bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modernising Fieldwork, Part 1: Realising the Potential
Authors: Fisher Angela , Savin-Baden Maggi 
Published: April 2015

Fieldwork education has received much attention recently. Many authors have referred to a shortage of placements and highlighted the need to embrace alternative methods of placement provision. This article describes the results of a project that investigated the existing and potential placement capacity for occupational therapy students and the challenges faced by occupational therapists in health and social care. The Coventry and Warwickshire Workforce Development Confederation commissioned this project on behalf of the West Midlands Region, which was where the study was undertaken. Part 1 presents the first three themes that emerged: placement capacity and barriers to provision; creative solutions; and modernising fieldwork education. Part 2 will present and discuss two further themes: issues of context and current and future models of fieldwork education. Overall, the findings indicate that placement capacity is not being realised and that barriers to placement provision are largely organisational in nature. It is argued here that fieldwork education needs to be seen as a key component of continuing professional development and central to the modernisation agenda, not as an added extra.
Older People and Participation within Disabled Facilities Grant Processes
Authors: Awang Darren 
Published: April 2015

As the numbers of older people increase, adapted home environments have become an essential requirement to support independent living. This article presents a qualitative study examining the perceptions of older people using Disabled Facilities Grants to acquire home adaptations. Using a participatory action research approach and within-method triangulation, the participatory processes of two local authorities and a Care & Repair agency were explored. Data collection included semi-structured interviews with nine service users and seven key adaptation agency workers, in addition to the examination of agency documentation. The data were manually categorised and analysed, using both within-case and cross-case analysis. The findings demonstrated that the publicity of grants was poor. Service users' experiences varied depending on the levels of support that were available. In addition to paper-based feedback methods, examples of organisational participative mechanisms included a disability forum and a service user group. There was no specific mechanism adopted primarily for older people but, significantly, the older service users welcomed opportunities to express their views. Overall, the participatory levels were low, with emphasis on sensitising services to users' needs (agency controlled) rather than on moves towards greater democratic involvement (user controlled). Further work is required to encourage older people's participation in shaping and controlling service delivery thereby improving the quality of practice in this area.
Pro-Motion: A Positive Way Forward for Clients with Severe and Enduring Mental Health Problems Living in the Community, Part 1
Authors: Heather Frances 
Published: April 2015

This is the first part of a two-part article describing a clinical therapeutic intervention planned and organised by a senior occupational therapist and mental health nursing staff for clients with diagnoses of severe and enduring mental health problems. The six participants had a diagnosis of schizophrenia or schizoaffective disorder or bipolar illness. Four were receiving the atypical antipsychotic medication, Clozapine. One was receiving Olanzapine, also atypical, and the last was receiving traditional antipsychotic medication. These clients were all receiving long-term support from the mental health rehabilitation unit. Participation was voluntary and each client gave written consent to participation and publication later. The aims and objectives of the initial group, the selection criteria and the content and process of the group over a period of 6 weeks are described. The subsequent group, also held for 6 weeks, will be described in part 2, together with a brief overview of the further groups that have taken place since. The evaluation methods of the first group were the Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI) together with verbal and written evaluation. The BAI and the STAI were not repeated in the second group and the rationale for this is explained. The perceived benefits to clients are illustrated with two brief case vignettes. The benefits to other clients are also mentioned, together with the perceived drawbacks. The article concludes with the plans for the second group.
The Legacy of Violent Attack: An Exploratory Study of Occupational Therapy Students' Experiences of Violent Attack
Authors: Whitehead Alison 
Published: April 2015

This study aimed to develop an understanding of occupational therapy students' experiences of violent attack by a client. A qualitative approach was chosen, which involved semi-structured interviews with three students and an analysis of the researcher's experience of violent attack. A wide variety of reactions to violent attack by a client was reported, including fear, anger, concern for others, minimisation and thoughts about changing career. The explanations for these reactions are reported and discussed. The participants reported changes in their therapeutic relationships with clients. The findings also suggested that there might be some occupational therapy personnel who feel that violence is ‘part of the job’. Three key issues are discussed: the nature of the reactions to violent attack, the perceptions of role and the therapeutic relationship with the client. It is suggested that these findings have important implications for the education and training and the support of occupational therapy students. Recommendations are made regarding the need for further research to inform the way forward in training and supporting those experiencing violence in clinical practice settings.
Struggling for Occupational Satisfaction: Older People in Care Homes
Authors: Atwal Anita , Owen Sharon , Davies Richard 
Published: April 2015

