bluuebunny/crossref_metadata_2025 huggingface dataset:
Description of self‐care training in occupational therapy: case studies of five Kenyan children with cerebral palsy
Authors: Guidetti Susanne , Söderback Ingrid
Published: March 2006

The purpose of this prospective case study design was to describe the changes in dressing skills for five Kenyan children with cerebral palsy who participated in a 10‐week occupational therapy intervention programme. The training sessions were individually designed to meet the needs of the child. The children's performances on undressing and dressing and the time these tasks took was used as a baseline and outcome measure. These measurements were documented by video films and then analysed using visual inspection and converted into the scores of the Klein‐Bell Activities of Daily Living (ADL) Scale. The results for each child were analysed using a simplified version of the Reliability Change Index. The results showed that four of the five children improved their ability to dress and that the children increased their time to undress significantly (p<0.05). Three children needed more time and two children needed less time for dressing (p<0.05). The results were influenced by the activity limitations among these children and the environmental, social backgrounds, cultural and economic situation unique to Kenya. It is recommended that case study research be used to validate clinical practice in paediatric occupational therapy and to understand cultural differences and its impact on health care. Copyright © 2001 Whurr Publishers Ltd.
Icelandic occupational therapists' attitudes towards educational issues
Authors: Ásmundsdóttir Elín Ebba , Kaplan Susan
Published: March 2006

The purpose of this study was to assess the readiness of occupational therapists in Iceland to accept a professional as opposed to a technical view of the profession. Most Icelandic occupational therapists were educated in other countries, with little emphasis on liberal arts, sciences and research. The first Icelandic occupational therapy programme, a university‐level programme, was founded in 1997. All Icelandic occupational therapists were surveyed. Eighty‐seven questionnaires were sent out and 80 (92%) were returned and used for statistical analysis. The results of the study showed that Icelandic occupational therapists valued academic skills over technical skills, emphasizing occupational therapy theory unique to the profession and research to validate practice. More recognition among other health professionals was considered the most needed change in the profession. The results of the study showed that the clinicians' attitudes confirmed in general what is emphasized in the curriculum and in students' fieldwork. Further research is needed to explore whether the Icelandic occupational therapy profession succeeds in promoting research and recognition by other health professions. Copyright © 2001 Whurr Publishers Ltd.
Fieldwork education: the future of occupational therapy depends on it
Authors: Aiken Frances , Menaker Lisa , Barsky Lori
Published: March 2006

Fieldwork continues to be the cornerstone of preparation for entry‐level occupational therapy clinicians. During the past five years the Canadian healthcare system has experienced decreases in federal funding, organizational changes such as the movement to programme management, and increased focus on community‐based needs. Two fieldwork projects were tested at a large health sciences facility, to meet the challenge of providing effective fieldwork experiences that build on current educational methodologies while still responding to changing realities in healthcare practice. The academic programme with which the health sciences facility is affiliated has developed a strong focus on self‐directed learning, using problem‐based and small group learning formats. The development, implementation and evaluation of the two fieldwork projects is described. Discussion focuses on the processes needed to facilitate innovative, flexible fieldwork models. Copyright © 2001 Whurr Publishers Ltd.
Success of non‐traditional students in an undergraduate occupational therapy programme
Authors: Wheeler Neil
Published: March 2006

An exit survey designed to examine the experiences of occupational therapy undergraduates was administered to 365 students in a four‐year honours programme. The survey had a response rate of 51% (186). The survey was informed and supplemented by focus groups with international students and computer‐mediated conferencing with community leaders from relevant ethnic minorities. Results showed that older students and those with non‐traditional entry qualifications in this sample were as successful as school‐leaver entrants (those with UK A Level qualifications). There were no significant differences between the support needs of the groups and previous experience did not have a beneficial or significant effect on support needs. Having to maintain part‐time employment significantly increased the likelihood that students would consider withdrawing from the programme. For those who considered withdrawing but who went on to successful completion, the desire to practise occupational therapy following their successful experiences in the programme was a powerful motivator. Copyright © 2001 Whurr Publishers Ltd.
Developing awareness of spirituality in occupational therapy students: are our curricula up to the task?
Authors: Kirsh Bonnie , Dawson Deirdre , Antolikova Sylvia , Reynolds Lorraine
Published: March 2006

Although spirituality is recognized as an important component of occupational therapy practice, students and clinicians are not well prepared to attend to this area. This study examines the manner and extent to which Canadian occupational therapy education addresses the concept of spirituality. A survey investigating spirituality in occupational therapy curricula was sent to all 12 Canadian occupational therapy programmes, with a response rate of 83%. Results indicate that although all Canadian occupational therapy programmes address spirituality in their curricula, the level of importance attached to the topic is low. Level of satisfaction with the preparation of students to address spirituality in practice is also low. A description of one Canadian occupational therapy programme's curriculum in the area of spirituality is included. Copyright © 2001 Whurr Publishers Ltd.
Competence unfurled: developing portfolio practice
Authors: Alsop Auldeen
Published: March 2006

