bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Local Authority Occupational Therapy Services: Developing an Instrument to Measure the User's Perspective
Authors: Calnan Siân , Sixma Herman J , Calnan Michael W , Groenewegen Peter P 
Published: April 2015

The aims of this paper are threefold: (1) to describe the development of an instrument measuring quality of care from the specific perspective of the users of local authority occupational therapy services; (2) to present the results from a survey of users' views about the quality of services offered by a county-wide local authority occupational therapy service compared with other health and social care services; and (3) to examine the potential of the instrument to form part of a more general process of quality assurance and quality improvement within local authority occupational therapy services. A combination of qualitative and quantitative methods was used. Focus group discussions with users preceded a postal survey. Questionnaires were sent to a random sample of 997 disabled people living in Kent who were users of the local authority Occupational Therapy Bureau. The response rate was 55%. An instrument was developed (QUOTE-OT) which was tailored to the expressed needs of the users of a local authority occupational therapy service (Kent Occupational Therapy Bureau). On the basis of this new instrument, the Kent Occupational Therapy Bureau received relatively high performance scores on the quality of care dimensions that were the most important for users, such as aspects that referred to courtesy and the level of professional competence. On the other hand, room for improvement existed on aspects such as the accessibility of occupational therapy services, information given to users and follow-up services. The evidence suggests that the QUOTE-OT questionnaire for assessing users' views of quality of care could be an appropriate tool for evaluating and monitoring local authority occupational therapy service quality.
Perceptual Dysfunction in Elderly People with Cognitive Impairment: A Risk Factor for Falls?
Authors: Buri Helen , Picton Joanne , Dawson Pam 
Published: April 2015

Elderly people with cognitive impairment are highly susceptible to falls and are likely to have perceptual dysfunction. However, the possible relationship between falls and perceptual deficits has never been considered. The purpose of this exploratory study was to investigate whether perceptual deficits are a risk factor for falls and, if so, which types of perceptual dysfunction may pose the greatest risk. A qualitative approach was adopted, using an interview with therapists and observation of elderly residents in care homes. Interaction with the environment, movement and psychological factors emerged as important markers of perceptual dysfunction related to falls. Spatial disorientation emerged as the most important perceptual risk factor. Occupational therapists and physiotherapists should seek ways to improve spatial orientation in elderly cognitively impaired people who fall or who might fall. Adaptive strategies to help them to interact with the environment and approaches to gait analysis that seek a cognitive-perceptual explanation for movement difficulties may be useful.
Do Occupational Therapists and Physiotherapists Teach Elderly People How to Rise after a Fall?
Authors: Kinn Sue , Galloway Linda 
Published: April 2015

Falling is a major problem for the elderly population and much research has been done to investigate the risk factors for and means of preventing falls. However, very little research has been carried out looking at if and how therapists teach elderly people how to rise after a fall. This postal survey was undertaken to investigate whether therapists do anything to try to prevent falls, assess elderly people for suitability and teach them how to rise after a fall. The results showed that almost all the respondents (127 of 137) identified falling as a problem that they had to deal with in their patients over 65 years. The main focus of occupational therapists was to prevent falls by making environmental changes (for example, removing hazards) whereas physiotherapists were involved in physical changes (for example, balance training). Over half the respondents had considered teaching people how to rise after a fall. A range of different methods was used, which broadly fell into physical and verbal instructions or referral to other health care professionals. The sources of knowledge for teaching how to rise after a fall came mainly from previous clinical experience. Falls are an acknowledged problem in the elderly population and among these hospital and community based therapists about half had considered teaching or had taught elderly people how to rise after a fall.
The Impact of Community Paediatric Occupational Therapy on Children with Disabilities and Their Carers
Authors: Stewart Sandra , Neyerlin-Beale Janet 
Published: April 2015

The need to demonstrate ‘best value’ in local authority settings is one of the remits of the white paper Modernising Social Services (Department of Health 1997). This study investigated the effectiveness of paediatric occupational therapy in terms of both increasing the independence of disabled children and reducing the strain of caring on the part of the carers. A before-and-after design was used, in which 33 children with a wide range of disabilities were assessed using two measures — the Community Dependency Index and the Canadian Occupational Performance Measure — prior to receiving and then following occupational therapy. The carers were interviewed separately, using three scales to assess the strain associated with their caring tasks. The findings show a statistically significant shift in the children's scores indicating that the levels of independence improved for most of the children, although many remained dependent on their carers for a number of daily living tasks. While the carers found the occupational therapy service very satisfactory, the evidence suggests that it did not reduce the strain of caring.
The Skill Acquisition of Two Newly Qualified Occupational Therapists
Authors: Spalding Nicola 
Published: April 2015

