of language in learning and performance is investigated. Language and communication are of the utmost importance for formation of concepts which will be used as symbolic mediators for the development of intellectual and cognitive structures. Perceptions will be based on concepts acquired in early childhood and through past experiences. The affective connotations of situations, as they are perceived, are learned in childhood and may affect use of these experiences functionally as a basis for cognitive expression in later years. Recent studies on language and performance are reviewed with some indications for emphasis in creation of a favorable learning climate in early childhood.
The Occupational Therapist Looks at Perceptual Disabilities
Authors: Gaylard Anne
Published: March 2013

Cet article discute de thérapie avec des enfants ayant des difficultés de perception et avec des adultes qui montrent aussi cette difficulté à la suite de leur incapacité due à un accident cérébro-vasculaire. Les programmes de traitement pour les enfants sont assez bien développés et peuvent être utilisés pour les enfants souffrant de problèmes d'apprentissage, ceux atteints de paralysie cérébrale ou de troubles émotionnels ainsi que pour les retardés mentaux.

Les programmes de traitement pour adultes ne sont pas très bien connus et cet article mentionne quelques-unes des conclusions d'un projet de recherche en cours à l'Institut de Réhabilitation de Détroit. Certains symptômes de troubles perceptuels se retrouvent chez les enfants et chez les adultes. Les adultes avec une hémiplégie droite montrent des problèmes dans la compréhension d'instructions verbales, dans l'incapacité de se rappeler une succession de noms et dans la lenteur d'exécution. Ceux atteints d'hémiplégie gauche manifestent surtout des troubles visuels, des problèmes d'organisation spaciale, des difficultés sensorielles et des distorsions de l'image corporelle, surtout du côté gauche.

Dans le projet de Détroit, les physiothérapeutes traitent les désordres du sens de position et de mouvement, tandis que les ergothérapeutes font l'entrainement dans le domaine de la perception visuelle et tactile. Toutes les thérapeutes traitent les problèmes ayant trait à l'apraxie, à l'image corporelle, aux relations spaciales visuelles et à la formation de concepts. Les activités de la vie quotidienne sont utilisées comme base de traitement. Des exemples de techniques employées incluent: a) l'utilisation d'un miroir où la thérapeute mime la direction des mouvements pour aider le patient qui a de la difficulté à comprendre le language; b) bloquer la vision pour permettre la meilleure perception d'un stimulus tactile et proprioceptif chez un patient qui a des problèmes de perception visuelle. Comme les patients perçoivent et interprètent souvent mal un stimulus, il faut leur laisser le temps “d'apprendre à apprendre”. Il est préférable de pratiquer plusieurs exercices ayant une relation entre eux plutôt que de persister longtemps dans le même exercice.

Les lecteurs devraient se référer à la bibliographie pour plus d'information ayant trait aux tests de problèmes perceptuels chez le patient adulte.
Assessment of Function in the Rheumatoid Hand
Authors: MacBain K. Patricia
Published: March 2013

Cet article décrit des procédures d'évaluation de la fonction de la main. Elles furent établies en 1964, lors d'une étude faite sur des patients souffrants de rhumatismes et qui devaient subir une arthro-plastie métacarpo-phalangienne. L'on voulait savoir dans quelles mesures l'opération améliore la fonction de la main. Le système d'évaluation se devait d'être bref, afin qu'on puisse s'en servir dans un département achalandé; simple en équipement; spécialisé et objectif afin de permettre des comparaisons; et surtout il devait répondre aux besoins réels des patients.
L'ERGOTHERAPIE, SES RESSOURCES, SES LIMITES
Authors: Jobin Denys
Published: March 2013

By its very nature and its ideology, occupational therapy draws upon the motivational element of human being, in that it satisfies a basic need to create and at the same time enhance oneself by this very process. Furthermore, it responds to man's preservatory instinct in challenging him to actively participate in his own treatment.

The potential and limits of occupational therapy are those of man himself, and it is in the awareness of these potentials and limits that the occupational therapist can come to treat the individual whether on a physical or psychic level of functioning. Occupational therapy of the future must meet the challenging new problems of medicine placing it in its socio-economic context.