bluuebunny/crossref_metadata_2025 huggingface dataset:
Adapting Structured Learning Therapy for Use in a Psychiatric Adult Day Hospital
Authors: Nickel Irmie
Published: March 2013

Patients in an adult day hospital program were found to have difficulties in practising and transferring the new learning acquired in insight-oriented group psychotherapy to other life situations. This paper presents a method used by occupational therapists to help patients become more proficient in transferring their newly acquired insights and skills to their real life situations. The method is an adapted form of Structured Learning Therapy. Its development and rationale supporting its purpose and function is presented. This is followed by a discussion of the modifications necessary to make Structured Learning Therapy useful for the particular patient population found at the adult day hospital program described.
Application of Pressure: A Principle in the Biomechanical Frame of Reference
Authors: Kennedy Myra
Published: March 2013

The application of pressure is proposed as a principle for preventing a limitation of range of motion where hypertrophic and keloid scars interfere with range of motion. The addition of this principle to the biomechanical frame of reference described by Trombly (1983), would assist occupational therapists to more appropriately assess the need for application of pressure as a means of preventing deterioration in range of motion. Pressure has typically been applied to prevent soft tissue contractures in burn treatment and recently it has been used in the prevention of soft tissue contractures associated with scleroderma. A review of the literature has lead the author to propose the application of pressure as a scientific principle which must be considered when shortening of skin and subcutaneous soft tissue interferes with range of motion except when spasticity is involved.
Developing Community Occupational Therapy Services in Canada
Authors: Townsend Elizabeth
Published: March 2013

International trends in health care point to increasing development of community services. However, the majority of occupational therapists work in institutional settings. A study, between 1985 and 1987, defined and created a profile of existing community occupational therapy services across Canada, and identified the processes and strategies which led to the development of these services. One hundred and eighty nine (189) services, including home care, other salaried services, and private or consulting services were identified. A national sample of community occupational therapy program developers described processes and strategies from which the author suggests a general “ripple effect” strategy to enhance the occupational therapy contribution to the community.
The Functional Assessment Scale as an Instrument for Measuring Changes in Levels of Function of Nursing Home Residents Following Occupational Therapy
Authors: Breines Estelle
Published: March 2013

The Functional Assessment Scale (FAS) (Breines, 1983) was used to measure the performance of nursing home patients at the outset of occupational therapy and every two weeks thereafter until patients were discharged from treatment. Of 249 patients at ten nursing homes, 186 patients improved in Levels of functional performance; 234 patients improved in Units of skill development. Fifty-two patients reached Levels of independence or returned to home with family support. Seventy-five percent of patients improved in Levels of performance, 94 percent increased in the number of skills they could perform. These results suggest that theFAS is an effective tool for measuring changes in patients' performance for both individual and comparative study.
Post-Operative Metacarpophalangeal Arthroplasty Dynamic Splint for Patients with Rheumatoid Arthritis
Authors: Fairleigh Angela , Hacking Sally
Published: March 2013

Following metacarpophalangeal (M.C.P. implant) arthroplasty, post-operative regime dictates the use of a splint for control of joint movement during capsular healing. At the Arthritis Society — British Columbia Division, a splint has been developed which allows for movement in the flexion and extension plane, adaptability to individual post-operative progress, and accurate positioning. This article provides a step-by-step outline for construction of this splint.
The Ontario College of Occupational Therapists: A Survey
Authors: Reid Denise , Kawaguchi Dorothy
Published: March 2013

A survey was conducted to examine how familiar Ontario occupational therapists are with the Ontario College of Occupational Therapists (OCOT), and to identify their attitudes concerning self-regulation. A questionnaire was mailed to 100 occupational therapists, 50 non-members and 50 members of the OCOT. Sixty-four (64%) occupational therapists comprised the final sample; 30 members and 34 non-members. The prototypical member is over the age of 30 years, has worked more than ten years, and has graduated from a diploma program in occupational therapy. The prototypical non-member has worked for less than five years, has graduated from a degree program in occupational therapy, and is under the age of 30 years. The results indicated that: (1) both members and non-members work full-time in a hospital setting in the area of adult physical medicine as staff therapists; and (2) are involved in their professional associations, i.e., the Ontario Society of Occupational Therapists (OSOT) and the Canadian Association of Occupational Therapists (C.A.O.T.). Both groups support the concept of a self-regulatory body, however they view its purpose quite differently. The study further suggested that the majority of occupational therapists surveyed are not aware of the many issues surrounding regulation, i.e., provisions asked for by the OCOT under the Health Disciplines Act. The results are discussed with their implications for the OCOT and for Ontario occupational therapists.
Montreal Normative Data for the Southern California Postrotary Nystagmus Test
Authors: Weiss-Lambrou Rhoda , Messier Sylvie , Maag Urs
Published: March 2013

