bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Exploration of Individuals' Expectations of their Stay on an Elderly Care Unit
Authors: Dady Karen F , Rugg Sue 
Published: April 2015

This article describes the elements of a qualitative cross-sectional study which explored the relationship between the expectations and the experience of 20 individuals with regard to their stay on an elderly care unit. The study data were gathered using semi-structured interviews and analysed using content analysis techniques. The participants were found to hold a variety of expectations about the tangible and conceptual elements of their experience. Their comments focused primarily on the outcomes experienced rather than on the processes occurring. Their expectations appeared to change in conjunction with both time and experience, with common themes emerging. The study concluded that the participants' expectations were formed on hunches and/or previous information. They described their situation largely in terms of a mismatch between their expected and actual experience or with regard to unexpected situations. The results suggested that the unit concerned might usefully provide additional information to those admitted. They also raised some broader issues of potential interest to occupational therapists as a whole.
Advantages and Disadvantages of the Home Setting for Therapy: Views of Patients and Therapists
Authors: Stephenson Sue , Wiles Rose 
Published: April 2015

A qualitative study was undertaken to explore patients' views and perceptions of a home-delivered therapy service. Fifteen subjects with hemiplegia were recruited from one health district, 10 women and 5 men. All subjects had experienced at least three consecutive sessions of both home-delivered therapy and hospital-based therapy in the preceding 18 months. A semi-structured interview was undertaken with each subject. Transcribed data were analysed using the grounded theory approach (Glaser and Strauss 1967). Five main themes were identified: ‘Convenience’, ‘Therapeutic environment’, ‘Social contact’, ‘Control’ and ‘Grateful recipient?’ Two discussion groups were held with six therapists after the data collection phase to explore their perceptions of the themes emerging from the interviews. The subjects identified convenience and being comfortable within the home as two significant advantages of home therapy. The therapists highlighted the greater relevancy of the home environment for intervention and goal setting. The disadvantages identified by the subjects included the lack of equipment and floor space and the demotivating effect of the home setting. The therapists identified the difficulty of determining control within a therapy session. The study demonstrated that the assumptions about the advantages and disadvantages of community-based rehabilitation services made by service providers are not necessarily experienced by the users of such services.
Using Programme Logic Models in Evaluation: A Review of the Literature and the Spinal Outreach Team Experience
Authors: Cox Ruth J 
Published: April 2015

The evaluation of intervention is becoming increasingly important in occupational therapy practice and management. Programme logic models aim to assist evaluation by linking programme interventions with intended outcomes. These models include a hierarchy of programme inputs, processes, outputs, outcomes and impacts. This article reviews the literature regarding programme logic models and uses a case example, the Spinal Outreach Team, to illustrate the utility and limitations of this approach to evaluation. A figure is included which illustrates part of the programme logic model developed for the team. It is concluded that use of a programme logic process by occupational therapists facilitates the development of comprehensive evaluation plans and relevant performance indicators.
Designing the Home Falls and Accidents Screening Tool (HOME FAST): Selecting the Items
Authors: Mackenzie Lynette , Byles Julie , Higginbotham Nick 
Published: April 2015

The Home Falls and Accidents Screening Tool (HOME FAST) was developed as a screening instrument for use in a community preventive care trial for older people. This paper describes the first stage of the development of this screening tool. The objectives of the study were (i) to review existing home safety measures, (ii) to field test an instrument containing a pool of home safety items with the goal of identifying those hazards associated with falls in the home and (iii) to select the items for inclusion in a 25-item tool using an expert panel. The field testing took place in a rural area of Australia, where the pooled checklist was used to evaluate hazards within the homes of 83 older people. No individual hazards were associated with the risk of falls at home and, although participants who had experienced falls had a higher mean number of home hazards (mean = 13.7, SD 8.2), the differences between fallers and non-fallers was not significant. Items relevant to a rural population were indicated through field testing. Further psychometric testing of the HOME FAST and a meaningful method of scoring the checklist are now warranted.
Empowered or Discouraged? A Study of People with Learning Disabilities and their Experience of Engaging in Intimate Relationships
Authors: White Emily , Barnitt Rosemary 
Published: April 2015

