bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns and Antecedents of the Development of Self-Awareness following Traumatic Brain Injury: The Importance of Occupation
Authors: Dirette Diane K , Plaisier Brian R , Jones Susan J 
Published: April 2015

The purpose of this study was to explore the pattern of the development of self-awareness following traumatic brain injury (TBI). Further, the antecedents to change in self-awareness and the use of compensatory strategies were examined. A longitudinal descriptive method was used with 18 adult participants and their significant others. Each pair was interviewed at 1 week, 1 month, 4 months and 1 year post-injury, using the Awareness Questionnaire, the Patient Assessment of Own Functioning Inventory and the Personal Evaluation of Community Integration. Comparative analyses were conducted between the participants and their significant others, as well as among the different levels of severity of brain injury. The participants with mild TBI showed better self-awareness than the participants with moderate/severe TBI. By 1 year post-injury, however, the level of self-awareness for the participants with mild TBI was not significantly different from that for the participants with moderate/severe TBI. The pattern of the development of self-awareness was different between the two groups. The participants with mild TBI initially overestimated deficits, but demonstrated good self-awareness throughout. The participants with moderate/severe TBI significantly underestimated deficits, but demonstrated a gradual increase in self-awareness. The reported antecedents to self-awareness were similar. Both groups primarily used a comparison of their ability to perform familiar occupations after the injury as a means for developing self-awareness. Severity of injury and time post-injury are both significant variables in the pattern of recovery of self-awareness following TBI. Occupational therapists should consider the use of familiar occupations to assist in the recovery process.
‘Alchemy and Magic’: The Experience of Using Clay for People with Chronic Illness and Disability
Authors: Timmons Alexandra , MacDonald Elaine 
Published: April 2015

Clay is used within various therapeutic settings, yet within the occupational therapy literature there is a significant lack of evidence to support its use. This phenomenological study sought to enquire into the experience of ceramics as a creative leisure pursuit for people living with long-term physical health problems. Six people responded to an invitation to participate published in an international ceramics journal. They were given the choice to be interviewed by telephone or in person, or to provide a written account about their experience of engaging in ceramics. The criteria for recruitment were people living with a chronic illness or a physical disability who currently engaged in the occupation of ceramics. The data collection and analysis utilised interpretative phenomenological analysis. Four main themes emerged from the data analysis: being productive and creating, promoting physical and psychological wellbeing, enhancing opportunities for social interaction and ‘alchemy and magic’. All the participants reported ways in which working with clay was beneficial to their health and contributed to personal wellbeing. The ceramic process afforded opportunities for experiencing flow and creative adventure, enabled social contacts, enhanced self-worth and provided the participants with a sense of achievement, all of which appeared to promote successful adaptation to ill health. For a minority, the material itself enabled expression about feelings of loss and, in some cases, maintained physical functioning. These findings have relevance for occupational therapists because they suggest that a meaningful creative occupation may be helpful for people learning to cope with chronic conditions.
The Way We Were: Romantic Assumptions of Pioneering Occupational Therapists in the United Kingdom
Authors: Hocking Clare 
Published: April 2015

This is the first in a series of three articles that explores occupational therapy's philosophical foundations in rationalism and Romanticism. The articles report the findings of a study that employed a history of ideas approach, which centres on the ideas people hold and how those change over time. The core idea in this study was that people's sense of themselves is expressed through the things that they have and use, a proposition that was explored in the context of occupational therapy as it was becoming established in the United Kingdom. The data comprised references to objects in occupational therapy texts and a precursor to the British journal published in England in the 25-year period between 1938 and 1962, which were analysed to identify the ways in which therapists thought about the things that they used in practice, along with those that they asked their patients to make. This article focuses on occupational therapists' Romantic assumptions. It introduces the Romantics, together with their historical context and their ideas, and outlines how those ideas were transmitted to occupational therapy through the Arts and Crafts Movement. It then discusses occupational therapists' Romantic accounts of the tragedy of illness and disability, the dehumanising effects of industrial labour, the joy of crafting things by hand and the transformative potential of occupational therapy. Finally, the seeds of discontent with Romanticism that surfaced within the profession are identified.
An Autoethnographic Exploration of an Occupation: Doing a PhD
Authors: Taylor Jackie 
Published: April 2015