In this report some of the characteristics of competence are explored. Learning is identified as a feature of competence. If occupational therapists are to survive and thrive in a changing world they need to develop and use their learning skills effectively to maintain competence and to develop proficiency and expertise. Occupational therapists should take steps to document evidence of evolving competence in order to demonstrate professional growth over time, and justify continued registration with their regulatory body. Copyright © 2001 Whurr Publishers Ltd.
Education and research in Africa: identifying and meeting the needs
Authors: Crouch Rosemary B
Published: March 2006

The development and promotion of occupational therapy in the Sub‐Saharan continent of Africa is seen as a challenge for the World Federation of Occupational Therapists. It is also a challenge for pioneering occupational therapists, mostly ex‐patriates, who have started occupational therapy services in many new countries of Africa over the past few years. This report identifies and addresses the problems. It is important that existing training centres for occupational therapists are maintained by attracting permanent, indigenous teaching staff and clinical supervisors, by promoting continuing support and development of existing occupational therapy services and by promoting the development of more rehabilitation and educational facilities. A priority is to help government departments to develop job structures for occupational therapists. Research is seen as being vital to this process. The report concludes by emphasizing the importance of developing confidence in the profession of occupational therapy by ongoing education, personal achievement and positive thinking. Copyright © 2001 Whurr Publishers Ltd.
Technological dreams: the implications of new technologies for occupational therapy education and evidence‐based practice
Authors: Steward Barbara
Published: March 2006

Computer technologies will change both occupational therapy education and practice. Technological optimists suggest that there will be positive benefits for distance learning and supervision, universal equal access to information and expertise, and positive cross‐cultural exchange. However, technologies have inevitable and unexpected costs. In this report I explore the potential for future problems with professional induction, educational reductionism, cultural imperialism and deprofessionalization through a review of the literature. I suggest that early recognition of the costs as well as the benefits of computer‐based education will be important to the development of international occupational therapy. Copyright © 2001 Whurr Publishers Ltd.
Patients' perceptions of their participation in rehabilitation planning and professionals' view of their strategies to encourage it
Authors: Lund Maria Larsson , Tamm Maare , Bränholm Inga‐Britt
Published: March 2006

The purposes of this descriptive study were threefold: first, to describe how patients perceived their participation in the planning of their rehabilitation; second, to describe nurses' and occupational therapists' view of the strategies they used to encourage patients' participation; and third, to compare the perceptions of the two groups. Data was collected through semi‐structured interviews with 57 hospitalized patients, 39 nurses and 11 occupational therapists. On the basis of the data patients were categorized as (a) ‘relinquishers’, (b) ‘participants’ and (c) ‘occasional participants’. Professionals were categorized as ‘information providers’ and ‘rehabilitation practitioners’. The strategies used by the professionals to encourage patient participation were approximately the same irrespective of patient category. It is suggested that professionals need to be sensitive to the patient's desire to participate in the planning of a rehabilitation programme. Further research is recommended to investigate circumstances affecting patients' participation and which strategies professionals can use to encourage their participation. Copyright © 2001 Whurr Publishers Ltd.
Inter‐rater and test–retest reliability of the Taiwanese rehabilitation functional scale
Authors: Pan Ay‐Woan , Chern Jen‐Suh , Chung Lyinn , Lai Jin‐Shin
Published: March 2006

The need of a standardized evaluation tool for clinical practice is acknowledged by occupational therapists worldwide. The purpose of this study was to examine the inter‐rater and test–retest reliabilities of the Taiwanese Rehabilitation Functional Scale (TaRFS) developed in Taiwan. Seventy‐five subjects with varying diagnoses were recruited to participate in the study. They came from an inpatient rehabilitation unit within a university‐affiliated hospital. All participants were tested on a functional measure of their independence on activities of daily living and cognitive–social tasks, and of their sense of well‐being. The Activity of Daily Living (ADL) and Cognitive‐Social Skills (CSS) subscales of the TaRFS were found to be reliable across raters and times. But individual items on the Subjective Well Being subscale were not stable across time. The results indicated that the ADL subscale as well as most items in the CSS subscale of the TaRFS can be utilized reliably in clinical practice. The SWB subscale of the TaRFS may need further revision in order to be used stably across time. The development of the TaRFS and future revision of the scale can be beneficial for occupational therapists in Taiwan to provide evidence of their intervention efficacy. Copyright © 2001 Whurr Publishers Ltd.
Work‐related stress and occupational therapy
Authors: Lloyd Chris , King Robert
Published: March 2006