Vulnerable people constitute the majority of referrals to occupational therapy services, due to age and social, psychological and economic circumstances. People with learning disabilities may fit all these categories. An argument has been put that vulnerable people should not be subjects in research (de Raeve 1994) and that there may be unacceptable risks in being a subject in a socially sensitive research project (Barnitt and Partridge 1999). However, avoiding research with people with learning disabilities would mean that the voice of these clients would not be heard and it is known that they have expressed the wish to be consulted and involved in research (Atkinson 1989). A collaborative study was carried out with eight adults with learning disabilities who lived in a community residential home. Interviews were completed which dealt with aspects of intimate relationships. Three themes emerged from the interviews: the experience of intimate relationships, the future of a current relationship and the involvement of others in relationships. The findings showed that the people interviewed had a generally positive experience of such relationships. However, while the attitudes of staff and family towards intimate relationships were mostly empowering, some negative views still existed. The results have implications for occupational therapists working with people with learning disabilities.
Client-Centred Practice: Is it Compatible with Early Discharge Hospital-at-Home Policies?
Authors: Lane Linda 
Published: April 2015

Current Government initiatives promote the provision of health care in the community rather than in medical institutions. Over the last decade there has been a growth in the number of early discharge hospital-at-home initiatives which provide a level of nursing and rehabilitation care in the home that previously would have been provided in an acute hospital. Simultaneously, there has been a move away from medical to client-centred models of health care delivery. These new client-centred models of health care emphasise collaboration between client and professional and encourage users of health care services to take greater control over and responsibility for their health care. Some occupational therapists may question whether the principles of client-centred care are compatible with the policy of discharging patients early from hospital while they remain in need of health care. This paper briefly reviews some of the principles of the Canadian Model of Occupational Performance; discusses some of the barriers to providing client-centred services in the early discharge hospital-at-home setting; and reflects upon whether the principles of client-centredness are consistent with early discharge from hospital policies.
Educating Occupational Therapists for Mental Health Practice
Authors: Craik Christine , Austin Chris 
Published: April 2015

The last of four elements of the Mental Health Project, established by the College of Occupational Therapists to produce a position paper on the way ahead for research, education and practice in occupational therapy in mental health (Craik et al 1998a), focused on educating occupational therapy students to work in mental health. First, the views of practitioners about their pre-registration education were derived from one component of the practitioners' survey (Craik et al 1998b). One hundred and eleven (81%) practitioners considered that their pre-registration education had been sufficient or partially sufficient to meet their needs on first working in mental health. Secondly, the views of occupational therapy educators were elicited by a short qualitative survey that replicated three questions about future issues in mental health, which had formed a key constituent of both the practitioners' survey (Craik et al 1998b) and the managers' survey (Craik et al 1999). Important issues for educators were focusing on clients who would benefit most from occupational therapy in community and primary care settings, preparing undergraduates for the unique approach of occupational therapy and the need for more research to support evidence-based practice. Both groups highlighted the value of positive fieldwork placements.
Fitness for Purpose of Occupational Therapy Graduates: Two Different Perspectives
Authors: Barnitt Rosemary , Salmond Rosemary 
Published: April 2015

A research study that looked at fitness for purpose of 312 occupational therapy and physiotherapy graduates was carried out between 1996 and 1999. The research was commissioned by the Department of Health and managed jointly by the Universities of East Anglia and Southampton. A particular emphasis of the research was the influence of joint undergraduate education on the performance of graduates in first post. A full report of the research can be found in Wiles et al (1999). Recommendations arising from the research report led to debate with service managers about the meaning of the results and thus the conclusions drawn. This paper was therefore prepared to explore the different perceptions of an educator and a service manager with regard to three themes arising from the research. These were the selection of students for occupational therapy education, the expectations of new graduates about their first post and the transition from student to therapist.
Home-Based Occupational Therapy: Stroke Patients' Satisfaction with Occupational Performance and Service Provision
Authors: Gilbertson Louise , Langhorne Peter 
Published: April 2015

This study evaluated a short post-discharge home-based occupational therapy service for stroke patients, including an assessment of the patients' satisfaction with occupational performance and service provision. A single-site, blind randomised controlled trial was conducted. One hundred and thirty-eight patients were randomly allocated to either a conventional outpatient follow-up or conventional services plus 6 weeks of home-based occupational therapy. The data were collected before discharge and at 7 weeks and 6 months after discharge using the Canadian Occupational Performance Measure (COPM), the Dartmouth COOP Charts, the London Handicap Scale and a patient satisfaction questionnaire. At 7 weeks the intervention group reported significantly greater changes in performance and satisfaction on the COPM, better emotional scores (Dartmouth COOP Charts) and improved work and leisure activity scores (London Handicap Scale). No other differences in subjective health status were described. By 6 months, the intervention group was more satisfied with several aspects of service provision but no other differences in subjective health experience were reported. A 6-week post-discharge home-based occupational therapy service can improve patients' perceptions of their occupational performance and satisfaction with services but may not have a long-term effect on subjective health outcomes.
The Utility of the Modified Barthel Index for Traumatic Brain Injury Rehabilitation and Prognosis
Authors: Shah Surya , Muncer Steven , Griffin Jenelle , Elliott Leesa 
Published: April 2015