The systematic and detailed study of occupations is challenging to occupational therapists, who would wish to understand better their meanings and therapeutic value. Such a study must attempt to capture the complexities of occupational form and performance, recognising occupations as spatially, socially and temporally situated phenomena that are culturally recognised and individually experienced. Autoethnography is a methodological approach in which the researcher is the focus of the research. It offers a way of accessing personal experience by focusing on physical artefacts, documentary evidence and reflections, and so is particularly useful for studying the complexity of occupational engagement. With ‘doing-a-PhD’ as its focus, this study used autoethnography to explore the subjective experience of engagement with an occupation in order to understand better its complexity, meaning and possible therapeutic value. The findings are presented under six headings, which explore the personal and social aspects of the occupation, the ways in which it interfaces with the contexts of time and space, its relationship with other occupations and roles, and the process of transformation that it brings about. The limitations of the approach are discussed and the implications of the study for occupational therapists are proposed.
The Way We Were: Thinking Rationally
Authors: Hocking Clare 
Published: April 2015

This is the second of three articles arising from a study that employed a history of ideas approach to explore how occupational therapists working in the United Kingdom before 1962 thought about their practice. The perspective taken was that people think about things in ways that are consistent with Western society's philosophical roots in Romanticism and rationalism. The data were drawn from books and journals published between 1938 and 1962. The purpose of the study was to learn about the profession as it was being established, in order to increase understanding of current practice issues and concerns. The focus of this article is occupational therapists' rationalism, which is evident in their careful accrual of technical expertise and attempts to account for their practice. Over time, occupational therapists' proclivity to organise and expand their knowledge base supported developments in vocational rehabilitation and activities of daily living programmes. These efforts were encouraged by other health professions and while they helped to secure occupational therapists' place in rehabilitation settings, they also contributed to the decline in craftwork, an emphasis on independence in activities of daily living, and circumscribed therapeutic goals.
Factors associated with the Acquisition of Expertise in Upper Limb Hypertonicity Management
Authors: Burgess Tegan , Rassafiani Mehdi , Copley Jodie 
Published: April 2015

Upper limb hypertonicity management is a complex domain, in which there is limited high level evidence to support treatment approaches. Therefore, it is important to identify clinical experts to assist practice development. This study aimed to investigate the relationship between the factors related to clinical experience and the development of expertise in this area. Through correspondence, 29 therapists were asked to choose the most appropriate intervention for 60 case vignettes. The responses were examined using the Cochran-Weiss-Shanteau Index of Performance, and were analysed in regard to therapists' ability to prescribe differing interventions based on differences in the vignettes and on their consistency when vignettes were unknowingly repeated. The number of professional development activities that the therapists had undertaken since attaining occupational therapy qualifications was the only factor significantly associated with increased levels of expertise. The factors not significantly associated with increased expertise included therapists' work setting, years of experience and current proportion of caseload comprising hypertonicity. The results indicated that expertise gained in the area of hypertonicity was not specific to clients' age or condition because, although all vignettes presented were those of children with cerebral palsy, there was no significant difference in the expertise found between paediatric and adult therapists. Further research is warranted to investigate the forms of professional development that best support the development of expertise in this area.
Assessments of Upper Limb Ability following Stroke: A Review
Authors: Rowland Tennille J , Gustafsson Louise 
Published: April 2015

The aim of this paper was to review the psychometric properties and clinical utility of assessments of upper limb ability following stroke. Upper limb ability was defined as the use of the arm in meaningful activity. The database searches identified 13 assessments of upper limb ability. The inclusion criteria were (a) an evaluation of upper limb ability post-stroke, (b) a quantitative assessment yielding a numerical score, (c) able to be administered by an occupational therapist and (d) published information building on the results of a review in 2001. The assessments included were reviewed with respect to the ability measured, equipment required, evidence of reliability and validity, and advantages and disadvantages of use. Seven assessments satisfied the inclusion criteria. These assessments have undergone varying degrees of psychometric testing as outcome measures for upper limb recovery and all demonstrate at least adequate levels of reliability and validity. There is variation in the availability of instruction manuals and time commitments for test administration. All test items are generally available and inexpensive, enabling departments to set up the assessments with minimal financial outlay. The assessments described are regularly used in research and all demonstrate psychometric properties that suggest that they could be incorporated into clinical practice. Occupational therapists are encouraged to consider how they may include these assessments into their own clinical practice. An important step in this process may be further research into the clinical utility of these assessments.
An Occupational Perspective on the Assessment of Social Competence in Children
Authors: Lim Sok Mui , Rodger Sylvia 
Published: April 2015