In the United Kingdom, a wide range of health care reforms has been introduced to enhance the wellbeing of older people. These reforms should ensure that both the public and the private sectors deliver best practice to older people. The role of the occupational therapist with older people is well established in a variety of health and social care settings but there is a noticeable absence of input in care homes, despite evidence that has demonstrated the importance of occupations for wellbeing. The Canadian Occupational Performance Measure (COPM) was used in a research study to determine the types of occupation that seven older people perceived as important, their perceptions of their performance and their perceived level of satisfaction. It was found that these older people most valued leisure and self-care occupations, although occupations related to productivity were also cited. A perceived high performance rating often transferred to a high satisfaction rating and a perceived low performance rating to a low satisfaction rating. The challenge for occupational therapists is to implement occupation-based therapy that meets all the needs of older people. Furthermore, there is a requirement to develop the evidence base and to look at strategies to promote occupation in order to ensure occupational satisfaction for all.
The Development and Evaluation of the Mayers' Lifestyle Questionnaire (2)
Authors: Mayers Christine A 
Published: April 2015

The Mayers' Lifestyle Questionnaire (2) is a client-centred tool which enables people with enduring mental health problems to identify and prioritise issues affecting their quality of life. It was developed following requests from occupational therapists working in community mental health teams. This article briefly describes how the tool was developed and then describes the main study used to evaluate the Mayers' Lifestyle Questionnaire (2). Eighty-three occupational therapists from around the United Kingdom offered to take part in the study. The results are from data returned by 33 occupational therapists and 75 clients. The occupational therapists and the clients were positive overall in their comments. Three occupational therapists in the study worked with people with brain injury rather than with clients with enduring mental health problems and, having seen and used the tool, they stated that it would prove suitable for some of their clients. The evaluation has led to minor changes being made to the Mayers' Lifestyle Questionnaire (2).
An Audit of Referrals to Occupational Therapy for Older Adults attending an Accident and Emergency Department
Authors: Smith Tony , Rees Val 
Published: April 2015

The greater number of older people in communities is reflected in their increasing demands on the services of accident and emergency (A&E) departments. Recognition of the complex needs of older adults attending A&E departments has resulted in many National Health Service trusts employing occupational therapists in these departments. The occupational therapists are required to assess and evaluate a patient's functional status and, using a team approach, to make decisions about his or her wider needs, including therapeutic requirements and social provision. In order to audit the provision of the occupational therapy service in an A&E department, data were collected monthly over a 3-year period in a single district general hospital on the referrals made by medical and nursing staff. The mean age of the patients referred was 80 years. The majority of the patients were female and living alone. The most common presenting problem was that of a fall, with a resulting fracture in half of the patients. The occupational therapy input in the A&E department was demonstrated in this study to save admissions to acute hospital care, amounting to an equivalent of two beds saved in each of the years covered by the audit.
Exploring the Evidence for Occupational Therapists' Interventions with Clients with Lateral Epicondylitis
Authors: Hong Quan Nha , Durand Marie-José , Loisel Patrick 
Published: April 2015

Lateral epicondylitis is known to be a major problem in work absenteeism and permanent partial disability. Although occupational therapists are often asked to treat clients with this disorder, its management remains controversial since there is insufficient research evidence to favour any particular intervention. This study gathered information on the current interventions used by occupational therapists with clients with lateral epicondylitis according to three phases: acute, subacute and chronic. A self-administered questionnaire was sent to a convenience sample of 219 occupational therapists working in the province of Québec in Canada. After two reminders, a participation rate of 81% was obtained. Over 20 interventions were identified and sorted into five categories: education, activities/exercises, assistive devices, environment and pain management modalities. Overall, education about risk factors was the most frequently used intervention by occupational therapists in all phases. Activities/exercises formed the second most frequently used intervention group, but were more preferred in the subacute and chronic phases. Although many interventions are currently used in health care facilities, few studies on their effectiveness have been conducted. This study explored the gap between research and practice by surveying clinicians on their management of clients with lateral epicondylitis, allowing the targeting of areas considered useful for future studies in occupational therapy.
Does Age at Entry have an Impact on Academic Performance in Occupational Therapy Education?
Authors: Shanahan Margaret M 
Published: April 2015