The aim of this correlational study was to examine the utility of the Modified Barthel Index (MBI) in measuring functional outcome and in determining its predictive ability at the commencement of rehabilitation. All 79 patients with a traumatic brain injury admitted in 12 months were the participants in the study. Functional status, as measured by the MBI total scores on admission to and discharge from comprehensive rehabilitation, and all available independent variables on admission were extracted. The study found that 85% of admissions were male. The participants' mean age was 28 ± 10.67 years, 73% of them were single and 97% had a diagnosis of closed traumatic brain injury confirmed by a CAT scan. Their rehabilitation stay was 61 ± 65 days. The admission MBI scores were 75 ± 30 and the discharge scores were 93 ± 29. In a stepwise regression, initial deficit as measured by the MBI, delay in commencing rehabilitation and age contributed to explaining 68% of variance. However, when the MBI scores were transformed, the fourth root of the admission score alone explained 84% of variance. This predictive ability is far superior to the findings of many other studies.
Multicentre Trials: Planning and Achieving TOTAL
Authors: Drummond A E R , Parker C J 
Published: April 2015

This article provides an overview for those conducting multicentre rehabilitation trials. It aims to highlight potential problems and difficulties which may not be obvious initially. TOTAL (Trial of Occupational Therapy and Leisure) was a multicentre rehabilitation trial. The aim was to test whether a leisure-based intervention was more effective than activities of daily living (ADL) based therapy at improving the mood, leisure participation and independence in ADL of stroke patients. During the study period, 466 patients were recruited from five centres in the United Kingdom. Postal assessments were sent out at 6 and 12 months after discharge to evaluate mood, leisure independence and ADL performance. The possible difficulties in recruiting centres are presented. The problems encountered were staff shortages, insufficient numbers of patients, concern over aspects of the protocol and funding issues. Day-to-day problems in running the trial and how these may be resolved are also discussed, such as access to the trial coordinator, finance, the need for written agreements and regular communication with each centre. While the complexity of conducting a multicentre trial should not be underestimated, preparation, good planning and an awareness of potential problems makes it a feasible proposition.
An Investigation into the Use of the Assessment of Motor and Process Skills (AMPS) in Clinical Practice
Authors: Chard Gill 
Published: April 2015

This study aimed to investigate how occupational therapists used the Assessment of Motor and Process Skills (AMPS) in their clinical practice following an AMPS training course. Questionnaires and group interviews were used over a 9-month period to follow up 53 occupational therapists and establish how they were using the AMPS in their workplace. It explored the difficulties that they experienced in implementing the AMPS in their clinical practice and using the AMPS with their client group and within their clinical team. The results showed that 96% of the occupational therapists were using the AMPS in their clinical practice at 5 months following training and 83% were still using it at 9 months. The difficulties experienced included problems associated with low staffing levels, high workloads or lack of time to introduce new work skills. Success was dependent on a supportive working environment, especially from managers, and adequate time available to allow for the development of a new skill. Occupational therapy managers need to support therapists following training to make the best use of the time and the cost involved in training individuals to use the AMPS.
To Serve Better: Addressing Poor Performance in Occupational Therapy
Authors: Bannigan Katrina 
Published: April 2015

A health care professional is not always ‘the right person, doing the right thing, in the right way, in the right place, at the right time and with the right result’ (Mead, quoted in Potter 2000, p3). In some renowned cases, health care professionals' interventions have resulted in the deaths of patients. For this reason and others, such as unacceptable variation in practice, poor performance is one of the six aspects of clinical governance, which is an integrated quality framework (Sealey 1999). Clinical governance, although a National Health Service development, has implications for all occupational therapists, whatever setting they work in. This discussion paper presents the concept of poor performance in the context of performance management, which is a mechanism for the early identification and the remedying of poor performance. Early recognition, feedback on performance, decisive intervention and effective self-regulation are the headings used to frame this discussion. The implications for occupational therapists nationally, locally and personally are also explored. The central theme is that identifying and dealing with poor performance is every occupational therapist's personal responsibility.
Falling from Grace or into Expert Hands? Alternative Accounts about Falling in Older People
Authors: Ballinger Claire , Payne Sheila 
Published: April 2015