Maintaining relationships and interacting socially are essential aspects of the occupational performance of childhood and adolescence. Social participation occurs during many childhood occupations, such as play and school work. Occupational therapists assess and treat children with difficulties in social participation. Rather than assessing a child's social skills deficits in isolation, the use of occupation-based theoretical models guides clinicians to consider the individual in his or her environments and during occupations. Familiarity with existing models of social competence and available assessment tools provides occupational therapists with the basis for a comprehensive assessment of children. This paper presents an occupational therapy model (the Model of Human Occupation), models of social competence from cognate fields and a range of assessment tools in order to guide occupational therapists in assessing and treating children with social participation difficulties in a more occupation-centred manner. The paper also presents a rationale for the use of multiple methods for a comprehensive assessment of a child's social competence.
Chronic Fatigue Syndrome and Occupational Disruption in Primary Care: Is There a Role for Occupational Therapy?
Authors: Hughes Julie L 
Published: April 2015

This paper presents the findings of a postal survey that examined the experience of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in the primary care setting. The views of 51 general practitioners (GPs) (response rate of 30%) and 51 people that had experienced CFS/ME (response rate of 61%) were collected in an attempt to describe both the occupational disruption experienced due to CFS/ME and the current management offered in primary care, and to investigate whether there was an early intervention role for occupational therapy. The greatest level of occupational disruption reported was in the performance of self-care and productivity tasks and the most helpful intervention reported was that of acknowledgement of the condition and its implications. The GPs rated the use of cognitive behavioural therapy and graded exercise therapy as more beneficial than medical care for CFS/ME and many offered advice on these interventions, but 57% of people with CFS/ME reported that they had received unhelpful advice and/or treatment from their GP. Currently, there is little research evidence to support any particular interventions for people with CFS/ME in primary care and the prevention of occupational dysfunction, as often seen in secondary and tertiary care, is a role that could be fulfilled by occupational therapists.
An Evaluation of the Validity of the Test of Visual Perceptual Skills - Revised (TVPS-R) Using the Rasch Measurement Model
Authors: Brown Ted , Rodger Sylvia 
Published: April 2015

The visual perceptual skills of children are often evaluated by health care and education practitioners. Even though the Test of Visual Perceptual Skills - Revised (TVPS-R) is one of the most frequently used instruments with school-age children, its construct validity has not been evaluated thoroughly. The purpose of the study was to evaluate the scalability/interval level measurement, unidimensionality, lack of differential item functioning (DIF), and hierarchical ordering of items of the TVPS-R and its seven subscales using the Rasch Measurement Model (RMM). The TVPS-R scores from a sample of 356 normally developing children (171 boys and 185 girls), ranging in age from 5 to 11 years, were used to complete the RMM analysis. When the seven individual TVPS-R scales were analysed, they all exhibited adequate measurement properties (scalability/interval level measurement, unidimensionality, lack of DIF, and hierarchical ordering). However, when they were collapsed together to form an overall composite scale of motor-free visual perceptual skills, the TVPS-R items failed to group together to measure a unidimensional construct. In addition, many scale items exhibited RMM misfit or DIF. The results suggest that the seven TVPS-R subscales can be used on an individual basis with clients to generate a profile of their motor-free visual perceptual skills, but that they cannot be summed together to calculate an overall summary motor-free visual perceptual score or perceptual quotient. The TVPS-R composite scale does not exhibit adequate construct validity.
Cancer-Related Fatigue: A Review and a Conceptual Framework to Guide Therapists' Understanding
Authors: Pureell Amanda , Fleming Jennifer , Haines Terry , Bennett Sally 
Published: April 2015

Cancer-related fatigue is reported as the most common and distressing symptom experienced by people with cancer. There is limited research published to guide occupational therapists working with people with cancer to help address this distressing symptom. This article reviews literature on cancer-related fatigue and identifies several factors associated with the development of fatigue, including underlying medical factors and other factors. The underlying medical factors reported in the literature include biomedical mechanisms, such as anaemia, proinflammatory cytokines and specific cellular processes; disease-related factors; treatment-related factors; and comorbid conditions. Other factors reviewed include physical or behavioural factors, such as poor nutrition, decreased activity, sleep disturbance and pain; psychological factors, including anxiety and depression; and sociodemographic factors, such as social support, employment and education. The review identified a variety of factors associated with cancer-related fatigue, which must be considered by occupational therapists working with people with cancer. This presents a challenge to the clinical reasoning of occupational therapists attempting to treat such people. A framework of factors contributing to cancer-related fatigue is proposed in order to guide both the practice of occupational therapists working with adults with cancer and future research in this area.
Occupational Therapy Defined as a Complex Intervention: A 5-Year Review
Authors: Creek Jennifer 
Published: April 2015

