bluuebunny/crossref_metadata_2025_split huggingface dataset:
Should Multidisciplinary Pain Management Programmes Attempt to Reduce Self-Reported Pain in Patients with Chronic Back Pain? The Experience of a Welsh Inpatient Unit
Authors: Gough Mary , Frost Michael 
Published: April 2015

Given poor outcomes in pain reduction, It has recently been recommended in this Journal that the primary aim of multidisciplinary pain management programmes should be to improve physical functioning rather than attempting to reduce the experience of pain. This study evaluates the effectiveness of a pain management programme in reducing self-reported pain within the overall context of improvements in quality of life, as assessed by the SF36 Health Survey Questionnaire. Logistical and methodological problems in evaluating self-reported pain are discussed. The results at discharge show a statistically significant reduction in reported pain for the group as a whole and a clinically relevant Improvement in 53.8% of patients. These benefits are maintained up to one-year follow-up, which suggests that pain management programmes should not abandon the attempt to reduce self-reported pain.
The Use of Self-Directed Learning during Fieldwork Education: The Students' Perspective
Authors: Heath Lesley Anne 
Published: April 2015

The University of Derby is committed to educational strategies that develop reflective practice and lifelong learning in occupational therapy education. Self-directed learning is implemented during fieldwork placements, enabling students to become active in the learning process and integrating the individual's previous experiences, application of knowledge and present learning needs. The principles of self-directed learning adopted by the university also involve students in setting and evaluating their own aims and objectives, writing a learning contract and negotiating reports with fieldwork educators. The aims of the study were to consider whether students used the principles of self-directed learning during fieldwork placements and what influenced their use. The method was a two-stage process, involving a questionnaire and semi-structured interviews. The subjects were in their final year of education. The results showed an overall increase in the use of the principles of self-directed learning at the end of 3 years' education. From the six interviews conducted, the occupational therapy department, the style of supervision and the university procedure were identified as the main influences on the use of self-directed learning during placements.
A Study of the Housing Needs of Disabled Applicants to the Nottingham City Council Housing Department and the Problems Faced by Local Housing Providers in Meeting These Needs
Authors: Logan P A , Batchvarova M , Read C 
Published: April 2015

This study of the housing needs of disabled people and the problems faced by housing providers in Nottingham was carried out with a view to establishing a data base of adapted properties and disabled people. A small survey of 47 disabled people, with 22 respondents, reported problems when trying to find a new home. Less than a quarter of those who replied had been assessed prior to looking for a new home by an occupational therapist, while over half said that they would like help from an occupational therapist when choosing a new home. A survey of 42 housing providers found that, of the 26 respondents, over half had disabled people waiting for a property and a third had adapted properties that they were unable to let. These findings supported local concern about housing problems for disabled people and led to the development of the Disabled People and Adapted Properties Register (DPAPR). This register holds a computerised list of disabled people looking for a new home and of the adapted properties in Nottingham, for sale or for rent.
Snoezelen: Its Long-Term and Short-Term Effects on Older People with Dementia
Authors: Baker Roger , Dowling Zena , Wareing Lesley Ann , Dawson Jeannette , Assey Julian 
Published: April 2015

A randomised controlled trial was conducted to investigate the long-term and short-term effects of the Snoezelen environment on the behaviour, mood and cognition of elderly patients with dementia, and to gain an understanding of the processes occurring within Snoezelen. Patients participated in either eight Snoezelen or eight activity sessions. Pre-trial, mid-trial, post-trial and follow-up assessments were carried out at home and at the day hospital. Ratings of behaviour and mood were also made before, during and after each session. In the long term, the main benefits for Snoezelen patients were in the domain of socially disturbed behaviour. In the home setting, there was a highly significant difference between the two groups in favour of Snoezelen, and in the hospital setting it was nearly significant. Short-term improvements in behaviour and mood were evident for both groups after sessions, and communication was significantly better during Snoezelen sessions in comparison with activity sessions. The processes occurring within Snoezelen sessions seemed to involve facilitation of verbal expression and memory recall.
Understanding the Statistical Concepts of Measures of Work Performance
Authors: McFadyen Angus K , Pratt Joanne 
Published: April 2015

Increasingly, health and social care environments require occupational therapists to demonstrate cost and clinical effectiveness and appropriate outcome measurement of services, the importance of which has been discussed previously in this journal (de Clive-Lowe, 1996). Therapists may be required to select objective tools which can provide data to enhance their qualitative observations of client performance. It is argued that today's therapists require a working knowledge of statistical concepts (Drummond, 1996). This article attempts to provide an introduction to the main statistical concepts that underpin the selection and interpretation of data, from tools that have been designed to measure various aspects of work performance. The information provided is intended to be useful in assisting therapists to make informed decisions about the clinical applicability of a particular tool.
Coping with Chronic Illness and Disability through Creative Needlecraft
Authors: Reynolds Frances 
Published: April 2015