Falls in older people are a priority area for both research and clinical intervention in the United Kingdom. There is, however, currently an absence of research exploring the meaning and interpretation of a fall. Semi-structured interviews were conducted with 20 therapists and with eight older people with fractured hips. The therapists' accounts appeared to draw on a ‘risk discourse’ which constructed a fall as a predictable and preventable event, highlighting individual patient characteristics as causative factors and suggesting that therapists were more knowledgeable about this subject. The accounts of the older inpatients, conversely, made use of a ‘moral discourse’, in which commendable personal qualities and competencies were emphasised. It is suggested that this work has implications for therapy in that many falls prevention initiatives and health promotion materials may be falsely premised on an acceptance of vulnerability by older people.
A Physical Activity Intervention in a Community Alcohol Service
Authors: Ussher Michael , McCusker Monica , Morrow Valerie , Donaghy Marie 
Published: April 2015

People recovering from alcohol-related or drug-related problems are often in poor physical condition and have an extremely sedentary lifestyle. This article describes a study in which an occupational therapist in a community alcohol service implemented a physical activity intervention. The aim of the intervention was for clients with substance misuse problems to increase independent physical activities, to engage more in community-based activities, to increase their awareness of the benefits of exercise and to perceive benefits in their health following the programme. Seven people attended a 6-week programme consisting of nine sessions. Each session included an exercise class and group-based physical activity counselling. Case studies for five of the participants are presented. It was shown that it is possible for an intervention combining physical activity counselling with supervised and independent exercise to have an impact on the lives of a few individuals with substance misuse problems. Four of the five participants made substantial gains in all the target areas relating to independence, integration, education and health. It was also shown that it is feasible for an occupational therapist to play a pivotal role in promoting fitness-oriented activities for those with substance misuse problems. Controlled studies are required with larger samples, longer follow-up periods and the comparison of different intervention elements.
Occupational Therapy in Community Mental Health Teams: A Continuing Dilemma? Role Theory Offers an Explanation
Authors: Hughes Julie 
Published: April 2015

Occupational therapists working in community mental health teams (CMHTs) experience the difficulty of balancing the expectations of their profession with those of the team, their employers, the purchasers and the client group within the wider context of health care. This paper uses role theory as a framework to examine why occupational therapists may perceive threats to their professional identity and experience pressure to conform to the defined CMHT ‘role set’. It examines the concepts of role definition, role signs, role ambiguity, role incompatibility and role conflict and the resulting role stress. Occupational therapists need to identify their role problems and either develop strategies to resolve them or suffer role strain. Conformity to the expectations of the role set may mean becoming less effective and less able to distinguish their role from that of the other members of the CMHT. This will have very real consequences for the future of occupational therapy within both CMHTs and the wider context of health care.
Safe Use of Disability Equipment and Manual Handling: Legal Aspects — Part 2, Manual Handling
Authors: Mandelstam Michael 
Published: April 2015

Part 1 of this article dealt with disability equipment. Part 2 deals with the law of manual handling and its practical implications for occupational therapists and their patients, clients and colleagues. It does so by considering the Manual Handling Operations Regulations 1992 themselves together with associated guidance, complementary health and safety at work legislation, the common law of negligence and a substantial body of case law handed down from the courts. In particular, it covers legal terms such as reasonable practicability, risk assessments and resource implications, emergency or exceptional situations, and balancing the health and safety of staff with the needs and wishes of patients and clients. It is concluded that an awareness of manual handling law is likely to facilitate better understanding and organisation of responsibilities, policies, procedures and practices. In turn, this will benefit staff, patients and clients by raising standards of decision making, and is likely to increase safety, reduce potential legal liability and save time and money.
Leisure Activities in Rheumatoid Arthritis: Change after Disease Onset and Associated Factors
Authors: Wikström Ingegerd , Isacsson Åke , Jacobsson Lennart T H 
Published: April 2015

The objective of this investigation was to examine the relationship between leisure-time occupations, quality of life and disease activity among patients with rheumatoid arthritis. Fifty patients with rheumatoid arthritis ± 39 females and 11 males, aged 30–45 years and belonging to functional class I-III according to Steinbrocker et al (1949) ± were recruited from the register at a hospital clinic and from a private outpatient clinic. The participants completed a questionnaire concerning education, occupation, pain, morning stiffness, current leisure activities and those pursued before the onset of the disease, and including the Quality of Life Scale (QoLS). The patients had given up two-thirds of their leisure activities since the onset of the disease. This decrease was observed for both sexes. It correlated positively with present disease activity, measured as pain on a visual analogue scale and as morning stiffness, and negatively with the present QoLS. Longitudinal studies are needed to disentangle further the causes and consequences of loss of leisure activities in rheumatoid arthritis patients.