bluuebunny/crossref_metadata_2025 huggingface dataset:
The Short-Term Effect of Resisted Grip Activity on Resting Finger Position
Authors: Worley J. Scott
Published: March 2013

The study's purposes were to establish reliable measurement of hand resting joint position (RJP) and to determine the effect of repeated resisted grip activity upon that position. Thirty-two volunteer college students meeting health screening criteria were randomly assigned as experimental or control subjects. Procedures included two measurements of the relaxed RJP of the left middle finger prior to 40 repetitions of resisted grip for experimental and no activity for control subjects. The RJP was then measured a third time. Intrarater test-retest reliability of the first two RJP measurements was high (r = .95, p < .0001). The change within the activity group was significant (t = 7.25(15), p < .0001) but not for controls. Subjects receiving resisted grip showed significantly greater change in finger RJP toward flexion after exercise (t (30) = 5.06, p < .0001) than did controls. Results indicate that RJP is relatively stable over short time periods, can be reliably measured, and is influenced by activity. They suggest that occupational therapists might find RJP a useful measure of the instantaneous state of joint function, of muscle tone and of the effects of treatment.
Implementing a Health Promotion Strategy in Occupational Therapy Education and Practice
Authors: Madill Helen , Townsend Elizabeth , Schultz Peggy
Published: March 2013

In response to the growing emphasis on health promotion, this article addresses four major questions: 1) How is occupational therapy's client-centred philosophy reflected in the principles outlined by the World Health Organization (1984)? 2) What are the roles of occupational therapy in health promotion? 3) How will occupational therapy education foster this development? 4) How will the practice of occupational therapy respond to the challenges and implement the strategies outlined in “Achieving Health for All: A Framework for Health Promotion”? Despite similarities between occupational therapy's client-centred approach and the health promotion framework, the need for occupational therapy education to reflect the developments in health promotion and prevention is very evident. A four part model is proposed, and the implications for graduate education as well as continuing professional education are outlined. Recommendations for practice, education, research and development are discussed.
Trunk Kinematics and Trunk Muscle EMG Activity during Five Functional Locomotor Types
Authors: Cooper Juliette , Quanbury Arthur , Grahame Ruth , Dubo Hyman
Published: March 2013

The incidence of back injury is a significant problem in heavy industry, but little is known about the demands placed on the spinal mechanism during functional types of locomotion such as might be used in the workplace. In this study electromyography was used to analyze the activity of erector spinae and rectus abdominis muscles in 18 normal male subjects during level walking, stair climbing, stair descent, ramp climbing and ramp descent. Body segment position in the sagittal plane was recorded on high speed cinefilm. Comparison between the five different locomotion types showed significant differences in segment positions, range of motion and myoelectric activity. The results of this study could be used by occupational therapists to design assessment instruments, work hardening programs and modifications to the workplace for back injured clients and to recommend prevention programs for persons at risk for low-back injury.
Student Values and Preferences: What Do They Tell Us about Programme Selection?
Authors: Madill Helen , Macnab Donald , Brintnell Sharon
Published: March 2013

Allied health professionals are thought to acquire their orientation through professional socialization and education, but it is likely that they share similar values before being admitted to any educational programme. The results of a study involving occupational therapy, physical therapy, and speech pathology / audiology students (N=276) support this contention. The Life Roles Inventory, Vocational Preference Inventory and a student information sheet were the Instruments employed. Using discriminant analysis, the results demonstrate that although respondents endorse the same values, the level of that endorsement differs significantly between the three student groups. Similarly, the same Holland Code was generated for each group, but again the level of endorsement for the six primary scales varies in each case. The more allied health educators know about the values and preferences their students endorse, and how they seek to implement them, the better prepared educators should be to recruit, place, teach and counsel them.
Short-term Stress Management Programme with Acutely Depressed In-Patients
Authors: Stein Franklin , Smith Janet
Published: March 2013

A short-term stress management programme was carried out as a pilot study with seven acutely depressed in-patients. Various techniques in muscle relaxation and biofeedback were used in a six-session programme designed to decrease anxiety and to cope more effectively with stress. One occupational therapist served as a group facilitator and teacher of stress management techniques while a second occupational therapist served as the group recorder. During the one and a half hour sessions specific techniques were practised by the patients. These techniques included Benson ‘s Relaxation Response, visual imagery, Jacobson's Progressive Relaxation, heart rate and finger temperature biofeedback and behavioural rehearsal. A Stress Management Questionnaire, developed by the first author, was used to help the patients become more aware of the symptoms of stress, stressors that “trigger” symptoms and everyday activities that can be used to control stress. The State — Anxiety Scale was administered pre- and post-intervention to assess the reduction of anxiety. Results showed that there was a significant reduction in anxiety at the .05 level using a correlated t-test. Qualitative comments from the patients at the end of the stress management programme indicated that the sessions had a positive effect in increasing their ability to relax and in learning to recognize individual stress reactions as well as new alternatives to coping with stress.
An Occupational Therapy Medico-Legal Programme for Chronic Pain Patients
Authors: Potts Heather , Baptiste Sue
Published: March 2013

