bluuebunny/crossref_metadata_2025_split huggingface dataset:
Activity Pacing in Chronic Pain Management: One Aim, but Which Method? Part One: Introduction and Literature Review
Authors: Birkholtz Marietta , Aylwin Louise , Harman Rachel Megan 
Published: April 2015

People with chronic pain often adopt activity patterns that can exacerbate their pain and undermine their quality of life. Activity pacing is considered an essential component of occupational therapy in pain management and other clinical areas to counteract the overactivity-underactivity cycle. Part one of this paper provides an introduction and literature review on the subject of activity pacing in chronic pain management. Based on case histories, the psychosocial issues arising from underactivity or overactivity, or a combination of the two, are explained. It is demonstrated that activity pacing is ill-defined and subject to discrepancies in practice. In particular, guidance regarding quota-based practice to prevent pain-contingency remains unresolved. Part one concludes that research is needed to clarify both the theory and the practice of activity pacing. Part two of this paper will present the outcomes of a national occupational therapy survey on activity pacing.
From ‘Gibbering Idiot’ to ‘Iceman’, Kenny's Story: A Critical Analysis of an Occupational Narrative
Authors: Finlay Linda 
Published: April 2015

Narratives can offer rich, valuable and powerful insights. However, they do not stand on their own: they need to be interpreted and contextualised. This paper offers a critical analysis of the occupational narrative of one man's journey towards finding a new occupational identity after experiencing mental health problems. The narrative reveals something of the man's, Kenny's, lived experience and his occupational needs, drivers and trajectory. The value of occupation (rather than simply employment) is demonstrated. The narrative is then briefly analysed: first, by taking a phenomenological approach focusing on the lived experience and, secondly, by taking a social constructionist approach which highlights how the story is both performed and co-constructed. This two-pronged analysis demonstrates how narratives are produced and constructed in particular social contexts. How we understand a narrative depends on how we frame it and the theoretical perspectives that we bring to bear. It is important to be reflexive – that is, to be critically self-aware – as we engage in narrative inquiry.
Activity Pacing in Chronic Pain Management: One Aim, but Which Method? Part Two: National Activity Pacing Survey
Authors: Birkholtz Marietta , Aylwin Louise , Harman Rachel Megan 
Published: April 2015

Part one of this paper suggested that, in order to attain activity goals, it is important to replace activity contingent on pain with activity contingent on quota, such as time or number. This is one aspect of activity pacing, which can help to break the detrimental overactivity-underactivity cycle. However, there are few established guidelines regarding activity pacing. Part two reports a study which sought to answer two questions: what are the main principles underlying activity pacing and how are activity pacing principles taught? A questionnaire was posted to all 78 members of the National Occupational Therapy Pain Association in order to sample current practice. The 49 (63%) respondents endorsed nine behaviours contributing to activity pacing, including planning activities, breaking activities into manageable parts, increasing activity amounts gradually and alternating tasks. The occupational therapists used varied methods to teach these behaviours and only half of them used time as the unit of increase. These therapists disagreed about how long to continue timer use for and what activities to use it for. The importance of time-contingency in activity pacing, and related teaching methods, is contentious. No alternatives were suggested to time-contingency to break the pattern of pain-contingency in activities. Studies are urgently needed concerning the efficacy of time-contingency, the efficacy of any alternatives and their acceptability to patients.
Writing a Literature Review
Authors: Steward Barbara 
Published: April 2015

The processes of searching for literature and appraising evidence critically are well documented. Yet effective ways to report literature reviews, either as pieces of research in their own right or as part of primary research reports, are less easily found. Reviews are often criticised for their lack of coherent construction, of synthesis of key themes and of well argued analysis. More importantly though, reviews are often the Cinderella of research, being less valued than primary research, or dull preludes to research reports. This article considers the structure and content of a good literature review and calls for a new injection of enthusiasm to reflect the fascination of finding ideas, engaging with others' research and building new theories from the assembled evidence. Publishing a review demands art as well as skill to help readers to make sense of a particular world of evidence and make them want to go and find out more for themselves. The article suggests ways to write better reviews and encourages the writing of more papers based on reviews.
What's Cooking? Theory and Practice in the Kitchen
Authors: Bryant Wendy , McKay Elizabeth 
Published: April 2015

