bluuebunny/crossref_metadata_2025 huggingface dataset:
Living in a Glasshouse: Exploring Occupational Alienation
Authors: Bryant Wendy , Craik Christine , McKay Elizabeth A.
Published: March 2013

Background. Community mental health care has shifted focus from resettlement to empowerment, reflecting a wider agenda for social inclusion. Purpose. This study evaluated mental health day services from the perspectives of thirty-nine clients. Method. Data analysis of the four focus groups explored the implications for occupational therapy. The data collected were subjected to constant comparative analysis and theoretical sampling. Results. Participants described how mental health day services structured their day and enabled access to support networks. However, many perceived aspects of the services as fostering their dependence and threatening sessions they valued. This dependency led to them feeling alienated and wishing to seek greater influence over decisions about their current and future life. The concept of occupational alienation was used to further interpret their situation. Practice Implications. Occupational therapy could overcome occupational alienation experienced by mental health day service clients, through the development of services within and beyond day services which promote a sense of belonging and offers meaningful occupation.
Dimensions of Meaning in the Occupations of Daily Life
Authors: Hammell Karen Whalley
Published: March 2013

Background. According to the existential philosophers, meaning, purpose and choice are necessary for quality of life. Qualitative researchers exploring the perspectives of people who have experienced health crises have also identified the need for meaning, purpose and choice following life disruptions. Although espousing the importance of meaning in occupation, occupational therapy theory has been primarily preoccupied with purposeful occupations and thus appears inadequate to address issues of meaning within people's lives. Purpose. This paper proposes that the fundamental orientation of occupational therapy should be the contributions that occupation makes to meaning in people's lives, furthering the suggestion that occupation might be viewed as comprising dimensions of meaning: doing, being, belonging and becoming. Drawing upon perspectives and research from philosophers, social scientists and occupational therapists, this paper will argue for a renewed understanding of occupation in terms of dimensions of meaning rather than as divisible activities of self-care, productivity and leisure. Practice implications. Focusing on meaningful, rather than purposeful occupations more closely aligns the profession with its espoused aspiration to enable the enhancement of quality of life.
Facilitating Client-Centred Practice: Insights from Clients
Authors: Sumsion Thelma
Published: March 2013

Background. This paper adds to the established importance of client-centred practice in mental health programs by reporting on the outcome of client interviews in one community setting in England. Purpose. The purpose of these interviews was to determine the opportunities for, and barriers to, the application of a definition of client-centred practice. Methods. Purposive sampling was used to obtain 9 clients who participated in structured interviews. A combination of methods, including template analysis and the editing approach, were employed to determine themes and sub themes that are presented within the context of the clients' reasons for attending these programs. Results. These themes included initiating client-centred practice with the sub themes of providing information to enable choice, participate in negotiating goals, overcoming fear and the severity of illness. Other themes related to the therapist's response to the client's illness and the clients knowledge about client-centred practice. Practice Implications. It was clear from these interviews that client-centred practice was important to this group of clients and there were both opportunities and barriers to be considered by therapists.
The Influence of Virtual Reality Play on Children'S Motivation
Authors: Harris Kristan , Reid Denise
Published: March 2013

Purpose. This study explored the degree of motivation children exhibit during virtual reality (VR) play sessions. Method. Sixteen children with cerebral palsy aged 8 to 12 years participated. They were observed during a variety of VR environments that were video recorded. The Pediatric Volitional Questionnaire (PVQ) was used to measure children's motivation. The PVQ provides insights into children's inner motives as well as how the virtual environment enhances or attenuates children's motives. Nine VR environments were randomly selected to score with the PVQ. Results. Data were analyzed and descriptive statistics were calculated for modes and medians of total volition scores for each VR environment. Different environments produced varying levels of volitional behaviour. The features of environments that produced higher levels of volition included challenge, variability and competition. Practice Implications. The overall volitional scores of children with cerebral palsy in the current study indicate that VR play is a motivating activity and thus has potential as a successful intervention tool.
Cognitive Strategy Generation in Children with Developmental Coordination Disorder
Authors: Sangster Claire A. , Beninger Claire , Polatajko Helene J. , Mandich Angela
Published: March 2013

Background. Developmental coordination disorder (DCD) is a condition of impaired quality of movement and occupational performance. It has been hypothesized that the difficulties experienced by children with DCD may in part be due to an impaired ability to use cognitive strategies to solve occupational performance problems. Cognitive Orientation to daily Occupational Performance (CO-OP) is a verbally-based approach to helping children remediate this difficulty. The current pilot study investigated the use of cognitive strategies in children with DCD to determine whether cognitive strategy use is improved by CO-OP. Methods. Observations of video-recorded sessions of 18 school-aged children were scored for frequency and type of cognitive strategies used. Results. Differences within and between groups revealed changes in the types and frequency of cognitive strategies. Clinical Implications. The results of the present study support the use of a cognitively-based approach such as CO-OP in assisting children with DCD in developing cognitive strategies when solving occupational performance problems. However, further research using a larger sample is necessary to fully explore the impact of CO-OP on the strategy use of children with DCD.
Reliability and Validity of the Safety Assessment Scale for People with Dementia Living at Home
Authors: de Courval Louise Poulin , Gélinas Isabelle , Gauthier Serge , Gayton David , Liu Lili , Rossignol Michel , Sampalis John , Dastoor Dolly
Published: March 2013

