bluuebunny/crossref_metadata_2025_split huggingface dataset:
Studying Clinical Reasoning, Part 2: Applying Social Judgement Theory
Authors: Harries Priscilla A , Harries Clare 
Published: April 2015

Part 1 of this paper (Harries and Harries 2001) examined the reasoning studies of the 1980s and 1990s and critiqued the ethnographic and information-processing approaches, based on stated information use. The need for an approach that acknowledged the intuitive nature of experienced thinkers' reasoning was identified. Part 2 describes such an approach ± social judgement theory ± and presents a pilot application in occupational therapy research. The method used is judgement analysis. The issue under study is that of prioritisation policies in community mental health work. The results present the prioritisation policies of four occupational therapists in relation to managing community mental health referrals.
An Introduction to Q Methodology, a Research Technique
Authors: Corr Susan 
Published: April 2015

In an attempt to develop the range of research methodologies within the occupational therapy profession, it is necessary to consider methods that may be appropriate to use in studies. Q methodology has been used in the United States, and to a lesser extent in the United Kingdom, by a broad range of researchers, including psychologists, social scientists, educationalists, political scientists and other health care professionals. It is basically a quantitative method for analysing qualitative data, based on viewpoints. The process involves developing a Q sort pack (a number of items representing the range of ideas on a topic), administering the sort (asking participants to rank the ideas with reference to their own views), analysing the data (looking for patterns in the way that individuals respond) and interpreting the results. This approach has a number of potential uses in occupational therapy. It is recommended that this method is given consideration as a research tool when attempting to identify the perceptions of clients, colleagues, students or others on any service or educational issue.
An Investigation into Occupational Therapy Referral Priorities within Kensington and Chelsea Social Services
Authors: Wright Caroline , Ritson Elizabeth 
Published: April 2015

Thirty-two out of 33 occupational therapy services within London operate priority systems (Scott 1999), but there is a scarcity of published research into the accuracy of such systems. A study by Leonard (1993) identified discrepancies between priorities allocated before and after assessment, while Grime (1990) discussed the decision-making processes employed by community occupational therapists. Recognising that demand for services will continue to grow in the new millennium, this study investigated whether cases were prioritised appropriately within a team and identified the factors within referrals that influenced prioritising decisions. The referrals (n=45) were prioritised by the team leader, who then allocated the cases to the occupational therapists without revealing the priorities. The occupational therapists reprioritised the cases after the initial assessments; the priorities were then compared and the influencing factors identified. The results indicated that 56% (10 out of 18) of the lower priority cases were inaccurately prioritised, with a tendency to underestimate the priority. The service's referral-taking procedure was reviewed and the study replicated. The second study indicated that the accuracy of prioritising improved following revision of the guidelines, although further issues around service user involvement were highlighted.
Depression and Lability: The Effects on Occupation following Stroke
Authors: George Stacey , Wilcock Ann A , Stanley Mandy 
Published: April 2015

Case study methodology was used to explore the effect of emotional changes following a stroke on engagement in occupation. Two people who had had a stroke, and their partners, were interviewed. The participants' medical case notes from acute, rehabilitation and outpatient treatment were also reviewed. As a result of the stroke, one participant experienced depression and the other lability. The case studies illustrate the impact that emotional changes can have on the performance of occupations. They also illustrate the reverse, that perceived competence in the performance of occupations can affect emotions, either negatively or positively. The results point to a need for occupational therapists to take an occupational perspective, if wellbeing is to be maximised, as they consider and address the effects of emotional changes with people who have had a stroke.
Reform of the Mental Health Act 1983: Implications of Safety, Capacity and Compulsion
Authors: Carr Julie 
Published: April 2015

The Mental Health Act 1983 was written for a predominantly hospital-based service. The closure of mental health institutions reduced the number of inpatient beds available and created a community-based service. The move to community care was followed by a small number of high profile cases involving people with a mental illness. Media involvement incited a belief that mentally ill people were a dangerous sector of the community; as a result, public safety and compulsion for patients to accept treatment became powerful drivers to a review of the Act. In November 1999, the report of the Expert Committee appointed to review the Act was published alongside the Government's Green Paper Reform of the Mental Health Act 1983 – Proposals for Consultation (Department of Health [DH] 1999a,b). The report advised that incapacity should be central to the recommendations for changing the existing legal framework. Despite the expression of concern by professional bodies and individuals, the Government chose to reject the notion of incapacity from the White Paper, Reforming the Mental Health Act (DH 2000). There is, however, a strong emphasis on the role of compulsion for the patient to accept treatment. Although the White Paper is unsatisfactory in some aspects, those involved in the care of mentally ill people recognise that there remains a need for a legal framework within which to operate. This article discusses the issues of safety, capacity and compulsion covered by the White Paper, Reforming the Mental Health Act (DH 2000). Attention is drawn to the dilemmas for and impact on occupational therapists working with patients being treated under this Act.
Examining the Evidence Base for Occupational Therapy with Clients following Stroke
Authors: Unsworth Carolyn A , Cunningham Delia T 
Published: April 2015