Occupational therapists are challenged to demonstrate how their practice is informed by evidence of effectiveness. In the absence of evidence from scientific investigation, theories are used to frame judgements about clinical situations. This paper explores how the process of adapting a kitchen can be informed by occupational theories, based on the first author's experiences as a social services occupational therapist. The kitchen is a familiar space in occupational therapy and forms a key environment for meeting nutritional and social needs in the domestic setting. The process of altering a kitchen is used to illustrate concepts associated with occupation in everyday life. Issues arising from two kitchen adaptations are investigated using categories from the Canadian Model of Occupational Performance and the definition of therapeutic occupation (Nelson 1996). The limitations of applying theory to practice are explored, alongside analysis of how theory enhances practice. Finally, a synthesis, of knowledge based on science and creative practice based on art, is proposed.
Perceptions of Occupational Therapy compared with Physiotherapy and Nursing among Minority Ethnic and White United Kingdom School and College Students: Implications for Recruitment
Authors: Greenwood Nan , Lim Kee Hean , Bithell Christine 
Published: April 2015

There is currently a recruitment crisis in occupational therapy in the United Kingdom and also evidence that minority ethnic groups are underrepresented in the profession. This study comprised 651 self-completion questionnaires and 43 depth interviews with minority ethnic and white school and college students to investigate factors influencing attitudes to careers in occupational therapy. Occupational therapy was much less well known than nursing or physiotherapy and, compared with the white participants, the minority ethnic group participants were less familiar with it. Differences were also found in what the minority ethnic and the white participants wanted from careers. Significantly, the minority ethnic participants were more likely to regard doing a degree as important but were also less aware that occupational therapy was studied at degree level. The participants tended to perceive similarities between occupational therapy and nursing and the implications of this are discussed. In conclusion, while 1 in 10 participants would consider a career in occupational therapy, with lower proportions from the minority ethnic than the white participants, many characteristics of careers considered important by these students applied to occupational therapy. Efforts should be made to increase awareness of occupational therapy with, for example, emphasis placed on degree level study, job security and the level of responsibility and professional nature of the career.
Using the Measure of Processes of Care to Assess Parents' Views of a Paediatric Therapy Service
Authors: Knox Virginia , Menzies Shona 
Published: April 2015

Bobath Scotland is a tertiary referral centre providing therapy for children with cerebral palsy. The staff wanted to find a standardised tool that could assess parents' views regarding the care that their children had received. The aim of this study was to conduct a trial using a recently developed tool, the Measure of Processes of Care (MPOC) (King et al 1995), to investigate families' perceptions of the care received at Bobath Scotland and the extent to which they considered it ‘family friendly’. The MPOC questionnaire was sent to the families who attended Bobath Scotland during a 12-month period. The MPOC consists of five scales: enabling and partnership; general information; specific information; coordinated and comprehensive care; and respectful and supportive care. Items are scored on a 7-point scale, from the behaviour ‘never’ occurs (1) to ‘occurs to a great extent’ (7). Mean scores are calculated for each scale. Questionnaires were sent to 114 families and 72 were returned completed (63%). The mean scale scores were as follows: enabling and partnership, 6.3 (SD 0.64); general information, 4.3 (SD 1.69); specific information, 6.5 (SD 0.75); coordinated and comprehensive care, 6.3 (SD 0.75); and respectful and supportive care, 6.5 (SD 0.60). The overall mean scale scores were high, demonstrating that families were satisfied with their care. The MPOC proved an appropriate tool to investigate the perceptions of care of families attending a paediatric centre.
Occupational Therapy for People with Progressive Neurological Disorders: Unpacking the Black Box
Authors: Jain Shilpa , Kings Jill , Playford E Diane 
Published: April 2015

Progressive neurological disorders often present a challenge to occupational therapists owing to their variable presentation and relentlessly deteriorating course. The literature available to guide therapists either is process driven or describes key roles without detail of the specific therapeutic intervention used. This report describes an occupational therapy programme provided for eight people with multiple system atrophy as part of a randomised controlled trial. The framework given illustrates the three stages of the client-centred programme and provides a comprehensive account of the therapeutic interventions used to change occupational performance. The treatment included techniques to enhance skills, increase knowledge and change attitude. Upon completion of the 8-week programme, the clients reported benefit. Although it cannot be asserted that all these techniques are effective, the occupational therapy programme described constitutes a ‘black box’ and may be useful in formulating further research questions.
The Importance of Independence in Toileting: the Views of Stroke Survivors and their Occupational Therapists
Authors: Clark Joanne , Rugg Sue 
Published: April 2015

