bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Bathing in Occupational Therapy
Authors: Gooch Hilary 
Published: April 2015

Personal cleanliness is important for all of us. The ability to bath independently is considered important by occupational therapists and their clients. This paper describes the assessment methods used by occupational therapists working with adults with physical disabilities. In addition, it explores the factors that were considered important during the assessment and solution phases of bathing intervention. A survey questionnaire was sent to 108 occupational therapists working in health and social services within Greater London. The findings highlighted that the methods of assessment used most frequently by practitioners were observation in the home or in a simulated environment and face-to-face interviews. During assessment, the components ranked as most important for consideration were ‘mobility’, ‘client priorities’, ‘safety factors’ and ‘medical diagnosis’. During the solution phase similar factors were found, with the additional item of the availability of bathing equipment. The findings of this study raise questions related to bathing issues and indicate a need for further study. Of particular interest are the questions of client priorities within the process and the high number of practitioners not including water in the assessment of this potentially dangerous activity.
Culture, Cultural Competency and Psychosocial Occupational Therapy: A Middle Eastern Perspective
Authors: Awaad Terri 
Published: April 2015

A Western occupational therapist appointed to mental health services for Emirati nationals in Al Ain in the United Arab Emirates is faced with many questions regarding competent practice in what is, to the therapist, a largely alien culture. In an effort to develop a culturally sensitive approach to a new service development, an extensive review was undertaken of the cultural competency and related occupational therapy literature and a framework for culturally competent practice was proposed (Awaad 2003a). One of the key themes identified was the importance of attaining, and the skilful use in therapy, of specific cultural knowledge. This paper attempts to apply this principle through an exploration of the literature concerned with social, occupational and mental health practices in Middle Eastern Islamic societies and their relationship to psychosocial occupational therapy.
The Nature of Leisure in Adolescence: A Focus Group Study
Authors: Passmore Anne , French Davina 
Published: April 2015

Despite the recognition of leisure as a key concept in occupational therapy, there is limited evidence of the theoretical development of leisure within the occupational therapy literature. The wider literature makes claims about the relationship between leisure and health; however, little empirical support for the influence of leisure on wellbeing is demonstrated. Furthermore, leisure is identified as a dominant cultural context of adolescents. This study examined adolescents' perceptions of leisure in their daily lives. A sample of 119 students, aged 12 to 18 years and recruited from the general population, participated in a series of focus groups. Content analysis established a functional typology of leisure, which permits the grouping of diverse activities into a small number of comprehensive categories, namely achievement, social and time-out leisure. The affective dimensions of enjoyment and freedom of choice were reported to underpin the concept of leisure. The nature and value of these categories are discussed in the light of their genesis in the views of young people themselves. The implications for occupational therapy are addressed.
Quality of Life and Traumatic Brain Injury: A One-Year Longitudinal Qualitative Study
Authors: Conneeley Anne Louise 
Published: April 2015

This qualitative study aimed to gain an understanding of the experience of quality of life by those affected by traumatic brain injury. Eighteen patients, their significant other and members of the rehabilitation team were interviewed individually when the patient was discharged from the ward of a neurological rehabilitation hospital, then after 6 months and, again, at one year following discharge from the ward. When the data were analysed, several factors involved in the subjective experience of quality of life were identified. These included a sense of wellbeing, functional status, personal autonomy and the need for the acceptance of disability. An understanding of the experience of those with traumatic brain injury could raise awareness of the issues involved and hence assist those involved in the care of this client group.
Can Patients with Unilateral Neglect following Stroke Drive Electrically Powered Wheelchairs?
Authors: Dawson Jill , Thornton Heather 
Published: April 2015

People with unilateral neglect tend to have persisting disabilities and an increased probability of dependence following stroke. This preliminary research was designed to evaluate the potential use of an indoor electrically powered wheelchair with two people with unilateral neglect. Two male participants with a single-incident right hemisphere lesion were recruited; they were 32 days and 20 days post-stroke. Both had evidence of unilateral neglect on the Behavioural Inattention Test. An ABA single-subject experimental design was used, with a battery of measures administered every weekday for 6 weeks. The measures were the left collisions made and the time taken when negotiating an obstacle course in a powered wheelchair, and two tabletop tasks: the Star Cancellation Test and the Baking Tray Task. During the intervention phase (B), the participants were given 30 minutes of powered wheelchair training every weekday for 2 weeks. Both participants made marked improvements in driving accuracy by driving the wheelchair through an obstacle course for about 5 minutes each weekday for 2 weeks during phase A1. This improvement in driving accuracy unexpectedly occurred before the intervention phase (B), when the powered wheelchair training was introduced. Negligible changes in driving accuracy were seen during and after training had commenced. This suggests that negotiating the obstacle course, which was used as a measure, was acting as a form of treatment. The changes seen in the measures of unilateral neglect suggested that the participants learned to drive the powered wheelchair despite persisting neglect. Many patients with unilateral neglect are not given the chance to drive an electrically powered wheelchair owing to concerns about safety. This preliminary study suggests not only that this patient group can learn to drive indoors safely but also that this may be achieved with minimal therapeutic intervention. Further work needs to be carried out in this area.
Chronic Pain: Gaining Understanding through the Use of Art
Authors: Henare Diane , Hocking Clare , Smythe Liz 
Published: April 2015