In order to conduct occupational therapy services that are evidence based, studies are urgently required which demonstrate the effectiveness of interventions offered. This paper presents the findings of a study undertaken to determine occupational therapy outcomes for clients with stroke during inpatient rehabilitation. The participants were 43 clients with stroke and four occupational therapists. Therapy outcomes for personal activities of daily living were measured using the Functional Independence Measure (Adult FIMSM); instrumental activities of daily living were measured using the Assessment of Living Skills and Resources (ALSAR); and quality of life was measured using the Quality of Life Index (Q-L Index) and a semi-structured interview. The semi-structured interview was also used to understand clients' perceptions of the outcome of their participation in occupational therapy. The data were collected at client admission, discharge and 3 months' follow-up. The results indicated that the clients believed that their ability to perform activities of daily living (Adult FIMSM t (38) = −7.80, p = 0.000, and ALSAR t (35) = 4.82, p = 0.000) and their quality of life (Q-L Index t (39) = −7.23, p = 0.000) improved over the course of their inpatient rehabilitation. The therapists also rated the clients as improving during their rehabilitation in relation to activities of daily living (Adult FIMSM t (42) = −9.71, p = 0.000, and ALSAR t (40) = 7.75, p = 0.000) and quality of life (Q-L Index t (39) = −11.20, p = 0.000). Many of the clients interviewed attributed these gains to participation in the occupational therapy programme. In conclusion, this study demonstrated that a triangulated approach to data collection and analysis was useful in providing evidence that occupational therapy, as part of comprehensive rehabilitation, made a difference to the lives of many of the clients studied.
The Effectiveness of Splinting as Perceived by the Parents of Children with Juvenile Idiopathic Arthritis
Authors: Schroder Natalie , Crabtree Merrill J , Lyall-Watson Sarah 
Published: April 2015

Juvenile idiopathic arthritis (JIA) is an important disease of childhood with far-reaching effects on the child and family. Splinting is a major treatment modality used by occupational therapists for children with JIA. Parents play a central role in whether, when and how splints are used with their children on a daily basis. This paper describes a qualitative research project, which was undertaken to evaluate an occupational therapy service for children with JIA whose treatment had involved splinting. Using semi-structured interviews, the study investigated five mothers' perceptions of the effectiveness of splinting for their children. The interviews revealed five major points. First, the informants generally believed the splinting to be effective. Secondly, the children involved generally resisted wearing splints because they were physically uncomfortable and made them feel different to other children. Thirdly, the mothers used a variety of strategies to ensure that their children wore the splints. Fourthly, the perception of having a positive and supportive relationship with the therapist enhanced the mothers' ability to adhere to splinting. Lastly, the mothers' grief at having a child with JIA influenced their ability to understand and attend to information about specific interventions such as splinting. Practical responses to these findings are outlined.
A World Apart: How Occupational Therapists, Nurses and Care Managers Perceive Each other in Acute Health Care
Authors: Atwal Anita 
Published: April 2015

Multidisciplinary teamwork is one of the key processes through which care is managed in the British National Health Service. Working in a multidisciplinary team requires many skills, which include understanding not only one's own role but also that of other professionals. The aim of this paper is to provide an understanding of occupational therapists', nurses' and care managers' perceptions of each other and how these influence interprofessional relationships. In total, nine occupational therapists, nine care managers and 19 nurses within an acute physical health care setting were interviewed using the critical incident approach. The findings revealed that the interprofessional relationships between nurses, care managers and occupational therapists were often problematic owing to role confusion and competing priorities, which influenced communication. To prevent role ambiguity, occupational therapists must define their role clearly. It is suggested that multidisciplinary team members need continuing interprofessional education in order to understand the changing roles in the National Health Service.
Views from the Inside, Part 3: How and Why Families undertake Prescribed Exercise and Splinting Programmes and a New Model of the Families' Experience of Living with Juvenile Arthritis
Authors: Britton Carrie A , Moore Ann 
Published: April 2015