The profession of occupational therapy claims to be patient centred; however, research shows that the views of patients and health care professionals often differ. Toileting is a fundamental daily activity, yet to date there have been few studies investigating the perceived importance of independence in toileting. A qualitative study was conducted to determine the views of stroke survivors and their occupational therapists regarding the importance of independence in toileting. A symbolic interactionistic framework was used, allowing the views of these two disparate groups to be compared. Thirteen stroke survivors and seven occupational therapists were interviewed. Five categories were identified in the data collected: the occupational form normally used in toileting; incontinence and continence; independence and dependence in toileting; issues relating to toileting and hospital discharge; and the role of occupational therapy. Both participant groups agreed that independence in toileting was important in avoiding the need for assistance and in avoiding feelings of decreased self-esteem. However, the patient participants' views extended further in that they stated that the method of toileting was important, not merely that it was conducted independently. In conclusion, it is essential that occupational therapists consider how they can facilitate a return to the method usually undertaken for toileting by patients. If a return to the previous methodology for toileting will not be possible, then the occupational therapists must give consideration as to how to facilitate adjustment by the patients.
Continuing Professional Development: The Impact of the College of Occupational Therapists' Standard on Dedicated Time
Authors: White Elizabeth 
Published: April 2015

The 2001 College of Occupational Therapists' Research and Development Strategic Vision and Action Plan (Ilott and White 2001) gave as an objective that ‘managers will allocate regular, dedicated time within the work schedule for agreed research/quality-enhancement activities for all occupational therapy personnel’ (p275). This article describes a survey undertaken to establish the impact of the standard on the continuing professional development (CPD) activities of occupational therapy staff. The 1205 responses received demonstrated an increase in access to dedicated CPD time, which was used for individual study, group activities or service development. The monitoring of outcomes from this time investment was patchy. Dedicated CPD time was found to be beneficial to the individual, his or her service and the service users, although additional work pressure and a lack of study skills were noted. Some respondents were prevented from accessing CPD time owing to workload expectations, whereas others preferred to undertake development activities in their own time. Having a good CPD structure in place was found to contribute to clinical effectiveness and improved staff morale and recruitment. Creative approaches were described to manage competing time demands. It was evident that managerial support was crucial to the progress of development activity within the workplace.
Effective Measurement of the Functional Progress of Stroke Clients
Authors: Jacob-Lloyd Hilary A , Dunn Orla M , Brain Nicola D , Lamb Sarah E 
Published: April 2015

There is a need for occupational therapists to establish a range of outcome measures that can measure change effectively. The aim of this study was to identify effective methods of measuring the functional performance of individuals who had experienced a stroke and had been discharged from a rehabilitation ward. Measures with recorded validity and reliability and in clinical use were selected. The measures were the Barthel Index (Shah version), Nottingham Extended Activities of Daily Living scale, Motricity Index (Upper and Lower Limb), Rivermead Mobility Index and Nine-Hole Peg Test. Assessments were carried out at the point of discharge from hospital and 6 months later. Responsiveness was analysed using effect size and relative efficiency statistics. The practicality (feasibility) was established by comparing completion rates. The Nottingham Extended Activities of Daily Living scale and the Rivermead Mobility Index were found to be more responsive than the Barthel Index and Lower Limb Motricity Index respectively and to be practical after discharge from hospital. The Nine-Hole Peg Test was found to be more responsive than the Upper Limb Motricity Index but less practical. The analysis suggested that some measures are more suitable than others for tracking change in function after discharge from hospital for a wide case mix of people who have experienced a stroke.
Scholarship of Practice: Making Occupation-Focused, Theory-Driven, Evidence-Based Practice a Reality
Authors: Forsyth Kirsty , Mann Lynn Summerfield , Kielhofner Gary 
Published: April 2015

National and local policies require the profession to provide evidence on which practice is based. This paper illustrates an approach to meeting the expectations of these policies. Specifically, it describes the development of the United Kingdom Centre for Outcomes Research and Education (UKCORE). UKCORE was developed within a ‘scholarship of practice’ framework, which supports the development of robust partnerships between academia and practice whereby academic knowledge influences practice and practice knowledge influences academia. Within the partnership, all academic participants (educators, researchers and students) and practice participants (clinicians, clients and administrators) are called ‘practice scholars’ and are focused on practice scholarship. UKCORE was founded in London in 2001 in order to support the delivery of existing evidence into occupational therapy practice while simultaneously supporting practice to engage in generating new evidence for occupational therapy practice. This article provides an overview of the academic and practice changes that have been put into place. The changes are designed to support the development of practice that is occupation focused, theory driven and evidence based.
Developmental Coordination Disorder and Self-Esteem: Do Occupational Therapy Groups Have a Positive Effect?
Authors: McWilliams Steve 
Published: April 2015