Occupational stress and burnout have been studied extensively in the human services. It has been suggested that healthcare professionals in particular are at risk of stress owing to the caring nature of their work. Articles related to occupational therapy and work‐related stress were reviewed in regard to practice in Australia, Canada, the United Kingdom, the United States and Sweden. Although the empirical literature is relatively weak for occupational therapy, it has been argued that occupational therapists in health care share risk factors with other healthcare professionals. These risk factors include repeated exposure to distress and difficult behaviour, prolonged interventions and uncertain outcome. Issues such as professional status, staffing issues and the nature of the profession have been identified as additional risk factors for occupational therapists. However, empirical studies that enable burnout rates of occupational therapists to be compared with those of related occupational groups suggest that this may not be the case. Occupational therapists may in fact be protected from some stress and burnout factors. Further research is recommended to clarify the nature of stress experienced by occupational therapists and to identify both risk and protective factors characteristic of the profession. Copyright © 2001 Whurr Publishers Ltd.
Development of the Competency Based Fieldwork Evaluation (CBFE)
Authors: Miller Linda T , Bossers Ann M , Polatajko Helene J , Hartley Mark
Published: March 2006

Recent changes in health care have contributed to an increase in community care and a consequent increase in community fieldwork sites in professional practice education. Evaluations of student performance designed before this transition are limited in their applicability across diverse settings. This article describes the development of a student performance evaluation, the Competency Based Fieldwork Evaluation (CBFE), based on a set of core competencies. Specifically, the CBFE was created to be used across a variety of rehabilitation professions: (a) to evaluate student performance in a variety of fieldwork settings, (b) to provide a cumulative record of student competency acquisition, and (c) to ensure competency for entry to practice. Focus group discussions and review of evaluations across disciplines led to the compilation of seven competencies common to all rehabilitation professions: (1) practice knowledge, (2) clinical reasoning, (3) facilitating change, (4) professional interactions, (5) communication, (6) professional development, and (7) performance management. A pilot version of the CBFE, using a visual analogue scale (VAS) for each competency, was field tested. Content analysis supported the seven competencies. However, concerns regarding the use of a VAS led to revision to a numeric rating scale with descriptors reflecting the stages of professional development. Evidence to date supports the use of the CBFE as a measure of developing clinical skills across diverse settings. However, most data have come from occupational therapy students. Future research is needed to evaluate the numeric rating scale, the reliability of the CBFE, and to evaluate the applicability of the CBFE across rehabilitation professions. Copyright © 2001 Whurr Publishers Ltd.
What do young school‐age children know about occupational therapy? An evaluation study
Authors: Royeen Charlotte Brasic , Zardetto‐Smith Andrea M , Duncan Maureen , Mu Keli
Published: March 2006

Occupational therapy is a poorly understood profession. In response to this fact, the American Occupational Therapy Association has launched a national campaign to increase awareness of occupational therapy among adults. Little is known, however, about children's perceptions of occupational therapy. The current evaluation study reports on the assessment of children's perceptions of occupational therapy prior to, and following, an interactive demonstration on occupational therapy as part of a larger neuroscience exposition. One hundred and three elementary school‐aged children (55 boys and 48 girls) from local schools attended a one‐day neuroscience exposition held at the Boys & Girls Clubs of Omaha. At three of 18 booths at the exposition, occupational therapy faculty and students explained what occupational therapists do, and demonstrated the link between brain function and occupational performance. Children completed pre and post questionnaires. Results revealed that on pre‐test, the vast majority of participants could not answer the question or had no idea of what occupational therapists do. On post‐test, 75% reported that they had knowledge of what occupational therapists do. These preliminary findings suggest that a campaign of public awareness about occupational therapy for children would be highly effective and beneficial, and that a neuroscience exposition including occupational therapy is one effective intervention to promote such awareness. Copyright © 2001 Whurr Publishers Ltd.
Occupational performance in older stroke wheelchair users living at home
Authors: Reid Denise T , Hebert Deborah , Rudman Deborah
Published: March 2006