The purpose of this study was to establish Montreal norms for the Southern California Postrotary Nystagmus Test (SCPNT). A total of 190 children, eight to twelve years of age, from Montreal, Quebec, participated in the study, 146 of whom were included in the normative data. The Montreal norms for the duration of postrotary nystagmus (PRN) were provided in the form of tolerance intervals. These norms were then compared with the original Los Angeles sample of 226 children. The findings revealed significantly different means and standard deviations in the duration of PRN between the Montreal normative data and Ayres' Los Angeles data. In addition, this study focused attention on the statistical and psychometric principles that must be considered when establishing norms. Future studies on measurement of PRN using the SCPNT were recommended.
Contracting in Fieldwork Education: The Model of Self-Directed Learning
Authors: Gaiptman Barbara , Anthony Arlene
Published: March 2013

The educational role of fieldwork supervisors has become an increasingly salient one in Occupational Therapy programs. This paper discusses the model of self-directed learning and the use of this model as a framework for the fieldwork education of occupational therapy students. The assumptions underlying the model of self-directed learning are presented and contrasted with the assumptions underlying the traditional model of learning in fieldwork education. The learning contract as a tool in the implementation of the model of self-directed learning is described and the four components of the learning contract are discussed. Areas for further investigation are identified.
Development, Change and Continuity Theories: An Analysis
Authors: Breines Estelle B.
Published: March 2013

Several theories are used by occupational therapists to describe development. These theories differ in form. Some are stage-descriptive; some are characterized by the unity of change and continuity Stage-descriptive theories are described as prejudicial and antithetical to occupational therapy's philosophy and practice. Theories offering change as adaptive-descriptive are deemed more suitable, as they are consistent with occupational therapy philosophy and can serve as structures for generating data on adaptive change in clinical situations.
Factors Affecting Myoelectric Prosthetic Use and Wearing Patterns in the Juvenile Unilateral Below-Elbow Amputee
Authors: Ballance Rosanne , Wilson Brenda N. , Harder James A.
Published: March 2013

The purpose of this study was to describe the wearing pattern, both past and current, the skill level and the degree of spontaneous, functional use of the myoelectric prosthesis in juvenile congenital unilateral below-elbow amputees. Data, in the form of parent and teacher questionnaires and individual evaluations using the University of New Brunswick Test of Prosthetic Function, was collected on 17 subjects ranging in age from 3-1/2 to 15 years. Results indicated an obvious decline in wearing time when children changed from a conventional prosthesis to a myoelectric prosthesis. Correlational results indicated some significant relationships between various factors of myoelectric prosthetic use.
Sensory Integration: A Survey of its Use in the Clinical Setting
Authors: Yack Ellen
Published: March 2013

This paper presents the findings of a survey conducted in the Winter of 1986 by the Sensory Integration: Toronto Study Group designed to investigate the use of sensory integration in clinical settings. The survey was distributed to occupational therapists in Southern Ontario who offer services to children with sensory integrative dysfunction. The results are discussed in relation to occupational therapy practice, literature and research. The findings suggest that sensory integration therapy is one of manytheoretical frameworks incorporated into occupational therapy programs for this population. In view of this information, the paper discourages the use of the term “sensoryintegration therapist” as it does not adequately represent the varied approach utilized by the respondents in this study or the extent of knowledge and skills they appear to possess. The paper proposes that the holistic nature of occupational therapy intervention needs to be considered in research designs to ensure valid and clinically relevant evaluation of sensory integration procedures.
Physical Disability and Depression a Methodological Consideration
Authors: Noh Samuel , Posthuma Barbara
Published: March 2013

Evidence that the physically disabled are at substantially elevated risk for depressive symtomatology has been widely reported. This paper considers the meaning of these reports with respect to the appropriateness of using a self-report depression scale (The Center for Epidemiologic Studies of Depression: [CES-D] with a disabled population. Results clearly demonstrate that the high scores of CES-D observed for the disabled population do not derive from elevated levels of somatic symptoms or transient symptoms that might be associated with the physical limitation itself. Rather, they derive from persistent psychological symptoms, suggesting that the elevated rates of depression among physically disabled adults may be real and not an artifact of measurement bias. It was concluded that standardized self-report scales such as the CES-D may well be used effectively to screen those patients with physical disabilities who may need psychological help.