This paper describes the interview process, the assessments, report writing and potential giving of testimony involved in an occupational therapy medico-legal service for chronic pain patients which is provided for lawyers, insurance companies and other community agencies. The programme is available through the occupational therapy department at McMaster University Medical Centre of Chedoke-McMaster Hospitals, Hamilton, Ontario. The assessment process is delineated, including descriptions of the initial interview and functional assessment using both standardized and non-standardized tests, a self-monitoring diary, a home visit, a job site visit, and a work placement. Potential treatment recommendations are outlined. The content of the medico-legal report is examined utilizing personal experience and current literature and recommendations for testimony are explored.
Evaluation of Treatment in Occupational Therapy. Part 1. Methodology Issues in Conducting Clinical Trials
Authors: Law Mary , Cadman David , Rosenbaum Peter , Russell Dianne , DeMatteo Carol , Walter Stephen
Published: March 2013

The purpose of this paper is to discuss important methodological issues that must be considered in planning and implementing clinical evaluation research in occupational therapy. The experiences of the authors in conducting a multi-centre intervention trial are used to illustrate issues and decisions which can both enhance the scientific integrity of clinical research while maint a ining its feasibility.

Methodological issues include choice of research design, identification of significant confounding variables, subject selection and enrollment, incidence-prevalence bias, selection of appropriate and responsive outcome measures, maintenance of treatment consistency and compliance, and “masked” evaluation of outcomes. Attention to these issues will increase the methodological quality of occupational therapy evaluation research and improve the credibility of its results.
The Immigrant Client: Issues in Developing Culturally Sensitive Practice
Authors: Dyck Isabel
Published: March 2013

A new challenge to the client-centred approach of occupational therapy emerges as therapists consider how best to meet the needs of the culturally different client How culture is conceptualized carries considerable implication for the ways in which this challenge may be met. Occupational therapy literature is building a body of knowledge concerning the sociocultural implications of practice. Ethnographic studies in the social sciences, which emphasize the complexity of the relationship between culture, environment and health experiences, contribute to the further development of an understanding of the immigrant client, and provide direction for both clinical practice and research.
Occupational Performance Measures: A Review Based on the Guidelines for the Client-centred Practice of Occupational Therapy
Authors: Pollock Nancy , Baptiste Sue , Law Mary , McColl Mary Ann , Opzoomer Anne , Polatajko Helene
Published: March 2013

In 1987, Health and Welfare Canada and the Canadian Association of Occupational Therapists Task Force recommended that work go forward to develop an outcome measure for occupational therapy which reflects the Occupational Performance Model. The first step in this process was to review critically those outcome measures which assess occupational performance and that are currently available in the literature.

This paper will present the review process, describe in more detail eight assessments that fulfilled many of the review criteria, discuss the limitations of these measures using the “Guidelines for the Client-centred Practice of Occupational Therapy as the framework, and make recommendations for the development of a new outcome measure for use in occupational therapy.
Application of the Guidelines for Client-centred Practice to Paediatric Occupational Therapy
Authors: Stewart Debra , Harvey Susan
Published: March 2013

This paper outlines the process of incorporating the “Guidelines For the Client-Centred Practice of Occupational Therapy” into the practice of occupational therapy in an out-patient rehabilitation facility serving young people with physical disabilities. Specifically, the areas of practice addressed are screening and assessment.

The process started in 1987 with an identification of the need to find a holistic framework that meets the complex needs of clients with chronic physical disabilities. The conceptual model of occupational performance, as outlined in the Guidelines, provided such a framework.

The process of incorporating the Guidelines into the screening and assessment practices of occupational therapists at Erinoak Serving Young People With Physical Disabilities is described, with examples of documents developed by the department. Suggestions are given to integrate the conceptual model of occupational performance into the practice of occupational therapists working with children and adolescents with physical disabilities.
Operational Review: Beyond the Numbers Game
Authors: Chilton Heather
Published: March 2013

The first response to operational review is, traditionally, an examination of productivity indicators and a rationale for their defense. This paper describes the creative approach chosen by one hospital setting with specific reference to the occupational therapy department. The focus was placed on outcome for the child and productivity measurement. Results of the review for the occupational therapy department were positive and established a precedent for parts of the presentation when the review continuedthroughout the hospital. Occupational therapy managers are encouraged to become more innovative in the effective management of their departments, continuing to develop and build leadership skills for the future.
The Application of the Client-Centred Approach to School-Based Occupational Therapy Practice
Authors: Madill Helen , Tirrul-Jones Anu , Magill-Evans Joyce
Published: March 2013