This article presents a research study that investigated age as a predictor of higher academic outcome in a sample of 425 recent honours graduates from 8 out of 19 (42%) occupational therapy schools in England and Wales. The initial analysis of the data showed that age was related to academic performance, but this relationship was much weaker when the qualifications used to gain entry to occupational therapy education were added to the statistical analysis. The data were strongly influenced by the superior academic performance of the students who had a previous degree on entry to occupational therapy education. When these degree-level entrants were removed from the age analysis, the academic performance of the remaining mature students did not differ significantly from that of the younger students, thus removing the effect of age that was initially seen in the data. This result indicates that entry qualifications, in particular a previous degree, have a positive predictive effect on the academic performance of students in occupational therapy education. This finding has implications for those planning new occupational therapy programmes and for admissions tutors in existing programmes.
Is Meeting Spiritual Need within the Occupational Therapy Domain?
Authors: Hoyland Marion , Mayers Christine 
Published: April 2015

The profession's present interest in the topic of spirituality initiated the decision to undertake this study, which aimed to investigate the extent to which occupational therapists consider clients' spiritual needs as part of their domain. The objectives of the study were to ascertain whether this was part of the occupational therapist's role and to identify the ways in which occupational therapists addressed the spiritual needs of their clients. Six senior II occupational therapists participated in semi-structured interviews. The participants felt that all individuals have spiritual needs, although not all would recognise or acknowledge them as such. All the participants considered spiritual care to be part of their role, but there was some uncertainty regarding the relationship of spiritual care to occupational therapy in general. Spiritual needs were addressed by a listening and holistic approach.
Occupational Therapy and Multidisciplinary Working on Acute Psychiatric Wards: The Tompkins Acute Ward Study
Authors: Simpson Alan , Bowers Len , Alexander Jane , Ridley Caroline , Warren Jonathan 
Published: April 2015

There is limited research into occupational therapy and interprofessional working on acute psychiatric wards. This study aimed to explore relations between occupational therapists and other members of the multidisciplinary team through structured interviews with 47 staff on 14 acute psychiatric wards. The study found that occupational therapists provided assessments, group activities and individual therapeutic work, with the assessment and development of activities of daily living being central. Linking patients with community resources in preparation for discharge was also important. Severity of illness among patients and speed of discharge were barriers to effective input. Nurses and psychiatrists appreciated occupational therapy input but rarely the breadth of the role. Multidisciplinary relations were generally positive, although some ward teams were disinclined to include occupational therapists in communications and decision making. The occupational therapists appreciated their professional knowledge and opinion being respected and considered. The study concluded that occupational therapists play an important if often misunderstood role on acute psychiatric wards, but that their involvement could be significantly increased through the employment of more experienced occupational therapists and the provision of interprofessional education. Further research is required to explore the facilities, resources and support required to maximise occupational therapy input and identify areas for increased interprofessional working.
From Paper to Practice: The Views of Occupational Therapists on the Impact of the National Service Framework for Older People on Practice
Authors: Jacob-Lloyd H , Booth J , Ward G , Dring P , Grant M , Steed A 
Published: April 2015

Philp (2003) outlined the fundamental role that occupational therapists could have in implementing the National Service Framework (NSF) for Older People and reforming services for older people (Department of Health 2001). A research project was undertaken, which aimed to investigate the views of occupational therapists about the implementation of the policy in order to identify the key areas and issues that have had an impact on practice. The research design was qualitative and took the form of focus groups. The focus group data were analysed using a long-table analysis method (Krueger and Casey 2000), which identified five key themes: a raised profile of older people's services, a changing delivery of services, a revisiting of occupational therapy core skills, assessment and resource allocation. The emerging themes suggested that the NSF for Older People has had an impact on the practice of the occupational therapists involved in the focus groups.
Making a Difference, Teamwork and Coping: The Meaning of Practice in Acute Physical Settings
Authors: Robertson Cathy , Finlay Linda 
Published: April 2015

Occupational therapists in acute physical settings face challenges and tensions between their holistic professional values and the often reductionist focus of their work. A hermeneutic phenomenological investigation explored the meaning of practice for nine occupational therapists in an acute National Health Service trust in England. Semi-structured interviews were analysed using a framework for interpretive analysis of phenomenological data. Critical reflective evaluation enables readers to judge the quality and relevance of the research. The three main themes described in this paper – making a difference, gaining strength from the team and coping strategies – illustrate the tensions, stresses and rewards of practice. The occupational therapists wanted to make a difference to their patients' lives. Although they could not always do as much as they would have liked, making an immediate difference by the provision of equipment was rewarding. Relationships with multidisciplinary colleagues generated both stress and satisfaction, but membership of the occupational therapy team enabled the therapists to cope with difficult situations. Effective coping strategies included acknowledging the realities of the acute setting and using reflection to identify those aspects providing value and satisfaction. Overall, the therapists experienced pride, excitement, reward and enjoyment from their work in the acute setting and were convinced of the value and importance of their role.
Occupational Therapy for Children with Acquired Brain Injury: A Survey of Current Practice
Authors: Jones Pru , Drummond Avril , Vella Kristina 
Published: April 2015