This research aimed to identify problems in occupational performance experienced by survivors of stroke who used a wheelchair, both from their perspective and from the perspective of their caregivers. Sixteen stroke survivors over the age of 65 years who had used a prescribed wheelchair for at least one year, who lived in their own home, who were able to participate in a conversational interview and who had a caregiver willing to participate comprised the sample. The Canadian Occupational Performance Measure (COPM) was used to identify occupational performance problems and to measure stroke survivors' and caregivers' perceptions of performance. The Functional Autonomy Measurement System (SMAF) was also used to evaluate the functional performance of stroke survivors from the caregivers' perspective. The frequency and type of problems identified by the COPM were descriptively analysed and compared for both groups. The results of Mann‐Whitney U tests showed no differences in the frequency of self‐care, productivity and leisure problems reported between the two groups. Within‐group comparisons using the Wilcoxon Signed Ranks Test showed that stroke survivors identified significantly more self‐care problems than productivity‐type problems (p=0.001), and more leisure problems than productivity problems (p=0.013). Caregivers identified significantly more self‐care problems than productivity problems (p=0.001). The most common self‐care problems reported by both stroke survivors and caregivers were dressing and bathing. Results suggest a high level of functional disability among the stroke survivors. There was a significant correlation between the score on the SMAF Instrumental Activities of Daily Living subscale and the frequency of caregiver assistance (r=0.747, p=0.001). Addressing the perspectives of both stroke survivors who are wheelchair users and their caregivers in identifying occupational performance problems at home is important for occupational therapists for planning home‐based intervention. Copyright © 2001 Whurr Publishers Ltd.
The development and reliability of the Cantonese version of the Allen Cognitive Level Screen
Authors: Chan Christopher LF , Ray Sharon , Trudeau Scott
Published: March 2006

The Allen Cognitive Level Screen is a quick screening test to assess the cognitive functions of people with cognitive impairments or psychiatric disabilities. The purposes of the study were to translate the Allen Cognitive Level Screen into Cantonese and to gather evidence of the reliability of the translated version. Translation was performed by three bilingual occupational therapists. A panel of another five bilingual occupational therapists verified the accuracy of translation. Thirty randomly selected Cantonese‐speaking healthcare workers performed the Cantonese version of the Allen Cognitive Level Screen. Results suggested that the test seemed to be accurately translated. Inter‐rater reliability and the test–retest coefficient of the Cantonese version of the Allen Cognitive Level Screen were 0.98 and 0.73 (test–retest interval = 28.3 days) respectively. Future research should be directed towards further exploring the psychometric properties and clinical application of the Cantonese version of Allen Cognitive Level Screen. Copyright © 2001 Whurr Publishers Ltd.
Occupational therapists' assessments of adults with long‐term pain: the Swedish experience
Authors: MÜllersdorf Maria , SÖderback Ingrid
Published: March 2006

The purposes of this study were to describe the needs for occupational therapy among people of working age with long‐term pain, and to describe treatment interventions based on these assessments. Occupational therapists working in primary health care and/or with special interest in pain management (n=109) assessed 113 people aged 18–58 years with long‐term pain with the Occupational Therapy Needs Assessment – Pain (OTNA – P) questionnaire. The occupational therapists recommended treatment interventions where appropriate. The results generated categories of needs that have implications for interventions: 1) need for patient education, 2) needs due to limitations in activity performance, 3) needs due to patient's discouragement, 4) need as a result of patient's dependency and 5) needs related to work. The suggested interventions focused on increased knowledge of how to handle daily occupations, mainly categorized as ‘education and stress management’ and ‘behavioural’ interventions. Significant correlations were found between the assessed needs and the suggested interventions. The results of this study could assist in developing guidelines for practitioners working in occupational therapy pain management programmes. It is recommended that further research is done on the effectiveness of occupational therapy interventions with patients with long‐term pain. Copyright © 2002 Whurr Publishers Ltd.
The role of mentoring on research productivity among occupational therapy faculty
Authors: Paul Stanley , Stein Franklin , Ottenbacher Kenneth J. , Liu Yuanlong
Published: March 2006

This study surveyed junior and senior occupational therapy faculty in order to further understand the role that mentoring plays in research productivity. Junior faculty with and without mentors were compared in terms of their overall research productivity, and the senior faculty who served as mentors were compared with senior faculty who were not mentors. The role of institutional support factors on research productivity was also examined. The results of this survey suggest that mentoring plays an important role in increasing research productivity in junior faculty in the field of occupational therapy. Also, senior faculty mentors perceived their mentoring experience to enhance their research productivity. A general profile of an occupational therapy mentor and mentee has emerged from the results. Analyses showed a low to moderate positive correlation between faculty research productivity and a number of institutional support factors. Availability of intramural funds, release time, chair and dean support for research, grant writing seminars, and availability of statistical and computing help correlated with research productivity. The authors recommend the need for mentoring in occupational therapy academia. New faculty should have a mentor or mentors to help them succeed in research, teaching and service goals. Developing short‐term and long‐term goals with the mentor and periodic evaluation of goals will help new faculty to keep pace with the demands and requirements of their academic positions. Copyright © 2002 Whurr Publishers Ltd.
Intermanual transfer of a new writing occupation in young adults without disability
Authors: Andree Megan E. , Maitra Kinsuk K.
Published: March 2006