Le fait que les handicapés physiques présentent un risque élevé d'être atteints de symptômes dépressifs a été abondamment publié. Cette présentation s'interroge sur la signification de ces publications en rapport avec la pertinence d'utiliser l'échelle d'autoévaluation de l'état dépressif (The Center for Epidemiologic Studies of Depression: CES-D) avec une population handicapée. Les résultats démontrent clairement que le fait pour une population handicapée d'enregistrer un pointage élevé suivant cette échelle, ne provient pas des niveaux élevés observés pour les symptômes somatiques ou transitoires qui peuvent être associés à l'incapacité physique ellemême. Ils proviennent plutôt de symptômes psychologiques persistants, portant à penser que les taux élevés de dépression chez les adultes handicapés physiquement sont véridiques et ne doivent pas être considérés comme des phénomènes artificiels issus de mesures biaisées. En conclusion, la standardisation d'une échelle d'autoévaluation telle que la CES-D peut être utilisée efficacement pour dépister les patients atteints d'incapacités physiques qui auraient besoin d'aide psychologique.
La Scénothérapie: L'utilisation du travail de l'acteur en ergothérapie
Authors: Roberts Suzanne
Published: March 2013

Cet article traite d'un nouveau médium ergothérapique, la Scénothérapie, qui est l'utilisation du processus de travail de l'acteur dans le cadre du traitement en psychiatrie. Considéré dans le cadre du modèle de la relation d'objet, ce processus, ainsi que le texte qui sert de canevas. permet de remplir les fonctions de l'activité telles que décrites par Bruce et Borg (1987). Différente du psychodrame et du jeu de rôle parcertains aspects qui seront abordés dans le présent exposé, la Scénothérapie soutient que le métier d'acteur sollicite l'apport de tous les aspects et de toutes les compétences humaines, puisque l'acteur doit vivre sur scène, physiquement, intellectuellement, affectivement et socialement le texte qui lui est confié par l'auteur. Pour cette raison, les techniques de l'acteur respectent la globalité de l'être humain, principe qui sous-tend toute intervention ergothérapique. A travers les mécanismes de l'interprétation, le client peut se projeter et, accompagné de l'ergothérapeute, vivre, ressentir, clarifier et se réapproprier ses problématiques personnelles. Le personnage du texte devient à la fois masque et objet médiateur.
Psychosocial Issues for People with Cancer Their Families
Authors: Lloyd Chris , Coggles Laura
Published: March 2013

The diagnosis of cancer has a devastating impact not only for the person diagnosed but for family members as well. A number of psychosocial problems become evident as the individual and family attempt to come to terms with the diagnosis and what it means. Occupational therapy intervention can contribute to the psychosocial adjustment of the person with cancer and their family.
Factors Affecting a Clinician's Decision to Provide Fieldwork Education to Students
Authors: Tompson Margaret , Proctor Leonard F.
Published: March 2013

Fieldwork represents an important component of the education of an occupational therapist. In this study thirteen occupational therapists in small Saskatchewan occupational therapy facilities were interviewed to determine the factors and the relationships among these factors that affected their involvement in the fieldwork process. The directors of the two large occupational therapy departments in Saskatchewan, together with eight Canadian university fieldwork coordinators were interviewed for comparison purposes. The findings of the study have shown that there were four major influences affecting Saskatchewan therapists' involvement in the fieldwork program of occupational therapy students. They were: workload: feelings of isolation; the parameters of a placement: and professionalism. This study is important because it has identified significant factors for university fieldwork coordinators to consider in their contact with therapists. It has also provided a model for other similar studies.
The Reliability and Validity of Self-Report Activities of Daily Living Scales
Authors: Edwards Mary Margaret
Published: March 2013

A measurement evaluation study was conducted to examine the reliability and validity of the Physical Self-Maintenance Scale and Instrumental Activities of Daily Living Scale (Lawton & Brody, 1969) as a discriminative measure to assess the independent living status of elderly hospitalized patients. A sample of thirty patients from two geriatric specialty units was used for the study. Inter-observer reliability was shown to be excellent (ADL r=.96, IADL r=.99) and test-retest reliability was considered to be good (ADL r=.59, IADL r=.93). The results comparing patient self-report of ability and ratings based on direct observation of performance indicated that patients consistently over-rated their ability in both ADL and IADL tasks. This provides support for the use of direct observation of performance to obtain valid data on an individual's ability. There was a significant difference in scores between those patients able to be discharged home compared to those requiring institutionalization; however, a score predictive of discharge location could not be identified with the study data. The study provided support for the use of this measurement tool for assessing the independent living status of elderly hospitalized patients. It provides the therapist with a measure that has had some validation and has the potential for clinical use in describing patients' ability and identifying areas requiring treatment intervention.
Crisis in Psychosocial Occupational Therapy: A Closer Look
Authors: Renwick Rebecca , Friedland Judith , Sernas Vida , Raybould Karen
Published: March 2013

To date, there are no existing data concerning similarities and differences in occupational therapist shortages among the broad areas of clinical practice. Accordingly, this study sought to develop a profile of therapist shortages in Metropolitan Toronto within three broad foci of intervention, namely, physical dysfunction (PD), psychosocial dysfunction (PS), or a combination of both (C). Seventy-seven questionnaires were mailed to occupational therapy managers in Metropolitan Toronto. The74% response rate from managers supervising a total of 516 therapists provided information which included numbers of existingpositions (full- and part-time), numbers of vacancies and vacancy periods, as well as perceptions concerning reasons for vacancies and need for additional positions. Although no significant differences were found among vacancy rates in the three areas there was a perception that the greatest shortage was within the PS area of practice. Implications of these results are discussed in light of the perceived crisis in psychosocial therapy. Recommendations for future research are delineated.
A Vision for Occupational Therapy: Tradition Meets the Future
Authors: Gill Thelma
Published: March 2013