Many people have chronic pain yet little is known about what it is like to live with pain on a permanent basis and how this experience affects people. This article reports the findings of a phenomenological study into the meaning of chronic pain for 14 people who were attending a pain management programme in New Zealand. The data for the study comprised artwork produced by the participants in the course of the programme and their explanation of its meaning. Five main themes emerged from the data analysis: gaining pain and losing self, redefining self, identity through others, being hopeful and being on a journey. The study found a strong association between participation in valued occupation, the maintenance and redefinition of identity, experiencing oneself as competent and being hopeful about the future. The research process supported the use of art as an expressive medium in occupational therapy.
Clinical Reasoning: How do Pragmatic Reasoning, Worldview and Client-Centredness Fit?
Authors: Unsworth Carolyn A 
Published: April 2015

Using both clinical reasoning data and literature from the past 20 years, this paper sought to examine the relationship between client-centred practice and clinical reasoning, to explore the concept of pragmatic reasoning and to present a diagrammatic conceptualisation of our knowledge of clinical reasoning in occupational therapy. The clinical reasoning literature published between 1982 and 2001 was reviewed and this information was combined with the findings from a study which used a head-mounted video camera to collect data and then explore the clinical reasoning of 13 experienced occupational therapists. The data were collected and analysed within a focused ethnographic framework. The findings showed that clinical reasoning occurred in the context of client-centred practice, but that a reciprocal relationship appeared to exist between client-centred practice and interactive reasoning. It also appeared that pragmatic reasoning was related only to the therapist's practice context and that all forms of reasoning were influenced by the therapist's worldview. A diagram was developed to depict this current understanding of the modes of clinical reasoning. While clinical reasoning has been described as the guiding force in a therapeutic practice, we are only just beginning to understand the nature of reasoning and reflection and how clinicians think. Further research is required to build and test the emerging theory of clinical reasoning in occupational therapy.
A Qualitative Study Comparing the Experiences of Tilt-in-Space Wheelchair Use and Conventional Wheelchair Use by Clients Severely Disabled with Multiple Sclerosis
Authors: Dewey Ann , Rice-Oxley Margaret , Dean Taraneh 
Published: April 2015

The aim of this study was to explore and compare the experiences of tilt-in-space wheelchair use and conventional wheelchair use in severely disabled clients with multiple sclerosis and significant spasticity. The research design was a descriptive qualitative approach, using in-depth audio-taped interviews in clients' homes carried out over a 9-month period. A total of 23 clients (7 tilt-in-space wheelchair users and 16 conventional wheelchair users) were recruited from three adjacent district wheelchair services in South-East England. The criteria for recruitment were that the clients were severely disabled with multiple sclerosis, had significant spasticity and were full-time wheelchair users, usually requiring hoisting. Their carers were also interviewed. The majority of tilt-in-space wheelchair users (6 out of 7) reported that their chairs were comfortable compared with only half of those in conventional wheelchairs (8 out of 16). The positive aspects of tilt-in-space wheelchair provision included comfort, improved postural support, enhanced seating stability, relief of pressure and being able to rest sitting out of bed for prolonged periods, often for more than 6 hours a day. One person reported improved catheter drainage and another reported reduced spasms. The negative aspects of tilt-in-space wheelchairs included their bulky size and lack of manoeuvrability compared with conventional wheelchairs. All the wheelchair users had experienced difficulty with transport and many had relied on family and friends to help with the purchase of expensive adapted vehicles. In conclusion, the majority of the tilt-in-space users were satisfied with their wheelchair, particularly in terms of comfort.
Occupational Therapy and Evidence-Based Practice in Mental Health
Authors: Lloyd Chris , Bassett Hazel , King Robert 
Published: April 2015