This is the final article in a trilogy that reports an ethnographic study about the insiders' experiences of families that include a child with juvenile idiopathic arthritis (JIA). The overall aim of the research was to explore and describe the experiences of families of children with JIA. The first article introduced the disease and the routes to diagnosis and presented the methodology of the study in detail. The second article reported the different experiences of the children with arthritis and their siblings, mothers, fathers and grandparents. This article presents the families' perspectives about prescribed programmes of daily exercises, splinting and medication. The article also introduces a dynamic model of the families' experiences. It concludes with recommendations for future health care service development and for individual practitioners who work with either this specific user group or the families of children with other long-term conditions.
Home Adaptations: User Perspectives on the Role of Professionals
Authors: Picking Clare , Pain Helen , Picking Clare , Pain Helen 
Published: April 2015

People with disabilities often carry much of the responsibility for the process of making adaptations to their homes and look to the professionals involved for support. The study described in this article asked people with disabilities whether they believed that they received appropriate professional support, information and practical help when adapting their homes and sought to learn more about their feelings about the adaptation process. A qualitative research method, using three focus groups in different geographical areas, was carried out with a purposive sample of participants who had received adaptations to their homes and had been assisted by their local authorities. The groups comprised participants from urban and rural populations, who had a mix of housing tenure and a variety of professional support. The findings demonstrated that this method was appropriate as a means of both discovering how people felt about the process and identifying what they found to be the most helpful assistance from the professionals involved. The study suggested that when problems arose or delays were experienced during the building process, an occupational therapist was not the only appropriate professional to provide support because this could be given in a variety of ways by different professionals and helping agencies. The study also suggested that, given sufficient information and choice, some people with disabilities preferred to organise their own adaptations, could manage with minimal professional intervention and should be empowered to do so.
Do Mainstream Schoolchildren Who Were Born Preterm Have Motor Problems?
Authors: Foulder-Hughes Lynda , Cooke Richard , Foulder-Hughes Lynda , Cooke Richard 
Published: April 2015

Children who are born preterm now have improved survival chances owing to major changes in obstetric and neonatal intensive care. Previous studies have indicated that such children who are attending mainstream school have an increased risk of long-term motor impairment when compared with those who were born at full term. The present study describes the motor outcome in a geographically defined population born at or below 32 weeks of gestational age, alongside a group of full-term children who were matched for age, gender and school. Motor skills were assessed using the Movement Assessment Battery for Children (Movement ABC) and the Developmental Test of Visual Motor Integration (VMI), in addition to a detailed perinatal history. A total of 280 preterm children were assessed alongside 210 controls. There were highly statistically significant differences between the preterm and full-term cohorts on both the Movement ABC (p<0.001, Mann-Whitney U) and the VMI (p<0.001, independent sample t-test), with the preterm group performing considerably worse than their peers. Using the 5th percentile on the Movement ABC, 30.7% of the preterm group were impaired compared with 6.7% of the controls. Occupational therapists may find increased referral levels of preterm children because of motor difficulties and associated functional problems.
Research Priorities in Forensic Occupational Therapy
Authors: Duncan Edward A S , Munro Karen , Nicol Margaret M 
Published: April 2015

National research priorities have been developed and published by the College of Occupational Therapists (Ilott and White 2001). Such an exercise, however, cannot provide the specific research priorities of a particular area of practice. A questionnaire survey was undertaken to ascertain the specific research priorities of forensic occupational therapists. The survey had three parts: determining research priorities, examining outcome measures and exploring the use of protocol-driven group work. Three specific research priorities were clearly defined by part one of the survey: the development of appropriate outcome measures, the development of rigorous and effective group-work programmes and the development of effective risk assessment tools. The nominal group technique was used in order to triangulate the data. The survey also examined the participants' use of outcome measures: a high number of the participants (62%, 44/71) stated that they used outcome measures in practice. The participants' responses to the third aspect of the survey, regarding the use of protocol-driven groups, were more varied. The majority of the groups reported by the participants were ‘home grown’, with little research base underpinning their implementation. The methodological weaknesses of undertaking such a survey are examined. The paper concludes that having identified clinicians' priorities in forensic occupational therapy research, the challenge is how best to gather robust evidence for practice.
Motor-Free Visual Perception Test — Revised: An Overview and Critique
Authors: Brown G Ted , Rodger Sylvia , Davis Aileen 
Published: April 2015