It has been shown that acquisition of a skill by one hand is facilitated by previous learning of the same skill with the other hand. This is called intermanual transfer of learning, or cross‐education. The investigators examined intermanual transfer of occupation of writing in a group of 10 right‐handed subjects with no known motor disabilities. Subjects learned to perform a novel occupation of writing a foreign alphabet letter with either their right or left hand. Later, subjects reproduced the skill with the practised and unpractised contralateral hand. Pen movements and surface electromyography of the first dorsal interosseus muscle were recorded to assess the transfer of learning. Analysis revealed an almost full transfer of the learned motor task between hands in either left‐to‐right or right‐to‐left direction when movement time and movement size were compared. This indicates that transfer did not depend on hand dominance. These findings suggest that a task already learned by one hand can positively influence the learning of the same task by the other hand. The results have important implications for occupational therapy – namely, that activities comprising tasks previously learned by one hand would be more effective in facilitating improved performance by the other hand than activities comprising previously unlearned tasks in the case of retraining skills in patients with amputation or hemiplegia. Because the participants in this study were a small number of college students, research should be carried out with larger participant pools and participants with disabilities to consolidate the findings. Copyright © 2002 Whurr Publishers Ltd.
An organizational case study of the case manager's role in a client's return‐to‐work programme in Australia
Authors: Russo Domenica , Innes Ev
Published: March 2006

The purpose of this study was to examine the case manager's role in a return‐to‐work programme in Sydney, Australia. The investigators examined the case manager's role assumed by occupational therapists, physiotherapists, psychologists and rehabilitation counsellors when providing occupational rehabilitation services. Files of closed cases (n=172) were examined to investigate the relationship between the case manager's profession and return‐to‐work outcomes. It was found that the provider of occupational rehabilitation examined in this study achieved above‐average return‐to‐work rates (83%), with no significant difference between case managers. There was, however, a significant relationship between the client's type of injury and the case manager (p<0.001), and case length was significantly different between case managers (p=0.004). The occupational therapist had the largest case management load (43%), followed by the rehabilitation counsellor (23%). There were trends (0.05<p<0.1) between the case manager's profession and return to the same employer, and return to pre‐injury, modified or new duties. The provider allocated cases on the basis of professional expertise and skill, which proved to be successful. The provision of workplace‐based occupational rehabilitation services combined with case management provides a comprehensive and attractive package to employers and other referrers. Further research is required to investigate factors associated with case management that improve return‐to‐work outcomes. Copyright © 2002 Whurr Publishers Ltd.
Functional needs: agreement between perception of rural patients and health professionals in China
Authors: Murphy Donna D. , Lam Cindy L.K.
Published: March 2006

This study aimed to investigate the common areas of functional needs of patients with different chronic diseases and to compare the level of agreement between patients and doctors, and patients and an occupational therapist, on perceived priority functional goals. A sample of 113 rural patients from Hebei Province attending outpatient neurology, orthopaedic and cancer clinics completed the COOP/WONCA Charts. These charts are a screening tool that assesses limitations in a set of functional domains. The 80 patients who indicated significant functional difficulty on the charts, 11 doctors and one occupational therapist then responded to questionnaires to elicit the perceived priority functional needs. Respondents remained blind to one another's responses. A consulting doctor and the occupational therapist saw each patient's COOP/WONCA Charts before interviewing the patient. Additional questionnaire items and a focus group interview provided data by professionals on health services thought to be beneficial to improve the function of clinic patients. The difference between the mean percentage of agreement on perceived functional difficulty in therapist/patient matches and doctor/patient matches was 18.5% (95% CI for the difference=12.4% to 24.6%). The therapist on average agreed or matched with patients significantly more often than did doctors (p<0.0001). The discrepancy between the doctor's and patient's perception of priority functional goals was substantial, indicating a need for initiated effort to narrow this gap. The match rate of doctors with patients in choosing priority goals was significantly lower than for the therapist with patients in this study. Doctors expressed a desire for closer involvement in clinics by appropriate rehabilitation staff. This could expedite the process towards the starting level of a patient‐centred approach to health care, within the natural context of teamwork, and with little disruption to clinic routines. Replication of this study using a control group would allow direct comparison of patient incidents when the charts are used and when they are not. Copyright © 2002 Whurr Publishers Ltd.
Occupation reconsidered
Authors: Royeen Charlotte Brasic
Published: March 2006