Evidence-based practice (EBP) represents a paradigm shift in health care. This review has two aims. The first is to consider the merits of EBP, especially in respect of its use in mental health settings. The second is both to identify psychosocial interventions that have an established evidence base for effectiveness and to provide an analysis of the quality of this evidence and its implications for occupational therapy. Supported employment, family psychoeducation, assertive case management and integrated substance use treatment are examined in detail. It is proposed that occupational therapists working in mental health give priority to psychosocial interventions that are based on evidence and incorporate these into their practice. It is further proposed that, in implementing EBP, practitioners take an active evaluating position in relation to published evidence, paying particular attention to the evidence of effectiveness in equivalent clinical environments.
Patient Perceptions of the Quality of Information Provided in a Hospital Stroke Rehabilitation Unit
Authors: Tooth Leigh , Hoffmann Tammy 
Published: April 2015

This study explored the extent, source and format of the information received by stroke rehabilitation patients and their perceptions of the quality of that information. Additionally, the readability levels of the written materials received were assessed. Fifteen patients were interviewed approximately 1.8 months post-inpatient rehabilitation. Occupational therapists were the principal sources of information about returning home, equipment/ assistive devices, activities/exercise after stroke and the physical effects of stroke. The patients wanted additional information on the following topics that occupational therapists can address: treatments after stroke, the causes of stroke, risk factors/future prevention, stroke support groups, what to expect in rehabilitation and emotional problems/ difficulties during recovery. Most information was verbal. Although 70% of the patients felt that they had not received enough information and 87% identified gaps in what they had received, the information was considered relevant to their needs, easy to read/understand and helpful in coping with lifestyle changes. Two-thirds had received written information, written at an average grade 12 equivalent; this was a level too high for educating lay people about health. The implications for occupational therapists are that general information may be being provided at the expense of the information of most importance to the patients. Occupational therapists should assess and address patients' informational needs and identify the patients' preferred formats for receiving the information. The assessment of readability is also useful.
‘Baking Gives You Confidence’: Users' Views of Engaging in the Occupation of Baking
Authors: Haley Lesley , McKay Elizabeth Anne 
Published: April 2015

The quality of care in acute inpatient areas has been identified as unacceptable and, in some areas, as counter-therapeutic (Sainsbury Centre for Mental Health 1998). Occupational therapy continues to make a significant contribution within this practice area. However, specific research that has addressed the acute service user's perspective of engagement in occupation is limited. This qualitative study explored 12 mental health service users' perspectives of engagement in the occupation of baking through a semi-structured interview. The findings identified that the opportunity to acquire new skills and, importantly, confidence while producing an end product stimulated the participants to attend the treatment session. The engagement in baking was also influenced by the participants' desire to add structure to their daily routine. The study concludes that the physical and social environment in which the therapy takes place is a powerful motivating factor in facilitating individuals to participate in an occupation. The findings emphasise the importance of engagement in occupations, in conducive settings that meet the individual's needs. The study highlights that baking has many recognisable benefits for service users, offering a flexible and valued occupation.
The Application of Cognitive Orientation to Daily Occupational Performance (CO-OP) with Children 5–7 Years with Developmental Coordination Disorder
Authors: Ward Amanda , Rodger Sylvia 
Published: April 2015

There has been an increase in the use of cognitive frameworks in occupational therapy with children with developmental coordination disorder (DCD). Investigations into the utility of one such cognitive approach, namely Cognitive Orientation to (daily) Occupational Performance (CO-OP), with children with DCD have shown the intervention to be effective with children over 7 years. However, there has been limited research into its utility with younger children. This paper presents two case studies to demonstrate the use of CO-OP with children aged 5–7 years. Two boys with DCD engaged in 10 sessions of CO-OP. These younger children were found to be able to use the global framework (Goal, Plan, Do, Check) to improve their task performance, to develop plans using domain-specific strategies and to engage in checking strategies. Issues relating to attention, motivation and goal setting are discussed in the context of the two case studies.
Overcoming Problems with Generic Working for Occupational Therapists Based in Community Mental Health Settings
Authors: Reeves Scott , Mann Lynn Summerfield 
Published: April 2015