Paediatric occupational therapists often assess and treat school-age children and youth presenting with visual perceptual dysfunction. It is, therefore, important that occupational therapists use visual perceptual instruments that possess sound measurement properties (such as validity, reliability, responsiveness and clinical utility). The Motor-Free Visual Perception Test – Revised (MVPT-R) is an instrument frequently used by paediatric occupational therapists. Clinicians need to be cognisant of the measurement properties of the assessments they use in order to provide the best level of care for the paediatric clients they serve. Therefore, a review and critique of the MVPT-R is presented. Even though the MVPT-R has been revised recently, little has been done to address issues related to its reliability and validity. Evidence of criterion-related validity and construct validity, in particular, is still lacking. The rationale for measuring motor-free visual perception is also not well developed and needs to be expanded in the MVPT-R manual. In addition, the issue of summing the scores from the five MVPT-R subscales is questionable. What the final MVPT-R summed score really measures in terms of a screening evaluation or diagnosis is also lacking. At this stage, this instrument should be used and interpreted by occupational therapists with caution.
Engaging People with Enduring Psychotic Conditions in Primary Mental Health Care and Occupational Therapy
Authors: Cook Sarah , Howe Amanda 
Published: April 2015

For people who have enduring psychotic conditions, interventions need to improve social functioning as well as reducing clinical problems. There is also a need to engage and keep in touch with general practitioner (GP) patients who have fallen out of contact with specialist psychiatric care. A new model of service was designed to engage this patient group: an expanded primary care team in an inner-city area. The team extended the GP role, provided occupational therapy and care management and used liaison psychiatry. A case study design with mixed methods was used to investigate the new service. This article reports the quantitative investigation of engagement, clinical and social outcomes and cost consequences. The results showed that, at the start of the study, 37 people with psychotic conditions were in the sole care of their GPs; of these, 34 (92%) engaged with the new service. The sample of 28 receiving 12 months' interventions started with low levels of social functioning, which required intervention. Following interventions, they showed significant improvements in social functioning, clinical symptoms and Health of the Nation Outcome Scales (HoNOS). The costs were favourable when compared with similar services. The study suggests that expanded primary care, with occupational therapy and care management, can be a feasible service to improve people's engagement and functioning.
A Clinical Audit of the Outcome of Occupational Therapy Assessment and Negotiated Patient Goals in the Acute Setting
Authors: Welch Amanda , Forster Susan 
Published: April 2015

The increasing emphasis on quality and effectiveness in the National Health Service requires occupational therapists to provide evidence of accurate assessment and of the outcomes of interventions, supported by clear and concise documentation. With the merging of two acute hospitals came the opportunity for the occupational therapy services of Newcastle upon Tyne Hospitals NHS Trust to audit the process of functional assessment and documentation. A review of the occupational therapy service was undertaken. Standards were set to combine the Modified Barthel Index with negotiated patient goal setting. Practice was then changed to meet the standards. A subsequent audit considered the outcome of occupational therapy. The audit findings reaffirmed the acute occupational therapy focus on activities of daily living. The service identified that patients had low levels of disability according to Modified Barthel Index scores on discharge. Importantly, it was found that the reliability and validity of goal setting as a basic outcome measure was dependent upon therapists' ability to write specific quantifiable goals. The practice benefits included promoting patient involvement, enhancing the evidence base to practice, promoting consistent and effective functional assessment and documentation and reaffirming the unique contribution of occupational therapy as that of assessing a patient's level of function in activities of daily living objectively.
Implementing the Assessment of Motor and Process Skills (AMPS) in the Workplace: A Comparison of the Experiences of Occupational Therapists and New Graduates
Authors: Chard Gill 
Published: April 2015

Learning to use new skills through continuing professional education courses is an important part of continuing professional development, contributing towards the evidence of competence to practise. Few studies have examined how such new learning is used in professional practice. This study investigated the experiences of occupational therapists when learning to use the Assessment of Motor and Process Skills (AMPS) and whether years of experience or clinical area affected how the AMPS was used in practice. Twenty-three occupational therapists who undertook a 5-day AMPS course completed three questionnaires over a 10-month period. Thirteen were senior level occupational therapists and 10 were new graduates about to commence employment in their first post. Significant differences between the two groups were found in three areas: the new graduates experienced more difficulties when starting to use the AMPS, completed fewer assessments and found workplace difficulties more time consuming. The two groups shared many difficulties when learning to use a new skill and implementing it within workplace teams, but the analysis of the ranking of these difficulties using the Mann-Whitney U test demonstrated no overall difference between the two groups. Successful implementation of the AMPS for all the participants depended on having sufficient time for new learning to take place and on support from managers so that they could change elements of practice to accommodate the use of new skills.