Chronic illness and impairment commonly restrict the individual's access to work and leisure activities. Furthermore, if increasingly dependent upon family care, the individual may experience loss of valued roles and self-esteem. The present study enquired into the role of a creative leisure pursuit in long-term coping with illness and disability. The qualitative study examined the written narratives of 35 women, aged 18 to 87 years. All had acquired a disability or a chronic illness in adulthood and shared needlecraft as a common leisure pursuit. In these accounts, the women described the circumstances in which needlecraft had been adopted as a leisure pursuit and the personal benefits experienced. The accounts showed that most of the women had taken up this activity in adulthood to cope with the crisis of illness. Needlecraft activities were commonly viewed as providing a means of managing pain and unstructured time, as well as facilitating self-esteem and reciprocal social roles. The women's accounts suggest that creative activity may be helpful for patients learning to cope with chronic conditions.
The Impact of Counselling Skills Training on the Interpersonal Skills of Undergraduate Occupational Therapy Students
Authors: Jeffery Bridget , Hicks Carolyn 
Published: April 2015

A considerable emphasis has been placed on the role of social and communication skills within the health care professions. As a result, many pre-registration education and training courses now include counselling skills modules, on the basis that these will ultimately enhance a range of interpersonal skills within clinical practice. In order to test this assumption, a study was carried out to assess whether completion of counselling skills assignments had an impact upon a range of interpersonal skills in occupational therapy. Using 36 first-year undergraduate occupational therapy students, the study investigated two related hypotheses. The first hypothesis compared the interpersonal skills performance on placement between those students who had completed the counselling skins assignment and those students who had completed an alternative. An unrelated t-test produced a non-significant result (t = 1.386, df = 34, p>0.05), which suggested that undertaking a counselling skills assignment had no effect on social skills. The second hypothesis was concerned with the relationship between interpersonal performance and the grade obtained for the counselling assignment. A Pearson's product moment correlation was carried out which also produced a non-significant result (r = 0.008, df = 34, p>0.05). This suggested that no relationship existed between performance on the counselling skills module and interpersonal skills in the clinical domain. These results challenge existing assumptions about the value of including counselling skills modules within pre-registration occupational therapy courses, and highlight the need to seek more effective alternatives for enhancing essential interpersonal skills.
Occupational Therapy for Children with Handwriting Difficulties: A Framework for Evaluation and Treatment
Authors: Chu Sidney 
Published: April 2015

Handwriting is one of the most complex skills that is learnt and taught. It requires motor, sensory, perceptual, praxis and cognitive functions, and the integration of these functions. When the complex nature of this skill is considered, it comes as little surprise that many children experience difficulty in mastering this area. When an occupational therapist observes that a child referred to the service is having difficulty with handwriting, it becomes necessary for the therapist to administer procedures to identify the strengths and weaknesses that will then become the basis for a remedial programme. This article presents a conceptual framework for evaluating and treating handwriting difficulties presented by children in mainstream education with specific developmental disorder, such as dyspraxia or dyslexia. The performance components and functional performance of handwriting are briefly reviewed. Both evaluation and intervention procedures are discussed in order to guide the therapist in developing remedial and instructional programmes. The article highlights the unique role of the occupational therapist in evaluating and treating a child's functional performance of handwriting skills.
Occupational Therapy in Community Mental Health, Part 1: Intervention Choice
Authors: Meeson Beverley 
Published: April 2015

Arguments about the blurring of roles between the members of multidisciplinary community mental health teams and the generic style of intervention within them are well rehearsed. However, an empirical description of the daily work practice of occupational therapists in this field has not yet been attempted. This article presents a study examining the choices made by 12 therapists in the south east of England when working with their clients. Part 1 reports quantifiable findings on intervention media chosen over a 4-week period, drawn from diary data. The results revealed diverse patterns of intervention choices. However, an emphasis on anxiety management chosen 295 times (16% of intervention selections), supportive counselling chosen 348 times (18% of selections) and problem-solving discussion with clients about aspects of their daily lives chosen 255 times (13% of selections) emerged. Follow-up interviews explored each participant's rationale for the patterns of practice highlighted by the diaries, which will be illustrated and discussed in part 2.
An Exploratory Study of People's Perceptions and Experiences of Wellbeing
Authors: Wilcock A A , van der Arend H , Darling K , Scholz J , Siddall R , Snigg C , Stephens J 
Published: April 2015