Advancing technology and world events will have an impact on the practice of occupational therapy. Computers, communication technology, and environmental concerns are all examples of issues that must be considered as major determinants in future practice decisions related to all groups. Incorporating these areas into the traditions of occupational therapy will result in a vital profession that cannot be replaced. However, these advances and events must not sway occupational therapists from their area of expertise. Technology will never be mastered if the profession continues to stray into areas of practice that do not form the core of occupational therapy.
A Survey of Canadian Occupational Therapists' Use of Hand Splints for Children with Neuromuscular Dysfunction
Authors: Reid Denise T.
Published: March 2013

This survey was designed to identify the current practice of Canadian occupational therapists who have identified themselves as working in paediatrics to determine: (1) what hand splints they use with children who have neuromuscular dysfunction; (2) what influences the therapists' selection of splints; (3) what therapy goals the therapists associate with the splints they use; and (4) what relationships exist between therapists' years of clinical practice and post-graduate training and the splints used. Questionnaires were mailed to 399 occupational therapists across the ten provinces and the Northwest Territories and the Yukon with a 60% return rate. Only three splints are used regularly by over 50% of the therapists. These were the resting palmar hand splint, the thumb splint, and the hard cone splint. For the remaining nine splints, over 65% of the therapists reported they had never used any of them. The major reason reported for not using these splints was a lack of familiarity. Another reason for not using hand splints was a lack of available resources (time and materials). Therapists who worked less than five years demonstrated a greater tendency to use hand splints as compared to those therapists with more years of clinical experience. The majority of therapists were employed in rehabilitation facilities with a trend toward community facilities. This pattern may in part explain the low frequency of hand splint use among therapists. Other suggestions are made for the interpretation of these results, along with questions for future research.
Skill Acquisition during Fieldwork Placements in Occupational Therapy
Authors: Missiuna Cheryl , Polatajko Helene , Ernest-Conibear Marilyn
Published: March 2013

A critical shortage of occupational therapy fieldwork placements has led therapists to pose the question: how many hours of fieldwork are actually required in order for a student to acquire the breadth and depth of clinical competence required for entry level practice? In this study, student scores on the Performance Evaluation of Occupational Therapy Students, gathered over a four year period, were utilized to address this question. The level of competence expected of a new graduate on the CAOT Occupational Profile (Bridle, 1981) was used as the criterion against which student scores were judged. Statistical analyses were performed to determine the level of acquisition of occupational therapy skills and techniques, by item and by groups of items; to identify “core” and “specialty” items; and to determine whether 1200 hours of fieldwork is the optimal choice for students to be able to demonstrate clinical competence in the field. Results indicate that, while most students attain many of the skills and techniques pertinent to occupational therapy, competence is reached only on those core skills which are frequently encountered and which have actually been experienced by the student across a number of placements. Recommendations include a re-examination by the profession of the expectations which have been set for an entry-level graduate.
Siblings of Children with Special Needs
Authors: Unruh Anita M.
Published: March 2013

Siblings of children with special needs have received little attention in the occupational therapy literature. However, siblings play an important role in the development of children with special needs. Siblings are also at risk for problems of emotional adjustment that have an impact on their own well-being as well as the well-being of the family. The research on siblings of special needs children is reviewed and followed by a description of the Ottawa Children's Treatment Centre sibling programme.
Client-Centred Practice: The True Impact
Authors: Sumsion Thelma
Published: March 2013

1993 marks the tenth anniversary of the release of the Guidelines for the Client-Centred Practice of Occupational Therapy which are now central to many clinical programmes and evaluation tools. This discussion paper presents some questions about how the model of client-centred practice is being applied by occupational therapists, and asks whether or not therapists clearly understand the implications of the model. The advantages of this model, such as the ability for the diverse definition of the term “client”, its applicability to community practice, and the presentation of therapeutic challenges, are discussed. The author also provides her opinion about how the truly client-centred process should be applied.
Development and Reliability of an Upper Extremity Function Test for the Elderly: The TEMPA
Authors: Desrosiers Johanne , Hébert Réjean , Dutil Elisabeth , Bravo Gina
Published: March 2013