Children with developmental coordination disorder (DCD) have motor difficulties that impede the acquisition of both functional and academic skills and evidence suggests that these children may also have reduced self-esteem. One approach to treatment often adopted by occupational therapists is in the form of group therapy. Anecdotal evidence indicates that although these groups may produce little improvement in motor skills, there may be an associated increase in the children's self-confidence and self-esteem. This pilot study aimed to evaluate whether this was the case. A mixed methodology was used to evaluate the self-esteem of 12 children with DCD and to obtain the views of their parents/carers. A repeated measure design was used to assess the children using a validated measure of self-esteem, the Culture-Free Self-Esteem Inventories (CFSEI-2, Battle 1992), at initial assessment and pre and post therapy group. The parents/carers of the children were asked to complete a questionnaire during the last therapy group session and this formed the basis of a post-group interview. The results indicated that for this group of children the therapy groups did have a positive effect on their self-esteem in the majority of cases. Although it is unreasonable to draw definite conclusions from this pilot study because of the small sample size, possible implications for policy and practice are discussed and suggestions for further research are given.
Living with Impairment: Learning from Disabled Young People's Biographies
Authors: Curtin Michael , Clarke Gill 
Published: April 2015

Little research has been published investigating the experiences of growing up with an impairment from the perspective of disabled young people. The aim of the present research was to investigate the life stories of a small number of disabled young people through their biographies. Nine young people who had a motor impairment, three girls and six boys aged between 10 and 14 years, were recruited through two segregated special schools. Each young person participated in several open interviews and was encouraged to tell his or her life story, collaborating in the co-construction of his or her own biography. Once the biographies were completed, they were thematically analysed. Four themes emerged from the analysis: family, friends, education and living with an impairment. The focus of this article is on the last theme. The findings indicate that the young people were positive about their lives even though they implied that it was a struggle at times, primarily due to the negative perceptions that the general public had of disabled people. They did not consider that their medical and therapy interventions contributed to their feeling different, but saw these interventions as important to maintaining and improving their function. They accepted that they had an impairment, but did not see this as a reason for not getting on with their lives. The findings challenge health professionals to believe that it is possible to lead a fulfilling life in spite of having an impairment and that interventions should reinforce the disabled young people's personal acceptance of themselves.
The Reliability of the Occupational Therapy Adult Perceptual Screening Test (OT-APST)
Authors: Cooke Deirdre M , McKenna Kryss , Fleming Jennifer , Darnell Ross 
Published: April 2015

The Occupational Therapy Adult Perceptual Screening Test (OT-APST) is designed to screen for impairments in visual perception and apraxia in adults following stroke. The OT-APST is a comprehensive battery that contains 25 items in the following seven subscale areas: agnosia (5 items); visuospatial relations covering elements of body scheme (4 items) and unilateral neglect (5 items); constructional skills (3 items); apraxia (6 items); acalculia (1 item); and functional skills (5 items). Several OT-APST items contribute to more than one subscale, hence there is a difference in the number of items in each subscale and the overall number of items. This study reports three aspects of the reliability of the OT-APST: interrater, intrarater and test-retest reliability. The participants in the interrater and intrarater reliability study were 15 people following stroke. Videotaped OT-APST performance was scored by nine occupational therapists and the results compared with the scores of the first author as the gold-standard rater. The participants in the test-retest reliability study were 10 people who were neurologically stable one year after stroke and were assessed 2 weeks apart on the OT-APST. The results obtained for each of the 25 OT-APST items included intraclass correlation coefficients (Type 3,1) for interrater reliability ranging from 0.66 to 1.0, for intrarater reliability ranging from 0.64 to 1.0, and for test-retest reliability ranging from 0.76 to 0.95. These results indicate that the OT-APST has good interrater, intrarater and test-retest reliability and offers a reliable screening tool for use by occupational therapists working in the area of stroke.
Friends United: An Evaluation of an Innovative Residential Self-Management Programme in Adolescent Rheumatology
Authors: Hackett Janine , Johnson Bernadette , Shaw Karen L , McDonagh Janet E 
Published: April 2015

Independence in activities of daily living, self-advocacy and peer support are important aspects of adolescent development. These skills are potentially affected by chronic rheumatic diseases and are worthy of attention by occupational therapists and other members of the multidisciplinary team. An innovative 4-day residential programme for young people diagnosed with chronic rheumatic disease, known as the ‘Independence Break’, was evaluated in order to determine its perceived benefits. The participants were invited to complete a brief evaluation form immediately after the trip to determine the benefits of participation in the programme. The levels of continuing social contact within the group were established 4 months later during a subsequent telephone call. Thirty young people (median age 14 years) attended the 4-day programme and reported friendship and improved performance in activities of daily living as the major benefits. The majority stayed in touch with at least one other person, with more girls staying in touch than boys. The preferred method of communication was text messaging. Overall, the programme was perceived to be a valuable experience and offered the young people an opportunity to develop informal peer support networks. The potential of text messaging within adolescent rheumatology is also highlighted.