Background. With the recent funding changes in health care services, more seniors with dementia are cared for in their homes and the nature of their condition puts them at higher risk for accidents and injuries. Purpose. The Safety Assessment Scale (SAS) was developed for use by community healthcare providers to evaluate and lower the risk of accidents, provide recommendations to family caregivers and enhance case management. Method. The scale was assessed in terms of the reliability as well as content, criterion and construct validity with 176 community-residing people with dementia in Quebec, Alberta and British Columbia. The Safety Assessment Scale was validated in French and English. Results. The SAS demonstrated an excellent test-retest (ICC=.91) and inter-rater (ICC=.88) reliability. Results for validity were also extremely good. Practice Implications. The scale is available in French and English. The short version of the SAS is a screening tool and the longer version provides an in-depth evaluation of safety and intervention planning. The SAS can be used by a variety of health care professionals who work with individuals who have dementia.
Relationships between Occupational Factors and Health and Well-Being in Individuals with Persistent Mental Illness Living in the Community
Authors: Eklund Mona , Leufstadius Christel
Published: March 2013

Purpose. This study identified relationships between occupational factors and health and well-being among individuals with persistent mental illness. Methods. There were 103 subjects assessed in regards to time spent in different occupations, activity level, satisfaction with daily occupations, and experienced occupational value. The health-related variables were self-rated health, quality of life, self-esteem, sense of coherence, self-mastery, psychosocial functioning, and psychiatric symptoms. Results. Subjective perceptions of occupational performance were consistently related to both self-rated and interviewer-rated aspects of health and functioning. While variables pertaining to actual doing showed weak or no associations with self-rated health-related variables, they exhibited moderate relationships to interviewer-rated health and functioning. Implications. The health-promoting ingredients in occupations were determined by the way occupations were perceived, rather than the doing per se. The findings indicate that perceived meaning and satisfaction ought to be prioritized when setting goals in occupational therapy practice, and, besides, that existing occupational therapy theory needs to be updated.
Comparing the Disability Creation Process and International Classification of Functioning, Disability and Health Models
Authors: Levasseur Mélanie , Desrosiers Johanne , Tribble Denise St-Cyr
Published: March 2013

Background. The conceptualisation of participation is important for both clinicians and researchers. Purpose. Analyse and compare two conceptual models, the Disability Creation Process (DCP) and the International Classification of Functioning, Disability and Health (ICF), with particular emphasis on the participation component. Method. Conceptual comparative analysis of the DCP and ICF models focused on participation. Results. We found more differences than similarities between the DCP and ICF models. Similarities concerned approaches, objectives, elements of the models' components, and, to some extent, the participation component itself. Differences were mainly in the underlying models, conceptualisation of components including participation, and the measurement tools of participation. Practice Implications. Based on the results of this conceptual comparison, occupational therapists working in clinical and research settings are encouraged to consider using the DCP, which is an excellent model to choose in regard to participation. Empirical studies are still needed to clarify the concept of participation.
Giving Youth a Voice (GYV): A Measure of Youths' Perceptions of the Client-Centredness of Rehabilitation Services
Authors: Gan Caron , Campbell Kent A. , Snider Andrea , Cohen Susan , Hubbard Janine
Published: March 2013

Background. Although client-centred care is regarded as the optimum way of delivering health care, there is currently no method to measure the client-centredness of services for youth with disabilities.Purpose. To develop a measure of youths' perceptions of the client-centredness of health care services in rehabilitation.Methods. The Giving Youth a Voice (GYV) questionnaire was adapted from the Measure of Processes of Care, a measure of caregiving from the perspective of parents. Items for a youth version of the questionnaire were generated from focus groups with youths who had received rehabilitation services. Content analysis of the groups yielded four themes, which became the subscales for the new measure.Findings. GYV, a 56-item measure, has good internal reliability and test-retest reliability. Convergent validity was estimated through correlations with the Client Satisfaction Questionnaire.Implications. GYV provides an opportunity for youth with disabilities to have a voice about the rehabilitation services they receive.
The Wheelchair Procurement Process: Perspectives of Clients and Prescribers
Authors: Mortenson W. Ben , Miller William C.
Published: March 2013