The current article delineates the need for the profession of occupational therapy to maintain relevance and be responsive to current trends. As part of such responsivity, this article proposes a reconsideration of the concept of occupation as an ‘adaptive response’ to the current societal need for clarification regarding occupational therapy. Reconsideration of what is meant by occupation for general use is discussed and illustrated by the ambiguous use of the term occupation as both a means and an end. Although occupational therapists are comfortable with such ambiguous use because of their apparent ease with complexity, use of the term in an ambiguous manner makes it harder for society to understand what is meant by occupation. Related to this, an annotation of literature on the definitions of occupation is presented in summary form. Furthermore, the political need to reconsider the term occupation is argued in light of the revision of International Classification of Functioning, Disability and Health (ICF), which includes the use of the word activity. Finally, this article proposes that occupation should be considered as the process of doing with meaning, and that activity should be the outcome. Such reconsideration renders us consistent with ICF and paves the way to reduce ambiguity in the use of the term occupation with the general public. Copyright © 2002 Whurr Publishers Ltd.
The use of silicon gel for treating children's burn scars in Saudi Arabia: a case study
Authors: Brown Cary A.
Published: March 2006

This case study is presented to illustrate the effectiveness of silicon gel as an important option in burn scar treatment and to provide treatment guidelines that address cultural, clinical and patient compliance issues in Saudi Arabia. The case study involves an 18‐month‐old child whose burn scar was treated for a period of 15 months with silicon gel. The Vancouver Burn Scar Scale assessment (Baryza and Baryza, 1995), used to track progress across the duration of treatment, reflected an improvement in the scar as the composite score changed from 9 to 2. Strategies for problem solving and addressing needs unique to the environment of Saudi Arabia were also developed over the treatment period. The findings of this case study indicate that silicon gel may be a superior treatment option under certain circumstances. Further research with a wider sample is indicated, given the high incidence of childhood burn injuries in Saudi Arabia. Copyright © 2002 Whurr Publishers Ltd.
Therapeutic strategies used by occupational therapists in self‐care training: a qualitative study
Authors: Guidetti Susanne , Tham Kerstin
Published: March 2006

Self‐care training is one of the most frequently used interventions in rehabilitation. However, there is a need for clear descriptions of what occupational therapists do during self‐care training with clients. The aim of this qualitative study was to describe what characterizes the therapeutic strategies used by occupational therapists during self‐care training. Twelve occupational therapists working with clients who had had a stroke (n=6) or spinal cord injury (n=6) were interviewed and asked to tell a therapeutic story focusing on the self‐care training process of one client. Data were transcribed and analysed using the Empirical, Phenomenological, Psychological (EPP) method, a qualitative method that aims to describe the essence, structure and character of the studied phenomenon (that is, therapeutic strategies). The characteristics of eight intervention strategies, used by all participants during self‐care training, were identified. Findings showed that the occupational therapists' strategies focused primarily on how to create a relationship built on trust with their clients, how to find the right way to motivate clients, how to support the setting of goals, and how to provide enabling occupational experience and adjust training to the needs of the client, rather than focusing on teaching clients how to use technical and compensatory strategies. The general aim for using the strategies was to support the clients in taking control of their lives again. One conclusion from this study is that occupational therapists could, through understanding the individual's unique situation, vary their strategies and adapt themselves, like a chameleon, to meeting clients' experiences and needs during self‐care training. However, the therapeutic outcome of using these strategies needs to be verified in future studies focusing on clients' experiences from self‐care training. Copyright © 2002 Whurr Publishers Ltd.
Occupational therapy adaptation of the home environment in Sweden for people with asthma
Authors: Frisk Margot , Blomqvist Anna , Stridh GÖran , SjÖdÉn Per‐olow , Kiviloog Jaak
Published: March 2006

The purpose of this study was to evaluate changes of lung function, respiratory symptoms and indoor air quality after reducing allergens and indoor pollutants in the home environment of people with asthma (n = 21). A quasi‐experimental pre‐/post‐test design with one group of participants was implemented. The interventions included removal of wall‐to‐wall carpets (n = 14) or improvement of indoor air exchange (n = 7). Participants' lung function, symptoms, medication and type‐1 allergy were recorded before and after the intervention. The indoor environment was monitored at house calls by an occupational therapist using conventional physical, biological and chemical methods. There was an improvement of lung function evidenced by an increased mean Forced Expiratory Volume (FEV1 %) and a reduction of airway obstruction (reversibility, % of baseline value), which indicate an improved asthmatic condition. Lung function assessed by vital capacity, bronchial hyper‐responsiveness, mean of Peak Expiratory Flow, symptom score and medicine consumption did not change significantly. There was a tendency that the amount of airborne dust (p=0.06) was reduced in the indoor environment. Relative humidity, carbon dioxide, formaldehyde and house dust mite levels had decreased after the intervention, but not significantly. Asthma symptoms related to the home environment are probably caused by several factors. When people with asthma suffer from increased symptoms in the home, house calls should be performed routinely. Dust samples from beds and carpets for analysis of allergens give information about exposure, and environmental assessments should be performed before interventions. Occupational therapists can make a valuable contribution in evaluating the home environment and suggesting ergonomic adaptations for individuals with asthma. Copyright © 2002 Whurr Publishers Ltd.
Validity of the Kohlman Evaluation of Living Skills (KELS) with Israeli elderly individuals living in the community
Authors: Zimnavoda Tal , Weinblatt Nurit , Katz Noomi
Published: March 2006