This research was an investigation, using a case study approach, to gain an understanding of the professional development of two newly qualified occupational therapists. Six interviews were undertaken with each therapist between November 1997 and June 1998. A reflective assignment written in May 1997 by the subjects when they were students also added to the data collection. The progressive nature of their learning resembled the Dreyfus and Dreyfus (1986) model of skill acquisition, where advancement to proficiency level of many skills was evident. Their progression in such a short time was an important finding of this research. This suggested that the amount of exposure to clinical experience was not an indicator of skill acquisition. Instead, the individual merits of the learner, as evidenced by the skills that he or she demonstrated, was a better indicator of professional development. The progression through the stages was explained by reflection on experience. The rapid advancement to proficiency level by the two therapists was thought to be due to their good reflective skills, which facilitated their learning.
Identity Issues for People Living with HIV/AIDS: Humans with Potential or Sexual Victims?
Authors: Yallop Sarah 
Published: April 2015

Sexuality issues are important to consider within the practice of occupational therapy. This is especially so when working with people with the human immunodeficiency virus and the acquired immune deficiency syndrome (HIV/AIDS), where issues related to sexuality are both relevant and present. Recent advances in HIV medications have improved the health and life expectancy for many people living with HIV/AIDS (PLWHA). This has been not only a medical and biological change, but also one that has had dramatic impact on the psychosocial issues, including those related to sexuality, relevant for PLWHA. This shift in HIV context prompted the creation of a new occupational therapy service for PLWHA — Positive Employment Support (PES). This paper describes data from a focus group held with PES clients, conducted to evaluate the client responses to PES and to direct future service provision. While the focus group provided the expected data about client responses to PES, it also provided rich data about the impact of the shifting HIV/AIDS context on notions of sexuality and identity. This paper explores these ideas and the resulting implications for occupational therapists, especially those working within the field of HIV/AIDS.
Implementing Evidence-Based Practice: Factors That Influence the Use of Research Evidence by Occupational Therapists
Authors: Humphris Debra , Littlejohns Peter , Victor Christina , O'Halloran Paul , Peacock Janet 
Published: April 2015

Developing a professional and organisational culture within National Health Service (NHS) trusts that is supportive of improving evidence-based practice will require both the generation and the use of research evidence. This article reports the findings of a study that explored the factors that inhibit and facilitate the use of research evidence by occupational therapists. The sample of 100 occupational therapists was drawn from across seven acute NHS trusts, in one NHS region, including two teaching hospitals. The postal survey achieved a 78% response rate. The findings illustrate that whilst occupational therapists have a positive attitude towards the use of research and are keen to make use of that evidence in practice, workload pressures are a major inhibiting factor. The challenge for practitioners and managers alike is to create organisational conditions that are supportive of the NHS policy objectives to enhance the use of evidence-based practice.
The Effect of Electrically Powered Indoor/Outdoor Wheelchairs on Occupation: A Study of Users' Views
Authors: Evans Rosemary 
Published: April 2015

In 1996, the Government provided an allocation of money for National Health Service wheelchair services to issue severely disabled people with electrically powered indoor/outdoor wheelchairs (EPIOCs). This funding was for 4 years only (NHS Executive 1996). Although further money for EPIOCs has been announced (NHS Executive and Department of Health 2000), it has not been ring fenced and could therefore be used in other ways. Evidence needs to be gathered in order to justify continued spending on EPIOC provision. To gather such evidence, this study explored the views of EPIOC users. A qualitative design (semi-structured interviews) examined the effect that EPIOC use had had on their occupations. Eight users were interviewed (mean age 55.5 years, range 39–76 years). The resulting descriptive data were content analysed. The data emerged in three sections. The main section contained four themes and indicated that EPIOC use provided a greater opportunity to participate in and control occupation. The other sections indicated how the EPIOC users had felt before and after provision. Negative feelings, such as depression, had changed to more positive feelings about themselves. The findings indicate that occupation was enhanced through EPIOC use. There is also a suggestion that this may have a positive effect on users' health. Further research is needed to discover whether the findings can be generalised to a wider population.
Mental Health Clients Confirm the Motivating Power of Occupation
Authors: Mee Jeannie , Sumsion Thelma 
Published: April 2015