This paper describes the review of the impact of the College of Occupational Therapists' publication, Occupational therapy defined as a complex intervention (Creek 2003). The background to the publication is outlined briefly. The method of data collection and the descriptive-explanatory method of data analysis are described. The three main findings are presented: occupational therapists have continued to access the definition throughout the 5 years since it was published; the definition has been read and used both in the United Kingdom and in other countries; and the definition is understood and used in a variety of different ways and for different purposes. The paper concludes that the definition of occupational therapy as a complex intervention captured a major shift in how occupational therapists understand the world, but that this way of thinking needs to be embedded more fully into all pre-registration and post-registration education programmes.
Triaging Patients for Allied Health Services: A Systematic Review of the Literature
Authors: Harding Katherine , Taylor Nicholas , Shaw-Stuart Lisa 
Published: April 2015

Occupational therapists and other allied health clinicians often need to make decisions about the relative urgency of referrals, which patients should be seen first and, in some cases, whether patients require services at all. A systematic review of the literature was conducted to investigate the properties and outcomes of triage systems applied to patients referred to allied health services. Literature was searched through the CINAHL, EMBASE and MEDLINE databases (until March 2008), combining the key elements of ‘allied health’ and ‘triage’. Seven articles were identified that met the inclusion and exclusion criteria, and these were assessed against quality criteria and a process of descriptive synthesis applied for the purpose of analysis and comparison. The findings indicate that there has been little investigation of the outcomes of allied health triage systems. Studies that have assessed triage systems have focused largely on measurement properties and the majority of these have indicated poor to fair reliability. A first step in introducing allied health triage systems is to establish reliability, involving the patient directly in the assessment process. There is not yet sufficient evidence to recommend any particular triage system for application to allied health services.
An Exploration of Communication between Clients and Professionals in the Design of Home Adaptations
Authors: Nord Catharina , Eakin Pamela , Astley Phil , Atkinson Andrew R 
Published: April 2015

This study explored communications between the people involved in the design of home adaptations, including clients and carers, occupational therapists, surveyors and builders. The aims were to explore (i) what constituted good communication in this context and (ii) how communication occurred. One London borough was selected as a case study. All participants lived or worked within the borough and had been involved in the adaptation process. Nineteen individual semi-structured interviews were conducted with six clients, four occupational therapists, six grant surveyors and three builders. The findings suggest that the professionals constituted a ‘community of practice’ (Wenger 1998) within which communication was good. The professionals used plan drawings to support communication between them. However, the study found that client involvement in the design was limited and that plan drawings were not effective tools in communication with them. The clients relied on the occupational therapist to represent their interests in the design process. Occupational therapists' communication with clients on the design of adaptations may be enhanced by the development and use of more sophisticated visualisation tools to replace the plan drawings. This would enable clients to become more engaged in the adaptations process.
Equipment Provision by Local Authority Occupational Therapy Teams Using the Fair Access to Care Services Eligibility Framework: A Vignette and Interview Study
Authors: Sackley Catherine , Lett Karen , Littlechild Rosemary 
Published: April 2015

Purpose: In April 2003, the first national eligibility framework for adult services, Fair Access to Care Services (FACS), was implemented by local authorities in England. The intention was to ensure equity in the provision of adaptive equipment. This study examined how the criteria were being used by local authority occupational therapy teams and if equity was being achieved. Procedure: Five vignettes or hypothetical case histories were used to capture the experiences of a purposefully selected group of 12 employees from three local authority occupational therapy teams in the Midlands. Semi-structured interviews were then conducted to explore the themes raised by responses to the vignettes. Interviews were recorded and transcribed. Thematic analysis was independently conducted by two of the authors. Findings: There are inconsistencies in the access to services and the use of eligibility criteria, particularly at the point of entry to the service and for those people who are classified as having ‘low’ level needs. However, there is consistency within professional practice and evidence that staff prioritise client need. Conclusion: The implementation of FACS has been inconsistent and has not resulted in equity of provision. Some occupational therapy staff appear to prioritise the needs of clients above organisational policies.