Accurate assessment of upper extremity performance is a critical element in determinimg the potential independance of the physically impaired person. An upper extremity function test for the elderly, the TEMPA (Test Évaluant les Membres supérieurs des Personnes Âgées), was developed, involving nine tasks related to routine daily activities. Each task is measured by three sub-scores: speed of execution, functional rating and task analysis. A test-retest and interrater reliability study was conducted with a sample of 29 subjects, aged 62 to 82 years, with various upper extremity impairments and varying degrees of functional independance. Intraclass correlation coefficients ranged from moderate to high (0.70 to 1.0), demonstrating temporal stability and sound agreement between evaluators. A preliminary construct validity study was conducted by correlating score of the TEMPA with functional independance to basic personal care (Spearman's Rho = 0.74). The TEMPA is a reliable instrument that appears to fill a void in the evaluation of the elderly. More psychometric studies are required to confirm its validity.
Respiratory and Head Position Influences on Late Stretch Reflexes
Authors: Clements Linda G. , Mackay William A.
Published: March 2013

The purpose of this study was to determine the relative effects of the asymmetric tonic neck reflex (ATNR) and of respiration on the upper limb, as measured by their influence on the stretch reflexes. Long latency stretch reflexes (M2 and M3) were induced in elbow muscles of human subjects. The subject's right forearm was strapped into a manipulandum. The forearm was perturbed with a torque test pulse at a fixed interval prior to an intended forearm movement. It was found that both the M2 and M3 reflexes, in triceps or brachialis muscles were significantly increased when perturbations were delivered during inspiration as compared to expiration. Rotated head positions to the right or left could also significantly alter reflex magnitude but there was no consistent pattern among subjects.

The clinical implications of these findings are discussed.
Family Adaptation to Altered Roles following a Stroke
Authors: Jongbloed Lyn , Stanton Sue , Fousek Barb
Published: March 2013

This paper analyzes the impact of a stroke on the roles of people who experienced a stroke and their partners, focusing on the relationship between the environment and role performance. Ethnographic research methods were used to discover the ways in which the meaning and content of roles are shaped within the context of social relationships. Suggestions are offered regarding questions occupational therapists can ask to assess family role structure, the effect of disability on family roles and the influence of the social and physical environment on family roles.
Development of the Safety Assessment of Function and the Environment for Rehabilitation (SAFER) Tool
Authors: Oliver Rosemary , Blathwayt Jan , Brackley Catherine , Tamaki Thelma
Published: March 2013

Increasing numbers of seniors are choosing to remain in the community; however statistics for in-home accidents indicate that the over-65 age group is at the greatest risk. The purpose of this article is to describe the Safety Assessment of Function and the Environment for Rehabilitation (SAFER) Tool, which was developed by occupational therapists to address the need for a comprehensive functional and environmental assessment tool to be used with the elderly in the community. It consists of 15 areas of concern arranged in a logical and sensitive manner, subdivided into 128 items or functions. All items must be addressed and if appropriate, checked off as a problem. The tool fulfills the requirements of being quick and easy to use and on completion, it provides clear directions for intervention and treatment.
Teachers' Perceptions of the Role and Effectiveness of Occupational Therapists in Schools
Authors: Fairbairn Margaret , Davidson Iain
Published: March 2013

Teachers' expectations from occupational therapists working with exceptional children in two Ontario public school boards were explored in this study. Information was obtained through a questionnaire distributed to all teachers (N = 143) who had worked with occupational therapists and personal interviews conducted with 10 of these teachers.

Findings suggested that all teachers believed that there was an important role for occupational therapists in the school system. They defined this role as offering programming suggestions, consulting with school personnel, providing and adapting equipment, liaising with school, home and community, assessing, and following-up school-aged children. Teachers also suggested that occupational therapists further define their roles and responsibilities in school, for themselves, and for school personnel. Finally, teachers suggested that occupational therapists must continue to support and share their knowledge about children with special needs with teachers by providing more demonstration, and modeling of suggested occupational therapy programmes and by working with exceptional students inside the classroom, rather than outside, whenever possible.
Performance Evaluation of Occupational Therapy Students: A Reliability Study
Authors: Polatajko Helene , Lee Leala , Bossers Ann
Published: March 2013

The Performance Evaluation of Occupational Therapy Students (PEOTS) is an instrument designed to evaluate the clinical competence of occupational therapy students. The purpose of this study was to carry out a preliminary evaluation of the inter-rater and test-retest reliability of the PEOTS. Thirteen occupational therapy students, completed a one week placement at one of four facilities. Two occupational therapists supervised each student and evaluated performance using the PEOTS on day three and day five of this placement. The results indicated that the instrument has good inter-rater reliability. Test-retest reliability was difficult to evaluate since learning was a confounding factor. These preliminary findings support the use of the PEOTS as an evaluation tool. Further research, however, is needed to establish test-retest reliability and internal consistency of the PEOTS.
La pénurie de places de stage: une lecture administrative de la problématique: résultats d'une enquête exploratoire
Authors: Gilbert Jacqueline , Dubouloz Claire-Jehanne
Published: March 2013