The Guidelines for the Client-Centred Practice of Occupational Therapy (Department of National Health and Welfare and Canadian Association of Occupational Therapists, 1983) have been successfully applied to various institutional and community settings. However one of the most challenging appears to be the application to school-based practice. In this article the conceptual frame of reference and the practice stages in the occupational therapy process are directly applied to school settings. Philosophical differences are apparent and these are likely influencing the development of occupational therapy services in schools. A case study is used to illustrate some of the issues andthe preparation of guidelines for school-based occupational therapy services is recommended.
Occupational Therapy in Schools: Identifying Items for a Referral Instrument
Authors: Magill-Evans Joyce , Madill Helen
Published: March 2013

As the first step in developing an instrument for referring students to occupational therapy in schools, a survey of Canadian pediatric occupational therapists was conducted. Sixtysix behavioural items which covered daily living skills, psychosocial functioning, sensorimotor skills, cognition, and therapeutic adaptation were selected. Therapists rated each item on a four point scale which reflected the extent to which an item indicated a need for occupational therapy in a school setting. Useable responses were obtained from 192 therapists (response rate of 61.5%) who had an average of 6.5 years experience in pediatric occupational therapy, 39 of whom worked in integrated school settings. Over 70% of the therapists identified 31 items as often or always indicating a need for referral, none of which were in the psychosocial domain. Comparisons between therapists in different work settings revealed few significant differences. Implications for practice and future projects are discussed.
A Comparative Study of Visual Perceptual Skills in Normal Children and Children with Diplegic Cerebral Palsy
Authors: Reid Denise , Drake Susan
Published: March 2013

The conceptual notion that children's visual perceptual skills may develop independently of their motor skills was addressed in this study. Visual perceptual abilities were evaluated in a group of children with spastic diplegia cerebral palsy and a group of normal children using the Motor-Free Visual Perceptual Test (MVPT) (Colarusso & Hammill, 1972) and the Test of Visual-Perceptual Skills (TVPS) (Gardner, 1982). The results indicated that the disabled children attained significantly lower mean perceptual quotient and perceptual age scores on both tests than a group of normal children matched for age and sex. In addition, the performance of the disabled children showed significantly lower mean percentile ranks on the TVPS than the normal group. Finally, high correlations (based on the perceptual quotient and perceptual age scores) of the TVPS and the MVPT scores were computed for both groups. The results are discussed with implications for future research.
Proximal & Distal Upper Limb Motor Development in 24 Week Old Infants
Authors: McBryde Catherine , Ziviani Jenny
Published: March 2013

The developmental concept that the maturation of motor skills proceeds in a proximal to distal direction, and thatdistal movements emerge only after proximal movements have been established has come into question. Neurophysiological and developmental research has suggested that proximal and distal development occur simultaneously, under the influence of two independent neural systems. In order to clarify the questions raised by such opposing viewpoints, twenty-nine normal infants (15 girls, 14 boys), 24 weeks of age, were videotaped reachingfor and grasping a cube deposited in a form-board. The degree of proximal (reach) and distal (grasp) maturity was rated by two independent scorers usinga scale specifically designed for this purpose. Correlation between each rater's proximal and distal scores for each child, evidenced a positive linear relationship (r1 = 0.58, p > 0.001; r2 = 0.79, p > 0.001). It is hypothesised that these results may be indicative of the speed in which the neural centres responsible for proximal and distal function, myelinate and develop functional synapses. Thus, although proximal and distal motor skills mature sequentially, they may nonetheless be contingent upon the controlling influence of two separate neural systems. These findings have implications for occupational therapy treatment approaches.
Construct Validation of an Acute Care Occupational Therapy Cerebral Vascular Accident Assessment Tool
Authors: Van Deusen Julia , Shalik Linda , Harlowe Diane
Published: March 2013

This study was the last in a series of six investigations of the construct validity' of the St. Marys CVA evaluation, a clinician constructed test composed of items designed to evaluate sensory, perceptual, motor, and self care performance in cerebral vascular accident patients. Data for the present study were obtained from 250 new patients referred for occupational therapy services from 1983 to 1988. Factor analysis with varimax orthogonal rotation was per formed on 22 items of the evaluation including perception, recovery stages, measures of grasp and pinch strength and other functional variables. Three factors emerged — Right Function, Recovery Stage, and Left Hand Strength. The results of the study, combined with results of previous research, indicate that this CVA Evaluation has reasonable construct validity as an occupational therapy assessment tool in an acute care setting.
Mealtimes of the Institutionalized Elderly: A Literature Review
Authors: Ott Fred , Readman Tim , Backman Catherine
Published: March 2013

The absence of social interaction at mealtimes and lack of independence in feeding and eating among residents have been identified as problems requiring investigation in Vancouver General Hospital's Extended Care Unit. An extensive literature review was undertaken, to examine various factors that influence the nutritional intake of the elderly and to learn about intervention programmes which have been aimed at improving mealtime behaviour. The literature review identified growing concern about feeding and eating problems of the institutionalized elderly. The major factors influencing the nutritional intake of the elderly appear to be physical and perceptual disability, social support systems and the opportunity to socialize, and cultural influences. Intervention programmes aimed at improving mealtime behaviours have mainly fallen within the following categories: rehabilitative approach, alteration of physical environment, and behaviour modification using operant conditions. This literature review is preliminary to a research project investigating ways of improving the mealtime functioning of the institutionalized elderly.