The Kohlman Evaluation of Living Skills (KELS) was developed to evaluate Activities of Daily Living (ADL) and Instrumental ADL (IADL) in a psychiatric population. Later the KELS was assessed and adapted for a geriatric population. The purpose of this study was to determine the validity of the KELS with elderly individuals living in the community in Israel. The subjects included 92 elderly people living in the community, in protected housing facilities for the elderly, and those living in the community and attending day care. Instruments included the Mini‐Mental State Examination (MMSE) to determine cognitive function, the Functional Independent Measure (FIM) to determine performance in ADL, and the Routine Task Inventory (RTI) as a measure of IADL to determine criterion validity. Results showed high correlations between the KELS and the RTI (r=0.895) and the FIM (r=0.70). The KELS was also found to be highly sensitive to the differences between all three groups, supporting construct validity. Furthermore, the KELS was found to be more sensitive to these differences than the other instruments used in the study. In conclusion, the results show the KELS to be valid and appropriate for use by occupational therapists with the Israeli elderly population, similar to the US population. The study's small sample size limits the generalizability of the findings. It is recommended that further research be done on the KELS with larger and more diverse elderly populations. Copyright © 2002 Whurr Publishers Ltd.
Women's experiences of hassles and uplifts in their everyday patterns of occupations
Authors: Erlandsson Lena‐Karin , Eklund Mona
Published: March 2006

The aim of this study was to investigate experiences of hassles and uplifts among women. One hundred working mothers were interviewed using the Target Complaints instrument. Content analysis, resulting in both qualitative categories and quantitative variables, was used.

Working mothers' hassles were mainly generated by their social, temporal and doing contexts and illustrate the importance of considering women's total patterns of everyday occupations and not focusing one‐sidedly on the work situation when treating occupation‐related ill‐health. Women's uplifts were experienced through the social context and by doing such different occupations as going to the movies, cleaning the house, or attending a class. This indicates the appropriateness of using a client‐centred approach in interventions with openness to the client's unique situation. Unexpected occupations were identified almost exclusively among the hassles.

This is important knowledge for occupational therapists since women will continue to be dual workers and at potential risk of developing unbalanced and detrimental patterns of occupations, in turn causing ill health. Copyright © 2003 Whurr Publishers Ltd.
A comparison of mothers' and fathers' experience of parenting stress and attributions for parent–child interaction outcomes
Authors: Esdaile Susan A. , Greenwood Kenneth Mark
Published: March 2006

Parents of children with disabilities are vulnerable to parenting stress, which may place them at physical and psychological risk. However, it is not clear whether fathers experience stress differently to mothers, or whether their experiences are reported less frequently. Additionally, there is little reported on the relationships and gender differences between mothers' and fathers' attributions for parent–child interaction outcomes. Parenting stress was assessed in this study using Abidin's (1990) Parenting Stress Index (PSI), and parenting attributions were assessed using the original (Bugental et al., 1989; Bugental and Shennum, 1984), and modified versions of the Parenting Attribution Test, also known as the Child Interaction Survey (CIS) (M‐CIS: Esdaile and Greenwood, 1995b). Participants were 53 mothers and 25 fathers of children with disabilities. Having a child with a disability was associated with elevated scores on the PSI; some gender differences were found. Only one significant outcome was found on the assessment of parenting attributions. Thus, the findings suggest that further research is indicated to explore differences in mothers' and fathers' experiences of parenting stress, and the assessment of parenting attributions.