La pénurie de places de stage est une réalité à laquelle l'ergothérapie comme profession est confrontée depuis plusieurs années. Get article présente les résultats d'une enquête exploratoire visant à connaître la perception des cliniciens face à la tâche de supervision clinique. Des stratégies pour aider à résoudre le problème de pénurie seront identifiées. Les informations recueillies portent sur les dimensions administratives, sur les moyens de valoriser la participation à la formation clinique et sur la motivation des cliniciennes à agir comme superviseur. Les résultats amènent à questionner la nature de la crise actuelle et invitent à clarifier de quelle façon peut être opérationnalisée la philosophic nationale de la formation clinique où sont stipulées les valeurs de la communauté ergothérapique en ce qui concerne ce volet professionnel.
Student Placements in Administration
Authors: Froats Barbara , Bossers Ann , Bolack Linda
Published: March 2013

From 1988–1993 the Occupational Therapy Manager at St. Joseph's Health Centre in London, Ontario provided nine block placements with a major focus in administration. The administration placements and the results of a questionnaire completed by the students are discussed. Strengths of the placement and suggested areas of change are included, using a Continuous Quality Improvement Framework. Suggestions regarding the future direction of administration placements are presented.
The Role of University Faculty in Fieldwork
Authors: Etcheverry Emily
Published: March 2013

Lack of consensus of the role of academic faculty as stakeholders in fieldwork education in Canada is identified. A liaison role which exists at the University of Manitoba is described and the perceived values of the role are discussed.
Maintaining a Balance in Service and Education in a Climate of Fiscal Crisis
Authors: Baptiste Sue , Martin Adele
Published: March 2013

Doubling enrolment in the undergraduate occupational therapy programme at McMaster University was introduced in a climate of fiscal crisis. This paper will discuss the creative implementation of a Quality Circle Model in the Occupational Therapy Department at Chedoke-McMaster Hospitals, Hamilton, Ontario, which promoted concerted staff participation and self management development in light of increased student learning needs. An alternate model of Clinical Supervision was examined. The impact of this proactive, problem solving approach will be addressed and may encourage application in other occupational therapy settings.
Theses and Dissertations
Authors: Tompson Margaret-Ann Michelle
Published: March 2013

Fieldwork is a complex educational process. The purpose of this study was to uncover meanings student occupational therapists made of their early fieldwork experiences — the practicum component of the curriculum.
Analyse qualitative des difficultés rencontrées par les mères d'enfants ayant une incapacité motrice
Authors: Tétreault Sylvie
Published: March 2013

Une étude qualitative portant sur la réalité des mères ayant un enfant avec une incapacité motrice (spina-bifida ou infirmité motrice cérébrale) a été menée auprès de 67 femmes de la région de Québec. Une analyse de contenu thématique des difficultés rencontrées par ces femmes a été réalisée. Les femmes interviewées affirmaient que le contact initial avec les membres du corps médical (particulièrement les médecins) représentait une source importante de frustration et de mécontentement. De plus, elles indiquaient que les caractéristiques physiques et psychologiques propres à. leurs enfants engendraient de nombreuses difficultés. Il est ressorti que les réactions du conjoint tout comme celles de la famille rendaient leur vie quotidienne encore plus ardue. À la lumière des commentaires des participantes, des recommandations pour les ergothérapeutes sont énoncées afin de mieux guider les interventions auprès de ces femmes.
Assessing Ability to Drive following an Acute Neurological Event: Are We on the Right Road?
Authors: Korner-Bitensky Nicol , Sofer Susan , Kaizer Franceen , Gelinas Isabelle , Talbot Lise
Published: March 2013

Every day in Canada occupational therapists are asked to assess clients with neurological impairments and to provide recommendations to provincial licensing bureaus regarding the individual's fitness to drive. These decisions have great impact on the client and on society. In this paper we briefly review the findings that have been published regarding the assessment of — individuals with neurological conditions who wish to resume driving. In addition, a description of the tools commonly used to assess individuals is provided, along with where available, the measurement properties of each. Finally, the Driving Evaluation Service of a physical rehabilitation centre is described.
Fidélité inter-examinateurs du “Profil des AVQ-Mise en situation” chez. la personne traumatisée cranio-encéphalique Partie 1: Étude sur la cote globale
Authors: Rousseau Jacqueline , Dutil Élisabeth , Lambert Jean
Published: March 2013