Les problèmes suscités par l'absence d'interaction sociale au moment des repas, ainsi que le manque d'autonomie pour se nourrir et manger, chez les bénéficiaires de l'unité de soins prolongés du Vancouver General Hospital, ont été étudiés. Une analyse en profondeur des publications sur ce sujet a été entreprise pour examiner différents facteurs influençant l'apport nutritionnel chez la personne âgée et pour connaître les programmes d'intervention visant à améliorer les comportements entourant la prise des repas. L'analyse des publications démontre que la nutrition et l'alimentation constituent une préoccupation croissante chez la population âgée vivant en institution. Les principaux facteurs influençant l'apport nutritionnel chez la personne âgée et pour connaître les programmes d'intervention visant à améliorer les comportements entourant la prise des repas. L'analyse des publications démontre que la nutrition et l'alimentation constituent une préoccupation croissante chez la population âgée vivant en institution. Les principaux facteurs influençant l'apport nutritionnel des personnes âgées semblent provenir à la fois d'une incapacité physique et perceptuelle, du système de support social, des possibilités de socialiser et des influences culturelles. Les programmes d'intervention visant à améliorer les comportements concernant la prise des repas se répartissent surtout suivant les catégories suivantes, l'approche de réadaptation, la détérioration de l'environnementphysique et la modification du comportement par le conditionnement opérant. L'analyse des publications précède un projet de recherche portant sur les façons d'améliorer le fonctionnement entourant la prise des repas chez une population âgée en institution.
Interview Scores and Academic Grades as Selection Criteria for Admission to an Occupational Therapy Program
Authors: Posthuma Barbara , Noh Samuel
Published: March 2013

This paper investigates the relationship of previous academic performance and selection interview results to the academic and fieldwork performance of students during four years of study in Occupational Therapy. Only students who met the basic academic requirements of the occupational therapy department were included. Half of the students who were admitted were selected on the basis of highest academic grades and half were selected on the basis of highest interview scores. At the end of the academic program evaluations indicated no significant difference beween the two groups in terms of academic performance. Over the four years those students who were selected by high interview scores showed more improvement in fieldwork performance than students admitted only on the basis of previous academic grades. Students who had some previous university experience exhibited significantly greater improvement in fieldwork performance than those admitted directly from high school.
The Effects of Splinting on the Spastic Hemiplegic is Hand: Report of a Feasibility Study
Authors: Langlois Sylvia , Pederson Linda , MacKinnon Joyce R.
Published: March 2013

Hand splints are used by occupational therapists as a method of reducing the increased muscle tone of the upper extremity following stroke. However, the paucity of research and inconsistent findings examining the effects of splinting on spasticity has resulted in this technique being a controversial one. Many parameters of splinting need to be investigated, such as the type of splint, the duration of use, and wearing schedules. This feasibility study was conducted to pretest instruments and procedures investigating the effects of a finger spreader on the spastic musculature of the wrist and to examine trends in spasticity associated with variables, including a splint wearing schedule, expectations and satisfaction with the splint, and compliance.

Nine subjects were randomly assigned to three groups defined by wearing schedules of twenty-two, twelve, and six hours per day. The greatest change in the level of spasticity was noted in the group wearing the splint for twenty-two hours. However, this trend was not statistically significant. A statistically significant relationship was found between expectations of the splint and compliance to the wearing schedule. Satisfaction with the splint outcome and therapeutic interaction was also observed to have a statistically significant relationship with compliance. This indicates that the procedures and measures designed for this study are worth pursuing in future research.
Explanatory Models in Brain Injury Rehabilitation: An Aid to Communication with Family Caregivers
Authors: Krefting Laura
Published: March 2013

Explanatory models are cognitive models that persons with a disability, family members and rehabilitation professionals hold about an illness or disability episode. This paper presents the concept of explanatory models (EM) as a way of facilitating therapists' communication with family members of persons with acquired brain injury. To illustrate the concept, the findings of a descriptive study of EMs held by family caregivers of brain injured people are presented. The clinical implications of negotiating EMs with family caregivers are addressed.
The reliability and validity of a revised version of the Erhardt Developmental Prehension Assessment
Authors: Pollock Nancy , Law Mary , Jones Lynette
Published: March 2013