The fact that having a child with a disability was associated with elevated scores on the PSI for both mothers and fathers indicates the importance of considering stress management as an integral part of occupational therapy programmes that involve parents of children with special needs. Therapists also need to consider possible gender differences when planning stress management programmes including both mothers and fathers of children with disabilities. Copyright © 2003 Whurr Publishers Ltd.
Content validity and clinical applicability of the Irena Daily Activity assessment measuring occupational performance in adults with developmental disability
Authors: Dychawy‐Rosner Irena , Eklund Mona
Published: March 2006

The purpose of this study was to investigate the validity of the Irena Daily Activity (IDA) assessment which measures occupational performance in adults with developmental disabilities. The instrument's content validity was investigated by elucidating its general appropriateness, its clinical applicability and the feasibility of the measurement procedure. Data were collected from a multidisciplinary panel of clinical experts working in day activity centres. Each expert independently judged and reviewed the IDA instrument's content validity. The results show that the content validity index (CVI) values ranged from 0.8 to 1.0 for the instrument's general appropriateness and clinical applicability, and from 0.7 to 1.0 with respect to the significance of the IDA domains' clinical applicability. The applicability of the IDA items were judged as satisfactory (CVI ≥ 80) with respect to their importance for planning treatment and intervention. The feasibility of the measurement procedure was estimated as satisfactory in relation to the items (CVI ≥ 0.70) and satisfactory with respect to the time needed and material used, with CVI values ranging from 0.8 to 1.0. The results of this study support the use of the IDA as a feasible and time‐efficient assessment that provides insights regarding the occupational performance of adults with developmental disabilities. A limitation of this study was that it could not illuminate all‐important aspects of validity. In conclusion, the IDA has the potential to become a reliable and valid clinical assessment, but additional research on psychometric properties is still needed. Copyright © 2003 Whurr Publishers Ltd.
Occupational therapy and early intervention: a family‐centred approach
Authors: Edwards Margaret A. , Millard Paula , Praskac Lee Ann , Wisniewski Patricia A.
Published: March 2006

The purpose of this study was to identify factors that encourage or inhibit family‐centred practice in the occupational therapy intervention process. A qualitative paradigm using grounded theory methodology was utilized to gather and analyse data. Participants included six families and four occupational therapists. Data analysis from the family interviews identified six categories: education, communication, relationship, parental roles, follow through, and scheduling. With further analysis two central themes of time and support were extracted from these categories. Analysis of the occupational therapists' interviews revealed six categories: education, communication, relationship, sibling/family participation, follow through, and empowerment. The central themes emerging from these categories are time and natural routine. The themes obtained from the families and occupational therapists were then compared and family individuality was identified as the core concept. Viewing families as a unique entity is necessary to assist occupational therapists in providing the most effective family‐centred occupational therapy. Copyright © 2003 Whurr Publishers Ltd.
Reliability and validity of the Canadian Occupational Performance Measure for clients with psychiatric disorders in Taiwan
Authors: Pan Ay‐Woan , Chung Lyinn , Hsin‐Hwei Grace
Published: March 2006

The purpose of the study was to examine the reliability and validity of the Canadian Occupational Performance Measure (COPM) in Taiwanese clients with psychiatric disorders. The COPM was translated into Mandarin and tested on 141 Taiwanese clients. The average age of the clients was 35.6 years; 94% were diagnosed with schizophrenia. The results of the study showed that the test–retest reliability of the COPM was r=0.842. The COPM identified occupational performance problems that included self‐care (37%), productivity (25%), and leisure occupations (20%). Fifty percent of the therapists were receptive in adapting the client‐centred approach and applying the COPM in their clinical practice. It was concluded that the COPM can be applied reliably to Taiwanese clients. Furthermore, the COPM was valuable in identifying information related to occupational performance that could not be identified elsewhere. Since 50% of the therapists felt reluctant about the appropriateness of the client‐centred approach in their culture, it was important to examine the gap between clients' judgements and actual performance, as well as to evaluate the feasibility of the client‐centred concept in clinical practice. Finally, the concept of the client‐centred approach needs to be disseminated and communicated to the occupational therapy profession in order that the COPM can be adequately applied in mental health practice. Copyright © 2003 Whurr Publishers Ltd.
Walking to school: incidental physical activity in the daily occupations of Australian children
Authors: Ziviani Jenny , Scott Joanne , Wadley David
Published: March 2006

Children's participation in physical activity is declining, and nowhere is this more apparent than in the incidental activity of walking to school. The aim of this pilot study was to examine the extent to which Australian children walked to and from primary school, and to survey parents to identify factors influencing this behaviour. Parents of 164 students in Grades 1–7 (mean age 9.1±2.02 years) from a primary school comprising 360 students responded to a questionnaire regarding psychosocial and environmental factors thought to influence the means by which their children went to and from school. Results indicated that parent perception of the importance of physical activity, parents' individual history of transport to school as well as distance from school were the most statistically significant factors determining children's involvement in walking to and from school. The results of this study highlight the attitudes and experiences of parents in determining the extent to which children are involved in non‐motorized access to school. Also implicated are organizational policies about geographical school regions. While this study is limited to one school community, further study is recommended with others to better confirm findings by examining socioeconomic, geographic and policy variables. Occupational therapists are challenged to examine ways in which incidental physical activity can be increased in the lives of young children. Copyright © 2004 Whurr Publishers Ltd.