Comme l'autonomie dans les activités de la vie quotidienne (AVQ) est un préalable la réinsertion communautaire de la personne traumatisée cranio-encéphalique, l‘évaluation de ces activités devient primordiale. Un nouvel instrument de mesure des AVQ a été élaboré: le “Profil des AVQ”. L'objectif de la présente étude est de vérifier la fidélité inter-examinateurs de la cote globale des 21 tâches de cet instrument. Dix-neuf personnes traumatisées cranio-encéphaliques sévères ont participé l’étude. Chaque sujet a été filmé, puis coté par quatre examinatrices. La statistique kappa (k) démontre des coefficients variant de “acceptable” (0,23) à “très bon” (0,72) selon l‘échelle de Landis et Koch. Il semble que les coefficients des tâches mieux circonscrites soient plus élevés que ceux des tâches dont les éléments clés présentent des niveaux de complexité différents. Des stratégies pour améliorer la précision de cette mesure sont proposées.
The Effectiveness of a Multisensory Writing Programme for Improving Cursive Writing Ability in Children with Sensorimotor Difficulties
Authors: Lockhart Julia , Law Mary
Published: March 2013

Children with sensorimotor difficulties experience significant challenges in the ability to write adequately. A single case experimental design with multiple baselines across behaviours was used to evaluate the effectiveness of a multisensory writing programme for improving the cursive writing ability of four children with sensorimotor difficulties. Five distinct letter groups were taught in random order, one group every two weeks. Repeated measurements of writing speed and quality for each letter group were made. Visual analysis indicated that specific letter groups for all of the children changed following intervention. Statistical analysis indicated that quality scores of one child changed significantly while there were no significant changes in overall speed scores. Teacher reports before and following the programme suggest that intervention may have had a positive effect on self-confidence in written output. Further research is needed to evaluate the use of multisensory writing programmes by occupational therapists working with this specific population.
Back to the Future
Authors: Picard-Greffe Huguette
Published: March 2013

The profession is heading through some treacherous waters and to navigate them the author suggests a return to the sources of occupational therapy practice, and in particular, a shift in attitude towards greater simplicity; listening to clients more sensitively; encouraging their self discovery, values and direction; and a raised consciousness that the subjects of our discipline are human beings who must be considered individually. Dealing with the issue of professional ethics is another suggested shift in attitude as more occupational therapists are confronted with choices. The balance between what is do-able and what is desirable is not always clear, and it is suggested that by fully embracing the two fundamental values of competence and ethics, the profession will ensure that the public confidence necessary to do its work is deserved. The author debates the tension between the particular needs of the client, and the limited technological, financial and human resources that are available, and concludes by challenging us to change some attitudes and to become more open to creative and diverse opinions and experiences.
Development of the Power-Mobility Indoor Driving Assessment for Residents of Long-Term Care Facilities: A Preliminary Report
Authors: Dawson Deirdre , Chan Roberta , Kaiserman Ethel
Published: March 2013

The Power-mobility Indoor Driving Assessment (PIDA) was developed to determine accurately a client's competency and safety in using a power mobility device. The instrument's content validity was established through a national survey of power mobility experts including consumers and occupational therapists. The final version of the assessment has 30 items. A pilot study of its reliability was conducted at the Sunnybrook Health Science Centre. The results indicate that the PIDA has moderately good intra-rater reliability (ICC=0.67) and very good inter-rater reliability (ICC=0.87). The PIDA provides quantitative data that will be helpful to occupational therapists who prescribe power mobility devices and implement training programmes.
Children Exposed to Drugs in Utero: Their Scores on the Miller Assessment for Preschoolers
Authors: Fulks Mary-Ann L. , Harris Susan R.
Published: March 2013

This article presents findings from a retrospective study of 54 children who were prenatally exposed to drugs and who received the Miller Assessment for Preschoolers as part of a developmental follow-up clinic protocol. Data were analyzed using nonparametric descriptive statistics to examine trends in the test scores compared to the test norms and to determine if a distinctive clinical profile was present. Although a distinctive clinical profile did not emerge, the overall test results indicated a skewness toward the lower end of the spectrum with poorer performance identified on test items measuring tactile, proprioceptive and vestibular processing, and language. Performance of items that assessed aspects of non-verbal cognition tended to be within the normal range. The difficulties of conducting studies within this group of children are discussed.
Occupational Therapists as Case Managers: Responding to Current Approaches to Community Mental Health Service Delivery
Authors: Krupa Terry , Clark Carrie C.
Published: March 2013

Case management has been identified as an effective approach to service delivery which can assist persons with severe psychiatric disabilities to live in the community. The conceptualization and development of case management services have been the focus of much discussion. Occupational therapists are attempting to define their role in relation to case management. The purpose of this paper is to explore the relationship between occupational therapy and the case management approach to service delivery. The case management approach will be described including its objectives, models, functions and training requirements for case managers. A discussion of some of the philosophical, educational and professional issues facing occupational therapists in the role of case manager will be examined.
An Occupational Therapy Course on Community Practice
Authors: Vanier Constance , Hébert Michèle
Published: March 2013