The Erhardt Developmental Prehension Assessment (EDPA) was designed as a measure of hand function for use with developmentally and physically disabled children. In this study the EDPA was revised (EDPA-R) by changing some of the test items, standardizing the procedures for administering the test and developing an objective scoring system. The inter-observer reliability of the EDPA-R, and the concurrent validity of the EDPA-R with the fine motor scale of the Peabody Developmental Motor Scales (PDMS) were evaluated. Thirty developmentally disabled children ranging in age from 3 to 18 months were tested in this study. The results indicate that the EDPA-R has high levels of inter-observer reliability, and that it has concurrent validity with the PDMS in this population. Further test revisions are necessary, however, to improve the EDPA-R's discriminative power.
Reality Orientation Thirty Years Later: Are We Still Confused?
Authors: Bowlby M. Carol
Published: March 2013

Reality Orientation (RO) intervention represents the first significant attempt at rehabilitation programming for the disoriented, institutionalized elderly. Early anecdotal accounts reported sweeping positive effects. A first sign of hope for this severely disabled population, RO rapidly became widely implemented and continues to be a commonly accepted approach by numerous disciplines. However, careful examination of the research and clinical practice literature reveals many difficulties with the conventional RO classroom programme. Reliable research is limited and weakly supports a modest, temporary gain in verbal orientation after involvement in conventional classroom RO. The actual significance of these gains for these severely disabled elderly persons and their caregivers is doubtful. Although not yet clearly articulated, other approaches (eg. sensory stimulation, environmental manipulation) and a reformulation of RO itself are showing promise of effecting a broader range of functional behaviours (eg. self-feeding). Orientation information presented for reassurance, not re-articulation, is proving to be both more nurturing for clients and more clinically significant.
Visual Perceptual and Visual Motor Performance in Children with Psychiatric Disorders
Authors: Daniels Linda E. , Ryley Carol
Published: March 2013

We examined the incidence of visual-perceptual and visual-motor deficits in children with psychiatric disorders. A retrospective chart review was performed for 25 subjects, 21 boys and 4 girls, to whom both the Test of Visual Perceptual Skills (Non-Motor)(TVPS), (Gardner, 1982) and the Test of Visual Motor Skills (TVMS), (Gardner, 1986) had been administered. Analysis of the data indicated that the TVMS scores were significantly lower than the TVPS scores. The findings suggested that clinicians should assess visual perception and visual motor performance as separate functions. The need for longitudinal research investigating the effects of age and attention on test results was discussed.
The Environment: A Focus for Occupational Therapy
Authors: Law Mary
Published: March 2013

Individuals in Canada with a disability encounter environmental constraints that limit their active participation in the daily life of our communities. Fundamental inequities in participation and integration continue to exist and there is a need for a concerted effort to eliminate these disabling environments. Several factors, including the built environment, societal production of space, classification of individuals based on norms, the perception of disability as deviance, the power of health disciplines and bureaucracy are examined to determine their contribution to the creation of these disabling environments. Recent modifications to occupational therapy theory and practice, while meaningful, have not fully explored ways in which disabling environments limit occupation. Prevailing ideas about occupation and the environment are examined for their contribution to solving these environmental problems. Principles which can assist occupational therapy intervention directed at changing disabling environments are described. The intent is to define methods of changing disabling environments, based on the desires and active participation of people with disabilities.
Faculty Recruitment: Where are the Applicants?
Authors: Posthuma Barbara , Noh Samuel
Published: March 2013

This paper investigates the interest, perceptions and attitudes of occupational therapists towards academic positions. An 18 item questionnaire was mailed to 300 occupational therapists, randomly selected on a proportional basis from each province. The 192 responses (64%) received indicated that loss of patient contact and perceived lack of qualifications were the prime deterrents of active interest in academic positions. Other deterrents were personal commitments (children, husband's work, disinterest in relocation) and perceived stress in faculty positions. Academic appointments were most appealing to therapists under 40 years of age, therapists with graduate degrees, and therapists involved in academic studies.
A Sensory Integrative Approach for Children with Hearing Impairment: A case Study
Authors: Schaffer-Pullan Anne , Polatajko Helene J. , Sansom Lynn
Published: March 2013

The purpose of this paper is to demonstrate the potential use of a sensory integrative (SI) treatment approach in the treatment of hearing-impaired children with vestibular deficits. The association between falling, hearing impairment and vestibular dysfunction is discussed. A case study using SI with a hearing-impaired child is presented. The resultsof this preliminary investigation suggest that sensory integrative treatment may be useful in promoting compensation in hearing-impaired children with vestibular dysfunction.
Evaluation of Social Skills: A Survey of Current Practice
Authors: Doble Susan E. , Bonnell Jeanne E. , Magill-Evans Joyce
Published: March 2013