This paper describes an exploratory study aimed at understanding peoples perceptions and experiences of wellbeing. As health and wellbeing are considered by world and national health authorities to be closely related, occupational therapists along with other health workers need to know more about wellbeing, particularly from the perspective of ‘the people’. Using a questionnaire, seven cluster samples of 20 people, giving a total of 140 participants, were asked to define their concept of wellbeing, how it felt to them and how often they experienced the feeling. Data were also collected about nationality, marital status, employment, income, religion and levels of education because these have been identified as affecting wellbeing. In this study, wellbeing was described as happiness, peace, mind and body health and self-esteem, and was strongly associated with occupations as varied as work, relaxation and dressing up; relationships; and environments. No particular associations were found with any of the demographic data.
Current Concepts and Controversies in Stroke Recovery: Rehabilitation Implications
Authors: Shah Surya 
Published: April 2015

This paper summarises the stroke incidence crude rate as 3.02 per 1000 people of 25 years and over and that of ‘mini-strokes’ as 2.89 per 1000 people. Many people with a mini-stroke may develop a full stroke within one year. Occupational therapists therefore need to shift their attention first to primary prevention to alter original organic pathology and then to restitution of hemiplegia. A number of issues in neurological recovery following hemiplegia are then highlighted. These include ‘penumbra’, a metabolic disorder, the understanding of which helps to know if a hemiplegic lesion is able to tolerate the loss of oxygen and whether it can adapt to the ischaemia, early mortality and implications of regional cerebral circulation changes for treatment of hemiplegia and for prognosis. In the treatment of hemiplegia, there is a need to understand the role of ipsilateral brain, that is, brain plasticity in stroke recovery, the role of uncrossed pyramidal fibres, the parallel versus hierarchical operation of the descending cortical influences, and the interactions of the pre-motor systems with the primary cortex. In treatment, the paper explains the implications of the use of Bobath-type therapeutic procedures, the use of unilateral or bilateral tasks in occupational therapy and the learned non-use of the hemiplegic side.
A Survey of Occupational Therapy Practitioners in Mental Health
Authors: Craik Christine , Chacksfield John D , Richards Gabrielle 
Published: April 2015

As part of the College of Occupational Therapists' Mental Health Project, a survey of occupational therapists practising in mental health in the United Kingdom was conducted. A questionnaire was sent to 200 members of the Association of Occupational Therapists in Mental Health and achieved a 68.5% response rate. The majority of the 137 respondents were female, with Senior I staff between 20 and 30 years of age, who were unlikely to have worked in another area, forming the largest group. Although most had received additional training, they identified the need for more training, especially in aspects of occupational therapy. Most were managed by an occupational therapist and 96% received supervision. Community mental health was the most frequently reported area of work, with leisure, counselling, anxiety management and creative activities the most frequently used interventions. The respondents were committed to the core principles of occupational therapy and the need to develop outcome measures and evidence-based practice, and were concerned about moves to generic working. This study has provided data not only for the position paper on the way ahead for occupational therapy in mental health but also for individual occupational therapists and managers.
A Degree in Occupational Therapy: How Do Traditional and Non-Traditional Entry Routes Compare?
Authors: Howard Lynne M , Watson Martin J 
Published: April 2015

There are different entry qualification routes to an honours degree course in occupational therapy. These differences, coupled with the considerable age-range of applicants, mean that students commence their courses from widely different starting points, which may have a bearing on their academic career. This study examined some chosen starting points briefly and, by retrospective analysis of 47 student progress files, looked at how students fared over their university careers. In particular, it examined whether certain pre-entry factors were associated with good degree results. A secondary focus was the relevance of A-level biology as an entrance criterion. The results indicated that students coming into occupational therapy via both traditional and non-traditional routes did equally well and that A-level biology was not associated with degree performance.
Levels of Stress and Perceived Need for Supervision in Senior Occupational Therapy Staff
Authors: Allan Fiona , Ledwith Frank 
Published: April 2015