This survey aimed to describe current occupational therapy practice for children with acquired brain injury in the Trent Region. Forty-three paediatric occupational therapists were sent questionnaires. Information was requested on referral patterns, amount of patient contact time, use of specific care pathways, assessments and the nature of interventions used, as well as contact with educational services. Eighteen therapists replied and their responses illustrated the difficulties involved in providing a service for this population. The therapists reported low referral rates, service pressures, difficulty in obtaining specialist paediatric equipment and inadequate training. It is suggested that services should provide and network with appropriate training for therapists, and continue the development of care pathways and outcome measures.
The Way We Were: The Ascendance of Rationalism
Authors: Hocking Clare 
Published: April 2015

This is the last in a series of three articles that report the findings of a study that explored the history of the ideas that pioneering occupational therapistsin the United Kingdom held about physical objects. Based on an analysis of references to objects in occupational therapy literature published between 1938 and 1962, it revealed the profession's rational and Romantic underpinnings. The first article described the assumptions rooted in Romanticism and the Arts and Crafts Movement philosophies. The second article explored occupational therapists' rational systematising of knowledge. The focus of this final article is how rationalism came to predominate over Romantic ideals, as the realism of using crafts to transform individuals was pitted against the urgent need to rebuild the nation after World War II. Contributing circumstances, particularly the lack of a research method to explore subjective experiences and outcomes, are identified and the consequences in relation to the balance of the profession's current knowledge base are proposed.
Predictive validity of the Montreal Cognitive Assessment (MoCA) as a screening tool for on-road driving performance
Authors: Kwok Jade Chiu Wai , Gélinas Isabelle , Benoit Dana , Chilingaryan Gevorg 
Published: April 2015

Introduction The objectives of this study are to determine (1) the ability of the Montreal Cognitive Assessment to predict on-road driving performance in drivers with a neurological condition and elderly drivers with suspected cognitive decline, and (2) the association between the performance on the Useful Field of View and the performance on the Montreal Cognitive Assessment. Method This study used a retrospective design. Clients were included who had completed the Montreal Cognitive Assessment and the on-road driving evaluation from November 2006 to May 2009 ( n = 154) in a driving rehabilitation program in the Montreal Area. Total scores on the Montreal Cognitive Assessment, Useful Field of View risk categories, pass or fail outcomes from an on-road evaluation, as well as demographic and clinical characteristics were recorded from participants’ medical charts. Results The Montreal Cognitive Assessment was found to have a sensitivity of 84.5% and a specificity of 50% with a cut-off of ≤25. It was significantly associated with the Useful Field of View risk category. Conclusion The Montreal Cognitive Assessment could be a valuable screening tool. However, its predictive validity is not strong enough to recommend its use as the sole instrument for identifying unfit drivers.
Art Therapy
Authors: Champernowne I. 
Published: April 2015

“Occupational therapy in psychiatry is a particularly fine art. Emphasis should be placed on constructive projects to awaken new interests and skills, and these must be adapted to the patient's individual needs. The patient emerging from a manic phase requires limited diversional activities, as it may only increase his responsiveness to environmental stimulation. The depressive patient responds better to easy tasks, as complex activities will increase his feelings of inadequacy. The emphasis here should be placed on diversion, which may take the patient out of himself. The schizophrenic requires activities symbolising reality, the neurotic with pent-up tension should be occupied with activities that give him an opportunity for energy release. Many patients will release more energy witnessing an international football match and by concentrating attention upon public affairs than in actual physical work. The patient identifies himself with his favourite player or team of players, political party or leader, etc. and, by projecting himself in real or imaginary actions, he secures a release of tension. Tension is a sympton of unreleased energy. In the properly selected work and recreations, the psychiatric finds an opportunity to release his unreleased tension, and this is the task of the psychiatric occupational therapist. It goes back to 1913 when the American Psychiatric Association adopted a resolution, namely ‘that occupational therapy marks the standing of a psychiatric organisation, and neglected or omitted the patients are not receiving the adequate care and treatment to which they are entitled.’ After all, occupational therapy is applied physical treatment.— Dr. Z. Wechsler on ‘Physical Therapies in Psychiatry’ in the Australian Association O.T. Bulletin, October, 1951.