Occupational therapists in the Atlantic Region were surveyed to identify their perceptions of the importance of evaluating social skills in their practice, and to determine how they evaluate clients' social skills. Although 79% indicated that social skills evaluations were relevant, the majority reported that clinical observations were used almost exclusively for assessment. Only 29% of the respondents reported using any formal evaluation of social skills. According to the respondents, the evaluation process was hampered by their limited knowledge of available evaluation tools, limited access to social skills models, and insufficient time. These results indicate that therapists' knowledge of existing evaluation tools must be increased. Development of a theoretical model that will enable therapists to define social skills and relate clients' social skills to their occupational performance will also facilitate the evaluation process. As a consequence, therapists' evaluation of clients' social skills will be more efficient.
Independent Living and the Physical Environment: Aspects that Matter to Residents
Authors: Cooper Barbara Acheson , Hasselkus Betty Risteen
Published: March 2013

Field interviews were conducted with seven clients with disabilities for the purpose of developing design guidelines for apartments suitable for independent living. Analysis of these data generated six factors that were highly valued and felt to contribute to the success of these individuals' venture into community living. Control appears to be the central construct and to subsume the other concepts: safety/security, accessibility/mobility, function, flexibility and privacy. These findings are presented and discussed here as a working model of environmental control. These ideas are suggested as hypotheses which would need to be tested and refined further before being used as a model to guide clinical interventions.
The Manpower Shortage in Occupational Therapy: Implications for Ontario
Authors: Salvatori Penny , Williams Renee , Polatajko Helene , Mackinnon Joyce
Published: March 2013

A consistently increasing imbalance between the supply of and demand for occupational therapists has led to a critical manpower shortage in occupational therapy. Based on a review of various government reports and related literature, this paper provides an overview of the extent of this manpower problem, identifies factors affecting retention and attrition of occupational therapists and discusses strategies to improve retention and reduce attrition. To address the supply-demand imbalance, recommendations in relation to education, employment, immigration and service delivery for the occupational therapy profession in Ontario are proposed.
Le jeu en ergothérapie: Réflexion préalable à l'élaboration d'un nouveau modèle de pratique
Authors: Ferland Francine
Published: March 2013

Cet article sur le jeu en ergothérapie auprès de l'enfant ayant une déficience physique, s'inscrit dans une réflexion préalable à l'élaboration d'un nouveau modèle de pratique. Après avoir exploré l'importance du jeu dans la vie de l'enfant normal et questionné sa présence dans celle de l'enfant présentant une déficience physique, une définition du jeu est proposée. La place du jeu en ergothérapie est alors considérée. La discussion aborde deux thèmes: l'analyse de ce domaine occupationnel en regard de la philosophie de l'ergothérapie et les éléments à considérer pour l'élaboration d'un nouveau modèle de pratique conçu pour l'enfant avec déficience physique.
Naming and Framing Occupational Therapy: A Lecture Dedicated to the Life of Nancy B.
Authors: Polatajko Helene J.
Published: March 2013

The case of Nancy B. is testimony to the importance of occupation to living and hence the importance of occupational therapy. Yet the importance of the discipline is poorly recognized. It is argued that the failure of occupational therapy to gain wide recognition is due to a problem in communicating its importance simply, easily and clearly and that the discipline needs to be named and framed in positive and powerful terms. The values on which to base this naming and framing are articulated. Based on the Occupational Therapy Values Statement, it is proposed that the discipline be framed in an Enablement Model and that, accordingly, occupational therapy be described as the discipline concerned with enabling occupational competence guided by an understanding of the individual, the environment and their interaction in determining occupational competence.
A Post-Discharge Study on the Use of Assistive Devices
Authors: Finlayson Marcia , Havixbeck Kim
Published: March 2013

Through this study of a heterogeneous patient population, the prescription and distribution of assistive devices was found to be a beneficial occupational therapy intervention. Although 97% of patients were satisfied with the education provided during occupational therapy intervention, it was discovered that more time is required to practice tub transfers, as well as to fully explain to patients the benefits of sock-aids. The need for further longitudinally based research in the use of assistive devices is recognized.
Assessment of Hand Function: The Relationship between Pegboard Dexterity and Applied Dexterity
Authors: Backman Catherine , Gibson Stacy Cork Deborah , Parsons Joy
Published: March 2013