Most occupational therapists, like the founders of the profession, believe that engagement in meaningful occupation is fundamental in helping to overcome the effects of disability. This paper describes the method and one of the resulting themes of a study that investigated the value, related to personal meaning, of occupation from the perspective of people with enduring mental health problems. Qualitative research methods were used in two mental health day service settings: a workshop, where woodwork was provided as a medium for creative therapy, and a drop-in facility. Clients were asked about their motivation, their occupational experiences and any benefits that engagement in occupation might have had for them. Participant observation was undertaken over 10 sessions and six in-depth interviews were conducted. The findings emerged through content and inductive analysis, as well as analytical triangulation of the data. Occupation was identified as a means for generating intrinsic motivation. By providing a sense of purpose and a structuring of time, within an empowering environment, engagement in occupation was seen to be of value and had personal meaning for the clients. However, more research needs to be undertaken to augment the findings. Such evidence will support increased provision of occupation for people whose lives have been severely disrupted by mental health problems.
Working with Adults with Enduring Mental Illness: Emotional Demands Experienced by Occupational Therapists and the Coping Strategies They Employ
Authors: Brice Helen Elizabeth 
Published: April 2015

This study addressed the following research question: what emotional demands may be experienced by occupational therapists working with adults with enduring mental illness and what coping strategies do they use? A survey approach, using semi-structured interviews, was employed for this qualitative research study. The sample comprised six senior I occupational therapists currently working with this client group in the community. The data analysis involved developing a thematic framework which identified key issues and recurrent themes in the data. This enabled participants' responses to be compared and contrasted and meaningful data relevant to the research question to be extracted. The findings indicated that working with adults with enduring mental illness can be emotionally demanding but that therapists also find their work rewarding. The characteristics of this client group which may cause emotional strain include their complex, long-term problems and the need for clinicians to provide support over a lengthy period. The most commonly used coping strategies were supervision and discussion with colleagues. The study emphasises the importance of occupational therapists maintaining their own emotional wellbeing, not only to protect their own health but also to provide an effective service for their clients.
The Canadian Occupational Performance Measure: Is it a Reliable Measure in Clients with Chronic Obstructive Pulmonary Disease?
Authors: Sewell Louise , Singh Sally J 
Published: April 2015

The Canadian Occupational Performance Measure (COPM) is now a widely used and accepted outcome measure for clients with chronic conditions. The aim of this study was to examine the reproducibility of the COPM in clients with chronic obstructive pulmonary disease (COPD). Test-retest reliability of the performance and satisfaction scores has yet to be established in this population. The reasons for examining reliability are discussed. Fifteen clinically stable clients (eight men and seven women, mean age 67.1 years) were interviewed by an occupational therapist and their COPM performance and satisfaction scores recorded. A reassessment of the performance and satisfaction scores then took place about 7 days later. The scores were analysed using the mean difference, 95% confidence intervals and correlation coefficients. The results were as follows: performance score 1 and performance score 2: mean difference = 0.14 (95% CI: −0.39 to 0.68); and satisfaction score 1 and satisfaction score 2: mean difference = 0.42 (95% CI: −0.18 to 1.01). The intraclass correlation coefficients between test 1 and test 2 were high (r = 0.92 for performance and r = 0.90 for satisfaction). This study indicates that the COPM is a reliable tool in clients with COPD.
Mothers with Arthritis, Child Care and Occupational Therapy: Insight through Case Studies
Authors: Grant Mary 
Published: April 2015

The role of occupational therapy in the treatment of mothers with arthritis has received little attention in the research literature to date. This study builds on previous work at the Psychosocial Research Centre at Coventry University on the theme of parenting in the context of arthritis. Qualitative case studies were undertaken with four mothers with arthritis and the two occupational therapists involved in their care. This involved the observation of occupational therapy sessions, interviews with mothers and occupational therapists and the use of field notes. The data were analysed using the middle-order approach (Dey 1993). The middle-order categories that emerged were physical and psychosocial parenting problems, the level of support available to mothers and their experience of occupational therapy. The subcategories included items such as difficulty in carrying children and with physical play, guilt and anxiety about the ability to fulfil the parenting role, inadequate or too much support from partners and increased knowledge and confidence through occupational therapy. Broad, overarching themes evolving from these data included the significance of mothers' attitudes to parenting based on preconceived notions of motherhood, the psychological state of mothers and the nature of the support available from partners. The implications for practice include the importance of nurturing a mother's own problem-solving strategies and balancing the physical and psychosocial aspects of intervention according to her needs.
Supervision in Occupational Therapy, Part 2: The Supervisee's Dilemma
Authors: Sweeney Grace , Webley Paul , Treacher Andy 
Published: April 2015