A survey was carried out to examine the links between self-reported levels of stress in occupational therapists, the perceived needs for professional supervision and future job intentions. A request was posted to a representative sample of 60 occupational therapy managers, who were each asked to give out anonymous questionnaires to five senior occupational therapy staff. The questionnaire asked for information on grade, length of time since qualifying, specialty area, perceived level of stress, extent of satisfaction with five aspects of supervision (opportunities to reflect on practice, to offload feelings, for professional support, for learning and for encouragement of professional development) and job intentions in 5 years' time. A return rate of 70% (211 out of 300) was achieved. Around a third of staff reported ‘high’ or ‘very high’ levels of stress and 19% said that they intended to have a job outside occupational therapy within 5 years. Around 40% wished for more of each of the aspects of supervision and only 25% were satisfied with all aspects of supervision. There was evidence that those who felt most stressed were more likely to want more supervision and that those intending to leave the profession felt particularly lacking in opportunities to offload feelings. It was estimated from the data that, across the United Kingdom, 2300 senior occupational therapists intended to leave the profession, which would take 3 years' Intake of new graduates to make good. It is suggested that more adequate levels of supervision, which could well be informal, would help to address the problem of the potential loss of many senior and experienced staff.
A Question of Good Practice? Community Cafe Law and Occupational Therapists
Authors: Mandelstam Michael 
Published: April 2015

Occupational therapists working in social services departments and delivering community care continue to be subject to anxiety about the legality of some of their actions. This article considers aspects of relevant legislation, decisions of the law courts and recommendations of the local ombudsmen. Community care law, afflicted by uncertainties and rapid change, sometimes lacks neat and precise answers; even so, legal awareness will assist occupational therapists to ask the right questions about the lawfulness of the local authority policies to which they work and of the individual decisions flowing from those policies. Readers might conclude that they face a formidable legal minefield, but will also observe that the principles applied by the law courts coincide to a significant extent with good professional practice and basic common sense. For example, judges have dealt with issues such as individual and holistic assessment of need, the importance of assessment as a benefit in its own right, bringing an open mind to assessment, taking account of what service users have to say, looking out for exceptional needs, identifying a range of solutions, formulating coherent care plans, writing accurate letters and keeping good records. In combination, lawful decision making and good practice form a dual incentive for occupational therapists to improve standards of service, even if both are sometimes jeopardised by the short cuts forced on local authorities by limited resources.
A Critical Review of Functionality Assessment in Natural and Prosthetic Hands
Authors: Light C M , Chappell P H , Kyberd P J , Ellis B S 
Published: April 2015

Functionality is a generic term used when considering the dexterity and manipulative ability provided by both natural and artificial hands. Despite this, there has been little standardised work to quantify this terminology, or to allow the performance of a hand prosthesis to be compared to that of the human hand. This paper details, with wide-ranging emphasis, existing hand assessment procedures developed for both clinical and research applications. The absence of conformity in these protocols, along with a reliance on subjective evaluations, produces concerns over their reliability and validity for providing meaningful information on hand performance. The assessment of prosthetic hands has been largely dependent on engineering tests and minimal activities of daily living. An evaluation of these procedures reveals a lack of uniformity and, moreover, an inability to quantify the functionality of such devices with respect to a benchmark, such as the human hand. Conclusions from the critical review of both natural and prosthetic hand assessment procedures are used to provide criteria for a standardised and objective protocol for use in a clinical environment, where emphasis on the collation of tangible and repeatable data is as important as the speed and cost of the procedure.
The Use of the Canadian Occupational Performance Measure for the Assessment of Outcome on a Neurorehabilitation Unit
Authors: Bodiam Carolyn 
Published: April 2015

The Canadian Occupational Performance Measure (COPM) was used as a client-centred outcome measure on a neurological rehabilitation unit. Seventeen clients with a variety of neurological disorders (eight with physical deficits and nine with physical and cognitive deficits) were assessed using the COPM on admission, and their occupational therapy incorporated activities that they identified as important to improve. Forty-six per cent of the chosen activities were related to productivity and leisure and 54% were related to self-care. The COPM was repeated on discharge. The results showed a statistically significant increase in client ratings of performance and satisfaction. The increase in ratings between initial and final assessments was higher for satisfaction than for performance in clients with only physical problems, compared with clients with both physical and cognitive problems where the increases were less marked. Further study of a group with only cognitive problems would confirm whether the differences were due to difficulty in self-rating of performance or to a lack of awareness of cognitive deficits. The effective use of the COPM as an outcome measure of occupational therapy in a rehabilitation setting is shown. Further studies in the hospital and community settings are suggested.
Management Strategies for Musculoskeletal Stress in the Parents of Children with Restricted Mobility
Authors: Nicholson Janet 
Published: April 2015

This article presents the results of a postal survey of parents caring for children with restricted mobility in Southern Derbyshire. The survey investigated the incidence of musculoskeletal problems in the study group and looked at the ways that these parents managed to care for themselves and what strategies they used to perform tasks that involved lifting and supporting their child. The results revealed a high incidence of musculoskeletal problems, particularly back pain. Few parents had received advice on lifting and handling issues, although they considered it useful. Their use of and attitude towards lifting equipment was poor; however, housing adaptations were instigated and valued. The implications for occupational therapy are considered and areas for further research are discussed.