The relationship between pegboard dexterity and applied dexterity was investigated by examining performance on the Nine-Hole Pegboard Test and on functional tasks from the Applied Dexterity section of the Arthritis Hand Function Test. Subjects were 395 adult volunteers aged 20–79 years, stratified by age and gender. Significant correlation coefficients were obtained for pegboard dexterity and applied dexterity at p < .01 for the sample as a whole. However, when the sample was examined by age groups, no significant relationships were found for the 20–29 years group. Pegboard tests are quick and inexpensive assessment tools, but if they have no relationship to the functional use of the hands they may be of questionable value. The results of this study suggest that the Nine-Hole Pegboard Test may be a useful screening device for detecting hand dysfunction related to dexterity.
A Survey of Workload Measurement Systems: The Occupational Therapy Manager's Perspective
Authors: Scott Elizabeth , Cockerill Rhonda , Wright Maureen , Pallas Linda L. O'brien
Published: March 2013

Interest in measuring workload for budget specific purposes has increased in recent years as health care managers are being forced to cope with the demands of cost containment and fiscal accountability. This paper reports on a survey of senior occupational therapy managers of Ontario facilities accredited by the Canadian Association of Occupational Therapists (CAOT). Respondents were surveyed on their experiences with, and attitudes toward, occupational therapy workload measurement systems and the ability of these systems to assist in management activities. The survey found that most departments were using the National Hospital Productivity Improvement Program (NHPIP) system. Seventy eight percent of managers indicated they were somewhat or very satisfied with the system, but 60% also indicated that it did not adequately meet all of their management needs. In terms of desirable features of a revised workload system, 87% of managers reported wanting a system based on diagnostic or case mix group recording. Client variables (91%), physical and psychosocial aspects of client care (89%) and therapist variables (85%) were also rated as important factors to address in developing new workload systems.
Surviving the Management Game: Workload Measurement Systems in a Cost-Conscious Environment
Authors: Wright Maureen , Scott Elizabeth , Cockerill Rhonda
Published: March 2013

Using a procedure-based occupational therapy workload measurement system developed at, and applied by, Sunnybrook Health Science Centre, this paper explores the objectives of such a system from the point of view of the occupational therapy manager. It also takes into account the synergistic relationship between the occupational therapist and the administrative/business aspect of health care, paying special attention to past and present trends in health-care accountability.

In this paper it is argued that occupational therapy managers must relate their procedures and overhead costs to actual client care, if they are to be included in programme management and client costing. The process used by occupational therapy to describe its own procedures for the system is outlined. The system was then developed in conjunction with other institutional, financial and management tools for the client cost conversion process. By using a procedure based workload measurement system, occupational therapy is able to accurately describe client costing, thereby articulating our role in client care.
Health Promotion, Occupational Therapy and Multiculturallsm: Lessons from Research
Authors: Dyck Isabel
Published: March 2013

Principles of occupational therapy practice make the profession an important potential partner in health promotion initiatives for immigrant groups. Health promotion embodies the principles of self-definition of health needs by target groups, and working with a community in initiating and supporting programmes. This paper discusses the implications of an exploratory study of the daily activities of immigrant Indo-Canadian mothers for translating health promotion principles into practice. The research process and an analysis of interviews conducted with the women suggest factors to consider in using a health promotion framework with immigrants who have experienced social and economic dislocation through the immigration process. Discussion of household structure, divisions of labour, childcare strategies, and parenting concerns raises issues requiring particular attention in sharing occupational therapy skills and knowledge with ethnocultural communities.
Occupational Therapy's Social Vision
Authors: Townsend Elizabeth
Published: March 2013

Occupational therapy has tremendous, unfulfilled potential. The lecture critically analyzes that potential in light of occupational therapy's social vision. The analysis is built on emerging views of occupational therapy's core philosophy of client-centred practice using the ordinary occupations of daily life as a form of therapy. Critical analysis shows that foundational features of occupational therapy are consistent with foundational features of social justice. However, analysis also shows that occupational therapy's social vision is narrowed to comply with dominant community, managerial and medical approaches to disability and aging. Given therapists' good intentions, critical analysis is unnerving, but it provides a guide for transforming practice and developing occupational therapy's potential.
Clinical Programme Management: A Model of Promise?
Authors: Baptiste Sue
Published: March 2013

As professionals working within a rapidly changing health care environment, it becomes critical to recognize alternatives for the management of clinical services to maximize the use of resources. However, it is also critical to remain constantly aware of the needs of valued and valuable employees, ensuring that the quality of working life is considered whenever any decisions are being made which will affect the work place.

This paper reviews some of the literature related to decentralized structural models for health care institutions, and details the selection and implementation of one model in a major teaching hospital. The process of development from the initial idea through to the actual operationalization of a clinical programme management model is outlined, providing a critique of strengths and weaknesses of the model in the context of this particular organization.
Managing Diverse Occupational Therapy Resources in a Creative, Corporate Model
Authors: Baptiste Sue
Published: March 2013

Two occupational therapy departments were amalgamated into a corporate whole and charged with the development of a workable, corporate structure. The departmental model which was developed served to enhance the concepts of quality of working life, employee autonomy, management team and quality circle theory. This paper provides a background from business and organizational literature, and outlines the development of the departmental model, in concert with the adoption of the client-centred model of occupational performance as a department basis for practice. This development was taking place concurrently with larger, institutional changes into a decentralized clinical programme management model. Discussion highlights the level of staff satisfaction with the changes, areas of concern during the development of the system and plans for the future growth.