Background. Increasing choices in assistive technology have made the process of procuring a wheelchair more complex and challenging. Purpose. To explore the intricacies of the procurement process from the perspectives of clients and therapists. Methods. Thirty-four participants were interviewed, including 13 wheelchair prescribers, 14 wheelchair users, and 7 wheelchair associates (family members and caregivers). Findings. Analysis revealed five main themes. “Who decides? ” described varying degrees of client involvement in the procurement process. “Expert knowledge” reflected the expert knowledge that all parties possessed. “Form versus function” captured the primary and, at times, conflicting outcomes that participants wanted to achieve. “Fitting in” depicted the environmental factors that affected wheelchair procurement. “(Re)solutions” illustrated strategies that participants felt improved the process. Implications. This study reveals clients' experiences with wheelchair procurement, identifies potential issues therapists may encounter, and suggests possible remedies they might consider when prescribing wheelchairs within a client-centred framework.
Validity of predischarge measures for predicting time to harm in older adults
Authors: Douglas Alison M. , Letts Lori J. , Richardson Julie A. , Eva Kevin W.
Published: March 2013

Background.

Concern is often expressed about the ability of persons with cognitive impairment to manage safely after discharge home from hospital. Measures validated for predicting safety are required.

Purpose.

The purpose of this study was to determine whether two predischarge functional measures were valid for predicting time to incident of harm after discharge.

Method.

Participants ( n = 47) were recruited from an inpatient rehabilitation unit. The Assessment of Motor and Process Skills (AMPS) and Cognitive Performance Test (CPT) were administered in hospital. Incident-of-harm outcome was measured by caregiver telephone questionnaire monthly for 6 months.

Findings.

Compared with all independent variables, AMPS Process scale was the best single predictor of time to incident of harm ( p = .01). CPT had a high specificity (91%) for identifying persons who did not have harm.

Implications.

Both AMPS and CPT demonstrated predictive validity for harm outcome over less predictive variables, such as comorbidities and activities-of-daily-living burden of care.
Le Retour Des Symboles Dans Un Cas De Readmission
Authors: Eevai Marie
Published: March 2013

The symbols are a means to express the patient's conflicts. In a psychotic stage they are able to reach a depth where normally only artists can get. But while the artist explores voluntarily those deep feelings, the patient is forced by his illness to plunge into his unconscious, tortured all the time that he might not be able to find his way back to reality.

We tried to demonstrate how the conflicts of a patient can be expressed by symbols. During this process the patient's personal symbols, related to his own individual case, get a plastic expression. If after many years the conflict is still not solved, it can evoke the same symbols expressed through a series of new pictures.

The symbols used by the patients may be found in the plastic art of different civilizations. Thus we can conclude that the personal symbols are related to the archetypes of the collective unconscious.
Death — A Topic for Occupational Therapy Curricula
Authors: Bridle Mary
Published: March 2013

This paper proposes that health professionals are negligent in meeting the needs of terminally ill patients because they feel afraid and inadequate when faced with death. It is suggested that occupational therapists should receive some education in this subject and a course of instruction is described. The results of a cross-Canada survey to establish the extent to which death and the dying patient is included in occupational therapy curricula are presented.
Groupe avec Vieillards Régressifs
Authors: Valade Ginette
Published: March 2013

Cet article décrit une expérience en milieu gériatrique psychiatrique chronique, avec un groupe fermé de six vieillards. Cette expérience se situe en mai-juin 75, lors d'un internat en psychiatrie et a été faite á l'Hôpital des Vétérans de Ste-Anne-de-Bellevue. Ces groupes avaient comme principal but d'améliorer la mémoire des patients. Tout au long de cet article, vous seront présentées les différentes activités de groupe qui ont eu lieu, les buts spécifiques recherchés, le déroulement des sessions ainsi qu'un bref aperçu des changements survenus au cours des sessions chez les patients. Ces groupes sont centrés, en général, sur l'expression verbale par l'utilisation de jeux thérapeutiques en groupe. Les buts de cette expérience ont été atteints. Les patients du groupe ont montré une amélioration de leur mémoire et se situaient mieux dans le temps et l'espace.
Rood-based Program for Decreasing Pre-feeding Behaviours
Authors: Loiselle Cécile
Published: March 2013

This article presents a review and organization of Margaret S. Rood's principles of neurophysiological intervention as related to the pre-feeding behaviours of tongue thrust, drooling, and gag reflex hypersensitivity in cerebral palsied children. General principles discussed include: functional divisions of the nervous system, combined effects of the primitive reflexes, and developmental sequence patterns.

Treatment aims for the pre-feeding behaviours are derived from their neurophysiological pathology as described in the literature. The author attempts to interpret the limited and confusing literature on the subject and uses it as a base in choosing sensory and proprioceptive techniques to meet the outlined treatment aims.