This report presents details of the design, delivery and evaluation of a short course aimed at enhancing occupation-focused practice among occupational therapists working in community mental health settings. The course was offered in response to concerns about an increasing amount of generic working that a number of therapists were undertaking. Consequently, it was felt that their professional role was being eroded within their multidisciplinary teams. The course had two broad learning aims: to explore and understand the issues and problems of generic working practices and to understand how Kielhofner's (2002) occupation-focused model of practice could be used to help occupational therapists to strengthen their professional role. A single-cohort pre/post test design was employed to assess the impact of the course. Questionnaires were distributed at the start of the course and directly following its completion. The findings revealed that the course was well received by the participants. Most felt that it had enhanced their understanding of the issues and problems of generic practice. It was also felt that the course had provided the participants with the confidence to begin addressing the problems of generic working within their respective teams.
Neuro-Occupation: The Nonlinear Dynamics of Intention, Meaning and Perception
Authors: Lazzarini Ivelisse 
Published: April 2015

This paper suggests revisiting and re-exploring the concepts of intention, meaning and perception through neuro-occupation, which theoretically operationalises nonlinear brain dynamics and occupation. A review of theory and research suggests that intention, meaning and perception are instrumental in understanding the client's unfolding life experiences through a self-organised process. In describing the organisation of the nonlinear dynamics of brain activity, it becomes apparent how intention, meaning and perception are the fundamental components of how human beings create meaning by engaging in self-directed and self-determined actions; hence, occupations. Through a fresh point of view and an improved understanding of the concepts of intention, meaning and perception, occupational therapy and occupational science may find common ground to integrate many diverse approaches into a more unified field.
Is Discrepancy between Actual and Preferred Work Activities a Factor in Work-Related Stress for Mental Health Occupational Therapists and Social Workers?
Authors: Lloyd Chris , McKenna Kryss , King Robert 
Published: April 2015

In the Western developed nations, the changing pattern of mental health care provision has necessitated mental health staff adopting new approaches to service delivery across a diverse and expanding range of service settings. The impact of changed service delivery on Australian mental health professionals is an area that has not been well studied. The aim of the study was to identify the current clinical work activities performed by occupational therapists and social workers and whether there was a discrepancy between the actual and preferred work activities. The study also aimed to identify whether any discrepancy between their actual and preferred clinical work activities was associated with higher levels of stress. A cross-sectional survey of 304 (response rate 76.6%) occupational therapists and social workers in Australian mental health services was conducted. A work activities scale developed specifically for this study and the Mental Health Professionals Stress Scale were used to measure actual and preferred work activities and stress respectively. Both groups experienced a discrepancy between their actual and preferred work activities, with the occupational therapists and the social workers mostly wanting to undertake a diverse range of activities to a significantly greater extent than they currently were. As predicted, stress was associated with the discrepancy between the kind of work that the participants wanted to do and the kind of work that their job actually entailed. Health workers require assistance to adapt to their new work roles and to achieve a balance between generic and discipline-specific competencies. This has implications for education and professional training.
The Practice Education of Occupational Therapy Students with Disabilities: Practice Educators' Perspectives
Authors: Hirneth Michael , Mackenzie Lynette 
Published: April 2015

Practice educators play a key role in ensuring that occupational therapy students with disabilities are not excluded from educational experiences. However, little is known about how practice education for occupational therapy and other health professional students with disabilities can be facilitated effectively. A qualitative pilot study was conducted to obtain phenomenological data from clinical practice educators on this subject. Stratified sampling was used to select six occupational therapists from throughout New South Wales, Australia, who had supervised students with a wide range of disabilities. Individual semi-structured interviews were conducted to explore the subjective experiences of and strategies employed by the participants when supervising a student with a disability. The participants often described the adoption of a ‘therapist’ role with these students. This approach was perceived as less effective than an ‘educator’ role in developing students' initiative and clinical reasoning skills. The participants identified both the need for more support and education from universities and the need for improved evaluation strategies to accommodate students' needs while maintaining professional standards. To ensure positive practice education outcomes for students with disabilities, future undertakings should focus on developing collaboration between universities, students and practice educators.
Accreditation of Practice Educators: An Expectation Too Far?
Authors: Craik Christine , McIntyre Anne , Gallagher Margaret 
Published: April 2015

The successful completion of practice placements is essential to the education of occupational therapists; however, ensuring quality placements is challenging for occupational therapy educators. In 2000, Brunel University introduced a revised system of accreditation of practice educators which involved attendance at a course, the supervision of a student and the submission of an essay to be assessed. An audit revealed that a total of 314 therapists attended 15 courses between 2000 and 2003; of these, 243 (77%) subsequently supervised students and 32 (10%) became accredited. The requirement to accredit practice educators, which is a commendable attempt to ensure quality, may paradoxically have been detrimental in achieving quality. The College of Occupational Therapists' apparent change of emphasis on this topic is welcomed.