During this period of massive and critical change in the delivery of health care services, there has been a trend in restructuring health care institutions towards decentralized models. This paper will describe the experience of one occupational therapy department in developing an innovative departmental structure involving participatory management amalgamation. It is believed that the experience of the past occupational therapy work units with one viable option for a renewed management model. Staff skill sets can be maximized and optimal potential realized while faced with inevitable resource shrinkage and service reorganization.
Occupational Therapists Chart a Course through the Health Record
Authors: Fearing Virginia G.
Published: March 2013

The absence of clear and practical guidelines for documenting on the health record often makes charting a disorganized and unsatisfying experience for occupational therapists. Like the health record, the occupational therapy process is structured to reflect a problem solving process that promotes clinical reasoning. The model described in this paper was developed to reflect the occupational therapy process as identified in the Occupational Therapy Guidelines for Client-centred Practice and proposes an additional section on problem naming. It is viewed as an open loop through which the client may move one or more times while learning to cope with change until enough momentum is gathered to move into adaptation. Emphasis is placed on naming and validating each problem with the client, and negotiating responsibilities and expected outcomes. This feedback loop summarizes the steps required to practice occupational therapy from a client-centred stance. Occupational therapists who develop competence in using this model, chart in an organized, client-centred, and therefore more satisfying manner.
La subluxation de l'épaule de la personne hémipléglque: Une recension des écrlts sur les déflclences et les incapacltés assoclées
Authors: Durand Marie-José , Dutil Elisabeth
Published: March 2013

La subluxation de l'épaule de la personne hémiplégique est une complication fréquemment rencontrée en réadaptation. L'ergothérapeute intervient quotidiennement par différentes stratégies pour la prévenir et la réduire. Jusqu'à récemment la subluxation était surtout considérée comme une simple complication orthopédique. Depuis quelques années, les recherches se sOnt diversifiées. La subluxation est étudiée en, fonction d'un ensemble de variables qui préoccupent l'ergothérapeute telles que la récupération motrice, la douleur, le statut fonctionnel et la qualité de vie. Afin d'actualiser les connaissances des clinicien-ne-s ou chercheur-e-s sur cette problématique, une analyse en profondeur de la littérature a été réalisée.
L'apprentissage expérientiel: Un modèle éducotif à Intégrer au processus ergothéraplque
Authors: Tremblay Manon , Chevrier Jacques
Published: March 2013

Le rôle d'éducateur est reconnu comme l'un des rôles de l'ergothérapeute. Cependant, dans la pratique, peu de modèles éducatifs semblent être utilisés. L'apprentissage expérientiel en tant que modèle éducatif paraît intéressant et pourrait enrichir certains types d'interventions ergotherapiques. Cet article a trois objectifs: a) définir la dimension éducation/ apprentissage dans la relation ergothérapique, b) présenter trois modèles d'apprentissage expérientiel, ceux de Kolb, de Pfeiffer et Ballew et de Walter et Marks, c) discuter des applications possibles de cette approche éducative en ergothérapie, de son cadre conceptuel jusqu'à son application clinique.
Analyse descriptive du comportement ludique d'enfants ayant une déficience physique et fréquentant la garderie
Authors: Simard Linda , Ferland Francine , Gilbert Monica O'Neill
Published: March 2013

Depuis toujours, les ergothérapeutes qui travaillent auprès des enfants ont recours à des activités de jeu comme ressources thérapeutiques. Afin de décrire le comportement ludique de l'enfant avec une déficience physique et de préciser certaines caractéristiques de son jeu, une recherche exploratoire a été menée au domicile et à la garderie auprès de 20 enfants, âgés de 3 à 5 ans, présentant une déficience physique. Pour ce faire, la Grille d'observation du jeu chez l'enfant d'âge préscolaire (Preschool Play Scale) et une adaptation de l'Historique du jeu (Play History) ont été utilisées. Les résultats obtenus permettent de retracer la séquence de développement du jeu de l'enfant présentant une déficience physique et d'analyser l'écart entre son âge chronologique et son âge de jeu.
Spirituality, Daily Practice, and the Occupational Performance Model
Authors: Urbanowski Reg , Vargo James
Published: March 2013

This article discusses spirituality as an integral component of the occupational performance model. Spirituality is defined as the experience of meaning in everyday life activities. Some of the difficulties commonly encountered in operationalizing the concept of spirituality are discussed. Strategies built on minimizing or eliminating some of the difficulties are reviewed. The recommendations for practising therapists encompass suggestions for assessment, goal setting, and practice.