A follow-up article by this author describes a study which evaluated the treatment program detailed here. (Part II)
De nouveaux débouchés via le stage communautaire
Authors: Poirier Françoise
Published: March 2013

Cet article a pour objet de décrire les objectifs et les avantages d'un stage de formation clinique en milieu communautaire pour l'étudiant en ergothérapie. Depuis 1975, l'École de réadaptation de l'Université Laval offre des stages communautaires dans son curriculum régulier.
References to Occupational Therapy in Popular Literature
Authors: Gill Thelma
Published: March 2013

This article contains an account of references to occupational therapy as they occur in five works of popular literature. These works are On Death and Dying, by E. Kubler-Ross; The Cracker Factory, by J. Rebeta-Burditt; One Flew Over the Cuckoo's Nest, by K. Kesey; I Never Promised You a Rose Garden, by H. Green and Beyond All Reason, by M. Coate. The author does not attempt to discuss the validity of these accounts, but rather presents them as indicators of a type of publicity which has been given to the profession of occupational therapy.
Trends in Lower Limb Splinting by Canadian Occupational and Physical Therapists
Authors: McKee Patricia R. , Brintnell E. Sharon
Published: March 2013

This article highlights the results of a survey which examined the distribution of lower limb splinting practices in selected occupational and physical therapy departments located in the same hospital, in January, 1977.

The responses yielded information on 72 (84%) of the 86 hospitals surveyed. The compiled data, therefore, provided a good indication of the distribution of the splinting practices for the two groups in question and represented a comprehensive collection of lower extremity splinting techniques by these professions.

The survey indicated that:

Both the occupational and physical therapy departments were involved in lower limb splinting; the former group, however, was more than twice as active as the latter. Occupational therapists were using low temperature thermoplastics almost exclusively, whereas physical therapists preferred plaster of paris. Many new techniques have been developed but few have been documented in occupational and physical therapy journals.

The implications of the study are that occupational therapists should make a greater effort to share current and newly-developed techniques through publications and should strive to maximize the quality and performance of their splints.
Programming to Meet the Needs of the Elderly in Institutions Part II
Authors: Burton Jean E.
Published: March 2013

This paper explores the principles of humanistic psychology and their application in the care of elderly institutionalized people. Activities already used by occupational therapists which can enhance the self-actualization process are described and other activities which could be incorporated into activity programs are suggested. The influence of staff attitudes on residents' well-being is a vital factor in geriatric care and must be taken into account in any form of programming.
Functional Reeducation and Electromyographic Evaluation of Left Handwriting in Right Hemiplegic Patients: A Pilot Study
Authors: Harvey Gilles , Simard Thérèse
Published: March 2013

The purpose of this study was to develop a new methodology for left handwriting reeducation. This method, evaluated by electromyography, was applied to right hemiplegic patients. The methodology included specific exercises for the rehabilitation of left upper limb motor skills. A training period of 4 weeks was divided into three steps: pre-writing, writing and post-writing. In order to evaluate progress and patient motor skills, both qualitative and quantitative graphic and electromyographic observations were used. At the end of the training period, all patients could write with legibility, regular speed and ease. It seems that with this new approach right hemiplegic patients can learn to write as a left-hander under specific selection and training conditions.
A Life Skills Program for Physically Disabled Adolescents
Authors: Bell Christine , Quintal Janet
Published: March 2013

Successful management of one's life involves the ability to solve problems, set realistic goals, make and evaluate decisions, and utilize personal and interpersonal skills. Adolescence is that time during which individuals are expected to develop these “life skills' that will enable them to cope effectively with the demands of daily living. Due to many factors, physically disabled adolescents frequently experience delay and difficulty in mastering the developmental tasks of this period. Formalized training in life skills is one approach that has the potential to equip these young people with the skills and strategies needed for adult independence. This paper describes the unique stresses of adolescence as experienced by the physically disabled population and the development of a Life Skills Program at the Hugh MacMillan Medical Centre designed to address some of these issues.
Current Supply and Future Requirements for Occupational Therapy Manpower in British Columbia
Authors: MacKinnon Joyce R.
Published: March 2013

This paper reports the results of a survey conducted to study the current supply and future manpower requirements in occupational therapy (OT). The purpose of this study was to obtain data relating to the current supply of OTs, their geographic distribution, facilities' future requirements for OTs, solutions related to the projected manpower shortage and the reasons some potential employers do not hire OTs, Implications of the findings are discussed.
Le Tableau d'activités de la vie quotidienne: Un outil de communication
Authors: Geoffroy Marie Lyne
Published: March 2013