This article outlines a course on occupational therapy community practice offered at the University of Ottawa and discusses its assets and limitations in terms of preparing students for the shift to community-based health services. The shift to community services in the health care systems of Ontario and Québec is described. Then the curricular components needed to prepare students for community practice are summarized. Finally, the community practice course at the University of Ottawa including its goal, objectives, class topics and evaluations is outlined. The strength of the community practice course described is that it includes many of the curricular components needed for community practice. On the other hand, limitations include the lack of skill training in some areas, its place in the last year of the programme, and its optional nature. Changes planned for the course and other recommendations for curricula are also discussed.
Repetitive Strain Injury: An Overview of the Condition and its Implications for Occupational Therapy Practice
Authors: Fast Catherine
Published: March 2013

The incidence of occupationally induced upper extremity disorders, often referred to as Repetitive Strain Injury (RSI), has increased dramatically in the last decade. An overview of recently published literature is presented which discusses economic impact, etiology, and historical and sociopolitical factors influencing these conditions. A number of prospective studies which conceptualize RSI as a complex biopsychosocial phenomenon framed within a chronic pain model offer some insights into the importance of a multidisciplinary, multifactorial approach to treatment. Opportunities exist for occupational therapists to make a significant contribution to enhancing the health of the worker in the workplace through participation in a team approach to treatment and in health promotion through workplace education with a view to prevention.
Culture and its Influence on Occupational Therapy Evaluation
Authors: Paul Stanley
Published: March 2013

In the increasingly multicultural society of north America, occupational therapists have a responsibility to develop awareness and knowledge concerning different cultural groups. By accepting and understanding clients' customs, values and beliefs, clinicians have a better chance of assessing and producing more effective outcomes. Since occupational therapy has incorporated western middle-class values into its theory and practice, many evaluation tools used are based on norrns developed for a white middle-class population. Using these evaluations with minority groups brings the danger of improper interpretation of test results. Consequently, increasing emphasis is being placed on the importance of culture fairness and the development of culture-fair evaluation tools for usage across different cultural groups. This paper will present a discussion concerning the importance, advantages and disadvantages of both culture-fair and culture-specific tests and evaluation tools.
Re-Engineering of Health Care: Opportunity or Threat for Occupational Therapists?
Authors: Gage Marie
Published: March 2013

The health care system is responding to a paradigm shift from the industrial era to the knowledge society. The rapidly changing administrative structures of some hospitals and increasing numbers of proposals for new models of care are disconcerting for therapists who are used to working in traditional organizational structures and models of care. However, with a broader understanding of the shift that is occurring, it becomes apparent that this paradigm shift is pushing the system toward care practices that are more consistent with occupational therapy practices than those of the traditional medical model. This paper describes the factors influencing the direction of the paradigm shift, the major emerging models of care and organizational structures associated with the paradigm shift, and then discusses the issue of whether the paradigm shift presents a threat or a challenge to occupational therapists.
Staff Rotation: Implications for Occupational Therapy
Authors: Taylor Ann , Andriuk Mary Lynn , Langlois Paule , Provost Eric
Published: March 2013

Occupational therapy departments of tertiary care hospitals can provide staff with opportunities to gain diverse clinical experience if they rotate through the various services such as surgery, medicine, geriatrics, plastic surgery and orthopedics. The system of rotation offers both advantages and disadvantages for the staff and the institution. The Royal Victoria Hospital in Montreal, a large university teaching hospital, had traditionally offered staff the opportunity to rotate. Changes in staffing and their needs however, resulted in rotation becoming an important issue within the department. This article presents the pros and the cons of rotation and non-rotation systems as identified by therapists and administrators across Canada. Staff rotation was found to have an effect on job satisfaction and a therapist's career orientation. Given these findings, administrators may want to reconsider the role of the generalist and specialist in their facilities.
Universal Arm Splint for Brachial Plexus Injuries
Authors: Sadra Hardeep
Published: March 2013

The residual movements after a brachial plexus injury can be used to perform desired tasks with the help of a variety of devices. An inexpensive, relatively simple splint has been designed for such a purpose. This article provides an outline for the fabrication of a universal arm splint to increase functional abilities after a brachial plexus lesion.
Client-Centred Practice: What does it Mean and Does it Make a Difference?
Authors: Law Mary , Baptiste Sue , Mills Jennifer
Published: March 2013

During the past 15 years, occupational therapists in Canada, through the Canadian Association of Occupational Therapists, have worked to develop and implement guidelines for practice of a client-centred approach to occupational therapy. One of the difficulties with the current Guidelines for the Client-Centred Practice of Occupational Therapy is the lack of a definition and discussion of the concepts and issues fundamental to client-centred practice. In this paper, key concepts of client-centred practice: individual autonomy and choice, partnership, therapist and client responsibility, enablement, contextual congruence, accessibility and respect for diversity are discussed. Two practice examples are used to illustrate these ideas and raise issues about obstacles to the practice of client-centred occupational therapy. Research evidence about the effectiveness of client-centred concepts in enhancing client satisfaction, functional outcomes and adherence to health service programmes is reviewed.