The first paper (Sweeney et al 2001) in this series of three on supervision in occupational therapy reported the views and experiences of occupational therapy supervisors. In contrast to the supervisor experience, where there remains a paucity of evidence in the general literature, the clinician as supervisee has been relatively well explored. However, the literature on the experiences of the occupational therapy supervisee is virtually nonexistent. This paper, the second in the series, describes a grounded theory study which set out to explore the process of first-line supervision from the perspective of the novice occupational therapy supervisee (those employed at basic grade and senior II levels). Data collection took the form of semi-structured, one-to-one interviews with 30 female supervisees, who were drawn from a wide range of clinical specialties within the National Health Service in the South West of England. The findings suggested that there existed a large gap between what many of the supervisees expected from supervision and what they actually received. In addition, there was evidence that the typical supervisee entered the supervision process with the aim of presenting a professional face to her supervisor and to the wider health care team and that she did this to protect her fragile sense of competence. Many supervisees employed a range of covert strategies within the supervision setting in order to facilitate the presentation of a professional face. The use of this approach carried with it a number of risks and benefits for the supervisee. The final paper in the series will discuss the implications of these two studies of supervisor and supervisee experience in order to distil recommendations for the future practice of supervision within the profession.
Occupational Science: The Key to Broadening Horizons
Authors: Wilcock Ann A 
Published: April 2015

In this paper, I will consider occupational science as a key to broadening horizons in occupational therapy. I start by clarifying and defining what occupational science is, and discuss the benefits that rigorous study of humans as occupational beings may bring to occupational therapy. I suggest that adopting occupational science will assist occupational therapists to think in occupational rather than medical terms. This alone would extend the profession's domain of concern considerably, because it becomes clear that it is not only the people with disorder of body or mind who are occupationally handicapped. Humans have ‘occupational needs’ which are related to maintaining health, and many health outcomes, either good or bad, can be traced back to basic occupational determinants that people have created over time. Our twentieth century founders recognised that we needed such a science and, even earlier, social philosophers wrote of its importance. If occupational therapists work as agents of change according to a sound knowledge base built upon the unique aspect of life and health which is their domain, they will be able to respond and develop according to rapidly changing economies and values. This keynote address was given on 4 July 2001 at the 25th Annual Conference of the College of Occupational Therapists, held at the University of Wales, Swansea.
Students' Choice of Occupational Therapy as a Second Degree
Authors: Craik Christine , Napthine Clare 
Published: April 2015

There has been little research in the United Kingdom into the recruitment of occupational therapy students. This study focused on one aspect and surveyed students already holding a degree, in order to ascertain the factors that attracted them to occupational therapy and why they chose a further 3-year degree course in preference to postgraduate alternative routes to qualification. Sixty-four students, holding degrees predominantly in the human sciences and the arts, were motivated to study occupational therapy at Brunel University through a desire to obtain a vocational qualification and to pursue a career that helped others and offered variety and personal satisfaction. The majority of the students learned of the profession through working in health and social care environments, and chose to study at Brunel University owing to its location in London and its reputation for attracting mature students. Although 90% of the students had been aware of the 2-year accelerated postgraduate diplomas in occupational therapy, more than a third preferred to undertake a 3-year degree course because it allowed more time for study and part-time employment. The need to target recruitment at school leavers, graduates in related degrees and those already working in health or social care was identified.
An Investigation of Carers' Burden: Before and after a Total Hip Replacement
Authors: Chow W H 
Published: April 2015

Osteoarthritis in the hip joint is a chronic degenerative condition, causing pain and disability. As the disease progresses, the individual's health deteriorates. This often results in one of the family members having to assume a carer role to assist the care receiver in personal and domestic activities of daily living. The purpose of this study was to investigate whether carers experienced stress from looking after individuals with osteoarthritis who were waiting for a total hip replacement. The survey was conducted with 23 carers using postal questionnaires before and 3 months after the care receivers had undergone a total hip replacement. It concluded that carers do experience stress from looking after people with osteoarthritis waiting for a total hip replacement and that the carers' stress level was not reduced significantly 3 months after the hip operation. The results of this study have implications for health care professionals who come into contact with this group of carers.