Un outil de communication sur le potentiel fonctionnel des résidents dans leurs activités de la vie quotidienne (A. V. Q.) a été créé au Centre de Santé Elisabeth-Bruyère, un centre de soins à long terme à Ottawa. Cet outil appelé «Tableau d'A.V.Q.» consiste en un tableau composé de différents dessins représentant les différentes activités que les résidents sont appelés à effectuer. À l'aide d'un code de quatre couleurs et de commentaires brefs, il vise à assurer que les résidents soient encouragés de façon constante et consistante à fonctionner de façon optimale dans leurs activités de tous les jours.
The Use of Films and Literature in the Treatment of Incest Offenders
Authors: Lloyd Chris
Published: March 2013

With increased referral rates to programmes for incest offenders it has become increasingly likely that occupational therapists will be required to provide treatment for this population. The following article describes father-daughter incest and the use of films and literature to help offenders become more empathic, to encourage appropriate role relationships and to help them appreciate the impact of sexually offensive behaviours on their victims.
Computerized Fieldwork Data Base: Applications and Implications
Authors: Polatajko Helen , Ernest Marilyn , MacKinnon Joyce
Published: March 2013

Fieldwork placement is a complicated and involved task. On the one hand, it requires insightful, professional judgement, but on the other hand, it includes numerous routine administrative and clerical tasks. To deal with fieldwork placement more efficiently and effectively it was decided to computerize the fieldwork placement system at the University of Western Ontario, London, Ontario. This paper describes the system developed and the resultant data base. The potential applications of the data base and the implications for students, facilities, educational programs, professional governing bodies and research are discussed.
The Standardization of the Riverdale Hospital's Home and Community Skills Assessment
Authors: Brown Harriette
Published: March 2013

This study was designed to refine The Riverdale Hospital's Home and Community Skills Assessment, and to develop a set of standards for it. This assessment includes a self-administered, objective, functional living skills assessment designed specifically for persons who have had traumatic closed head injuries. It is divided into seven functional living skill areas (FLS): Time Management, Kitchen Skills, Community Resources, Health, Money Management, Travel, and Vocation. Individual assessment results include partial scores in each of these functional areas, a total FLS score, and a seven component cognitive profile: Planning Skills, Ability to generate thought, Judgement, Work Speed, Ability to follow written instructions, the Amount of structure required to complete a task, and Writing legibility. Fifty normal subjects (those who have never suffered a brain injury or psychiatric disorder) aged 18–70 completed the assessment. Forty percent had post-secondary education; fifty percent were male. Data analysis consisted of removing or revising test questions when 80% of the normal subject group did not respond in accordance with previously established correct responses. Means and standard deviations were then established for each FLS area. Statistical analysis indicated: 1) no significant difference with respect to gender or age, and 2) a significant difference with respect to education level of the FLS areas only.
Relationship of Expectations for the Academic Chairperson's Role to Role Behaviours
Authors: Schaffer Robin
Published: March 2013

The purpose of this study was to examine the relationship between the expectations of the role-set for the academic chairperson's role and the chairperson's actual role behaviours using role theory and the role episode model suggested by Kahn et al. as the theoretical framework. The research was carried out on the population of heads of occupational therapy and physical therapy programs in Canadian universities. These subjects participated in indepth personal interviews and completed logs of their time spent in professionally-related activities; deans and faculty members, on the other hand, were surveyed for their expectations of the chairperson's role by means of a mailed questionnaire. Data analysis involved content analysis of interview transcripts and primarily non-parametric correlational statistics. The percentages of time which chairpersons spent on the various role responsibilities as well as the expectations of the role-set, both for time expenditure and for the importance of role responsibilties, were determined. While the results indicated a significant positive correlation between the expectations for time expenditure of physical therapy and of male chairpersons and their own role behaviours, no other significant correlations between the expectations of the role-set and the actual role behaviour of chairpersons were evident. Directions for future research as well as strategies to reduce discordance between expectations are suggested.
Factors Associated with Independent Meal Preparation, Self-Care and Mobility in CVA Clients
Authors: Jongbloed Lyn , Brighton Cathy , Stacey Susan
Published: March 2013

This study compared factors associated with and predictive of performance by stroke clients on two tests, namely a Meal Preparation Scale and the Barthel Index (a measure of independence in self-care and mobility). There is some overlap between factors associated with independent meal preparation and those associated with independence in self-care and mobility. However, motor function in the upper extremity is significantly (.05) more highly correlated with performance of self-care and mobility (r = .47) than with meal preparation (r = .28). Similarly, motor function in the lower extremity is significantly (.05) more highly correlated with performance in self-care and mobility (r = .47) than with meal preparation (r = .07). On the other hand, motor planning is significantly (.05) more highly correlated with meal preparation (r = .51) than with self-care and mobility (r = .28). Motor function in the upper extremity and visual-spatial perception on admission are predictors of future performance in both self-care mobility and meal preparation; but neither function can be predicted accurately using variables measured in this study.
The Objective Structured Clinical Examination as a Method of Occupational Therapy Student Evaluation
Authors: Edwards Mary , Martin Adele
Published: March 2013

An Objective Structured Clinical Examination (OSCE) was implemented in the Mohawk-McMaster Occupational Therapy Programme to assess knowledge of theoretical and practical aspects of physical assessment as applied to normal human movement. The OSCE was chosen because it was felt to have the potential to be a more objective and reliable method of evaluation than a practical examination. The OSCE is a circuit examination with a series of stations through which students rotate. Each station is designed to assess objectively one aspect of clinical competence such as knowledge or skill. This paper discusses the implementation of the OSCE, its advantages and disadvantages and will consider appropriate uses of the OSCE for evaluating the clinical skills of occupational therapy students.
Evaluation of Treatment in Occupational Therapy: Part 2. Practical Issues in Conducting Clinical Trials
Authors: Cadman David , Law Mary , DeMatteo Carol , Walter Stephen , Rosenbaum Peter , Russell Dianne
Published: March 2013

Clinically relevant and methodologically rigorous evaluation research in occupational therapy can be a challenge to implement. Attention must be given to: i) identification of a pool of study subjects, ii) strategies for recruitment of subjects, iii) monitoring the enrollment of study patients, iv) methods to maintain compliance with treatment protocols, and v) plans to deal with concurrent, non-study treatments offered to patients. This paper discusses how these practical issues affect the scientific merit of an evaluation study. Approaches to the resolution of these issues which have been found useful in conducting a multi-centre randomized control trial of upper extremity inhibitive casting and intensive neurodevelopmental therapy for children with cerebral palsy are discussed.
A New Definition of Disability: Implications for Rehabilitation Practice and Social Policy
Authors: Jongbloed Lyn , Crichton Anne
Published: March 2013

Until the 1970s, individual physical, be-haviourial and vocational limitations were seen as the main difficulties preventing people with disabilities from participating fully in society. Rehabilitation professionals concentrated on improving functional abilities of disabled clients and the main policy approaches were income maintenance and vocational rehabilitation. In the 1970s, the individualistic conception of disability was challenged by a socio-political definition. The socio-political model implies that improvement in the status of persons with disabilities requires alterations in the social environment as well as changes in individual functional abilities. This paper examines the extent to which disability policies and rehabilitation practice have changed to embrace this new definition. There has been some progress in policies related to shelter and transportation but little progress in the areas of employment and income maintenance. Rehabilitation professionals still have a largely clinical or individualistic ideology and focus very little on improving the circumstances of disabled people through changes in laws or social policies. They should be less willing to accept individual explanations for problems which are, essentially, economic, social or political and become more involved in advocacy with persons with disabilities.
Developing Guidelines for Client-Centred Occupational Therapy Practice
Authors: Townsend Elizabeth , Brintnell Sharon , Staisey Nancy
Published: March 2013

The Canadian Guidelines for the client-centred practice of occupational therapy are national, generic, consensus guidelines developed to address growing concerns inside and outside the profession for assuring the quality of health services. From 1979 to 1987, successive Task Forces, sponsored by the Department of National Health and Welfare and the Canadian Association of Occupational Therapists, developed three volumes of guidelines. A pivotal guideline in Volume 1 is a conceptual framework of occupational therapy's central concern: occupational peiformante within an individual's physical, cultural and social environment. Volume I also outlines stages in the process of client-centred occupational therapy practice, and specific assessment and program planning guidelines. Volume II covers issues, concepts and fundamental elements of intervention, as well as specific guidelines for intervention, discharge, follow-up and evaluation. Volume III reviews issues in outcome measurement given occupational therapy's primary concern for occupational performance. The authors, members of the Task Forces, provide an overview of the development of and their hopes for the Guidelines. Uses and influences of the Guidelines have not been formally documented. However, projects are arising from the Guidelines and a new CAOT Client-Centred Practice Committee is proposing an updating process for the three volumes.
Quality Assurance: The Current Challenge
Authors: Gruchy Carolyn , Rogers Laura G.
Published: March 2013

Occupational therapists are being challenged to measure and evaluate the care provided to their patients. This paper discusses the various stages of development of a quality assurance program within a large pediatric occupational therapy department. Several quality assurance activities undertaken are described, including the development of standards of clinical practice (based on the “Guidelines for the Client-Centred Practice of Occupational Therapy”) and the development of assessment and documentation protocols. Outcome measurement in pediatric occupational therapy is addressed in relationship to the process measures which were developed in the department. The approaches to outcome measurement are outlined within the context of an audit attempting to evaluate the effectiveness of occupational therapy intervention based on five areas of evaluation.
Revue et analyse d'instruments de mesure de la performance de la main et du membre supérieur
Authors: Desrosiersy Johanne , Dutil Elisabeth , Hébert Réjean
Published: March 2013

Les membres supérieurs jouent un rôle essentiel dans l'accomplissement des activités courantes de tout individu. Une atteinte de leur fonctionnement nécessite une évaluation précise pour guider l'application d'un programme de réadaptation. Afin d'aider le clinicien ou le chercheur à choisir un outil d'évaluation adapté à ses besoins et à ceux de la clientèle qui le préoccupe, 16 instruments de mesure de la performance de la main et du membre supérieur sont d'abord décrits, puis analysés selon des critères importants en milieu clinique et de recherche.
The Split Placement Model for Fieldwork Placements
Authors: Gaiptman Barbara , Forma Laura
Published: March 2013

There continues to be a shortage of placements in Canada for fieldwork education. It is crucial for occupational therapists to explore and implement a variety of supervision alternatives to maximize the utilization of fieldwork sites. This paper describes a model of split clinical placements, one in which students divide their time between two therapists who work in either different areas of clinical practice or in the same area of clinical practice. The supervision strategies that are most effective with this model are discussed as well as the advantages and disadvantages of this approach.
Silicone Gel and Hypertrophic Scar Formation: A Literature Review
Authors: Farquhar Kathy
Published: March 2013

Since 1982 a number of studies have investigated the use of silicone gel sheets in the prevention and reduction of hypertrophic scar formation. The statistical significance of several of these studies has been reduced by poor standardization of research methods, and the lack of a reliable and valid method of assessing hypertrophic scarring. When these studies are considered together, however, several clinically significant trends become apparent. The application of silicone gel appears to normalize the texture, colour, evaluation, and occurrence of subjective complaints (i.e., pain and pruritis) typically associated with hypertrophic scarring. These results are independent of the patient's age, method of attachment of the gel, or the location, age, or cause of the scar. The most appropriate treatment protocol for the application of silicone gel has yet to be determined. Current literature suggests that daily wearing tolerance be developed over the course of one to two weeks, the gel and scar be cleaned twice daily, and skin monitored regularly for signs of irritation. The optimal duration of treatment has not been established. Further research using standardized procedures and valid, reliable methods of measurement are required before this treatment can be ethically used to replace more established treatment techniques. However, the literature currently available would indicate that silicone gel may be an effective treatment technique for the prevention and reduction of hypertrophic scar formation following burn injury.
The Helping Relationship: The Application of Carkhuff's Model
Authors: Lloyd Chris , Maas Frikkie
Published: March 2013

Research has shown that good interpersonal skills are a prerequisite for a helping relationship to be effective. Carkhuff's helping model provides a framework in which to examine the nature of the helping relationship. The core helper dimensions and phases of helping are outlined. It is suggested that by incorporating this model into occupational therapy practice the delivery of care will be enhanced.
Parents' and Therapists' Ratings of Self-Care Skills in Children with Spina Bifida
Authors: Unruh Anita M. , Fairchild Sandra , Versnel Joan
Published: March 2013

Parent reports of children's abilities and difficulties are frequently used as part of occupational therapy assessments. However, there has been limited examination of parent and therapist agreement in assessment results. This clinical pilot study examined inter-rater agreement in the ratings of children's self-care skills by their parents and an occupational therapist. The Dressing, Elimination, and Mobility sections of the Klein-Bell Activities of Daily Living Scale were used in the study. Ten parents of children aged 6 to 15 years, with spina bifida and hydrocephalus, participated in this study. With one or two exceptions, percent agreement in ratings between parents and occupational therapists was greater than 85%. This clinical pilot study demonstrated that parental report can be a reliable assessment of children's abilities in activities of daily living. The study should be replicated using a larger, more representative sample.
Relationships among Three Clinical Measures of Muscle Tone in Shoulders and Wrists of Patients with Poststroke Conditions
Authors: Worley J. Scott
Published: March 2013

The association among three measures of muscle hypertonus were studied in shoulder internal rotation and wrist flexion on 49 poststroke subjects. Measures used were resting joint position, resistance to passive movement, and the angle at which the resistance appeared. Subjects were tested while seated with the affected arm supported and free to move in an adapted suspension armsling. Five of the six pairs of measurements (three at each joint) showed statistically significant associations with correlations between -.922 and .668 (p < .05) though the conditions under which they appeared differed. Results suggest that shoulder resting joint position and shoulder resistance to passive movement might be used interchangeably when muscle tone is measured only or first at the shoulder joint. Patterns of correlations suggest that factors underlying resting joint position differ fundamentally from those underlying resistance to passive movement and the angle at which resistance appears.
The Occupational Therapist as an Expert Analyst on the Cost of Future Health Care in Legal Cases
Authors: Harris Irene , Henry Alison , Green Nancy , Dodson Joanne
Published: March 2013

The purpose of this paper is to explain the legal criteria the court follows when awarding monies to an injured individual for Cost of Future Care. It also describes the role of, and procedures used by, the occupational therapist in analyzing future care costs for the court's consideration. It describes the benefits to the client, the legal system and society arising from the occupational therapist's expertise, and the role the therapist plays in obtaining information related to the client's case from other professionals.
Pilot Testing of the Canadian Occupational Performance Measure: Clinical and Measurement Issues
Authors: Law Mary , Polatajko Helene , Pollock Nancy , Mccoll Mary Ann , Carswell Anne , Baptiste Sue
Published: March 2013

The Canadian Occupational Performance Measure (COPM) is a measure of a client's self-perception of occupational performance in the areas of self-care, productivity and leisure. The COPM is administered using a semi-structured interview in which the client identifies significant issues in daily activities which are causing difficulty. Extensive pilot testing of the COPM has been completed with 268 clients in communities across Canada and in New Zealand, Greece and Britain. Results indicate the COPM has a median administration time of 30 minutes, is able to identify a wide range of occupational performance issues and appears to be responsive to changes in perception of occupational performance over time. A number of clinical and measurement issues centering around the interview, test construction, scoring, timing of the assessment, respondents, and the assessment process are discussed.
Facing Choices about Our Beliefs regarding Support Personnel
Authors: Hagler Paul , Madill Helen , Kennedy Lorian
Published: March 2013

This article is a rejoinder to the National Perspective (Strickland, 1993) which outlined the Canadian Association of Occupational Therapist's response to the Role and use of support personnel in the rehabilitation disciplines. (Hagler, et al, 1993). An invitation is extended to the Canadian Association of Occupational Therapists to re-examine its position statement on the training, use and supervision of support personnel. The authors consider that the Association's position is based on opinion and misinterpretation, and while they believe that opinions must be respected and that misinterpretations will occur, they challenge these misinterpretations and provide data to refute some of the opinions.
Spirituality and Occupational Therapy in a Secular Culture
Authors: Kroeker P. Travis
Published: March 2013

In an attempt to help plot the territory of the role of spirituality in occupational therapy, this paper examines the understanding of the mind-body-spirit paradigm in modern secular culture in order to examine critically its spiritual assumptions. It also suggests that occupational therapists might continue to explore the meaning of spirituality in a secular, pluralist culture through open dialogue that considers the spiritual meaning and aims of clinical practice with reference to particular religious traditions and symbols.
The Implicit Spirituality of Occupational Therapy Practice
Authors: Egan Mary , DeLaat M. Denise
Published: March 2013

The day-to-day practice of occupational therapy reflects an implicit concern for the spiritual dimension of life. This is demonstrated in what is done, why it is done, and how it is done. Occupational therapy enables clients to participate in occupation which allows connection with others and meaning-making. This is done because of a shared belief in the inherent value of all beings. Occupational therapy is carried out under a holistic, empowering framework using narrative reasoning. Attention is paid to the quality of the client-therapist relationship. Consideration is given to the personal limitations of the therapist and the opportunity for growth.
The Construction of Family Occupations: A Study of Families with Children Who Have Attention Deficit/Hyperactivity Disorder
Authors: Segal Ruth
Published: March 2013

Families are the main caregivers of children who have special needs and are essential in the client-centred occupational therapy practice. They also provide the immediate social and cultural environments of their children who have special needs. A qualitative study of daily experiences and adaptations of 17 families with children who have attention-deficit/hyperactivity disorder is described in this paper. The analysis of interviews with parents revealed that they developed and used strategies to enable their children' occupational competence. Further, whenever parents reported on the success of these strategies, they also described changes in the daily routines of other family members. The interactions between these enabling strategies and the daily routines of family members are presented and discussed in this paper.
Assessment and Intervention with Clients with Apraxia: Contributions from the Literature
Authors: Landry Jennifer , Spaulding Sandi
Published: March 2013

Individuals with praxis problems encounter difficulties engaging in occupation, and the occupational therapists who work with these clients are challenged to provide intervention that enables occupational performance. This extensive review of the current literature provides clinicians with information regarding the relevant descriptions and suggested mechanisms of apraxia. Errors noted in performance, different classification systems and the implications of the current knowledge will be discussed. The paper concludes by providing information for clinicians regarding occupational therapy evaluation and intervention strategies for praxis problems.
Beyond Sectarianism: The Missional Church in a Post-Christendom Society
Authors: Nikolajsen Jeppe Bach
Published: March 2013

An increasing number of theologians assert that the Western world has moved from a Christendom era to a post-Christendom era. In relation to this, this article discusses the charge of sectarianism. The article argues that the task that lies before the church in the Western world in not to bypass its distinctiveness with accusations of sectarianism, but to recapitulate an understanding of its own distinctiveness that should be seen as a precondition for its engagement in society. Such an ecclesiological position holds, it is asserted, important potential for an understanding of the role of a missional church in a post-Christendom society.