bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dressing after a Stroke: A Survey of Current Occupational Therapy Practice
Authors: Walker Christina M , Walker Marion F , Sunderland Alan 
Published: April 2015

The objective of this study was to determine occupational therapists' beliefs about the influence of cognitive impairment on dressing difficulties and to ascertain current practice when treating dressing problems. The study design was a questionnaire survey of occupational therapists experienced in stroke care who treated patients with dressing difficulties. Out of 137 questionnaires sent, 76 (55.5%) were returned. The frequency of dressing practice provided by the occupational therapists ranged from two to four times a week. Only 43% of the therapists used standardised assessments and the most common one used was the Rivermead Perceptual Assessment Battery. Apraxia was reported by 76% of the therapists as influencing a patient's ability to dress, neglect by 71 % and memory problems by 63%. Seventy-six per cent of the therapists reported that orientating clothing and relating it to body parts was a major dressing difficulty. Other dressing difficulties reported were sequencing by 56% and failing to dress the affected side by 34%. Ninety-eight per cent of the therapists spent time providing the practice of specific functional skills on a repetitive basis; however, 60% continued to use table-top tasks aimed at targeting a particular cognitive impairment. The majority of the therapists felt that cognitive impairment was a major reason for dressing difficulties in stroke patients. With the exception of one, all the therapists provided repetitive practice on dressing tasks and over half continued to use table-top tasks. The evidence to support the types of treatment used by occupational therapists remains controversial. Further research into this area is required.
Cognitive Impairment in Amyotrophic Lateral Sclerosis: A Consideration for Occupational Performance
Authors: Foley Geraldine , Neely Fiona 
Published: April 2015

Traditionally, amyotrophic lateral sclerosis (ALS) has been viewed as a degenerative disease, selective to the motor system. Until recently, research into cognitive impairment in ALS was confined primarily to a small proportion of patients with overt and clinically evident frontotemporal dementia (ALS/FTD). However, evidence from contemporary neuropsychological analysis and functional imaging studies, as identified in this review, indicates that a significantly higher percentage of patients with ALS presents with milder cognitive impairment in frontotemporal function. These deficits are considered progressive in nature, with increasing disability. Disturbances within the supervisory attentional system or central executive are thought to be responsible. It would appear that patients diagnosed with ALS may not be equally susceptible to developing cognitive deficits. The relationship between bulbar-onset ALS and increased cognitive decline is noteworthy. In ALS, the impact of cognitive disturbance on occupational performance must be considered in addition to physical disability.
Occupational Therapy Assessment of Self-Awareness following Traumatic Brain Injury
Authors: Simmond Melina , Fleming Jennifer M 
Published: April 2015

Impaired self-awareness is a common problem following traumatic brain injury. Without adequate self-awareness, a person's motivation to participate in rehabilitation may be limited, which in turn can have an adverse effect on his or her functional outcome. For this reason, it is important that brain injury rehabilitation professionals, including occupational therapists, both understand this phenomenon and use assessment and treatment approaches aimed at improving clients' self-awareness. This article provides an overview of self-awareness, reviewing the distinction between intellectual and online awareness. The current role of occupational therapy in the assessment of self-awareness is highlighted and the guidelines for new assessments of self-awareness suitable for use in occupational therapy are explored.
The Critical Reflective Muse as a Key Player in Research and Manuscript Review
Authors: Fitzgerald Maureen H , Yau Matthew K 
Published: April 2015

The critical reflective muse is not a new role in research. Research supervisors, mentors, professional colleagues and peer reviewers often play this role. However, the critical reflective muse is often not formally recognised as essential to the analytical and interpretive or the personal growth process, particularly in qualitative and alternative paradigm research. This paper suggests that the people who play this role in its most positive sense are important to the development of sound research projects and analyses and interpretations of data. People who engage in this role responsibly enhance the quality of research and the research literature and can push them to new levels of quality. They enhance validity and personal and professional development. It is proposed that greater attention should be given to this occupational role as a way to develop further the quality of occupational therapy research and the related literature in order to situate them better in the corpus of contemporary health science research.
Factors Enabling and Hindering Participation in Leisure for People with Mental Health Problems
Authors: Pieris Yvonne , Craik Christine 
Published: April 2015

Although leisure is recognised as a key aspect of occupational therapy, few studies have explored it in relation to people with enduring mental health problems. Using a qualitative design, semi-structured interviews were conducted with 10 participants with mental health problems living in the community, randomly selected from clients referred to a local assertive outreach service in South-East England. Initially, the data were analysed for content and the phrases, language and words used; subsequently, emerging themes were identified, which were confirmed by a second occupational therapist. The three themes arising from the data reported here were the number and range of occupations engaged in, the factors enabling participation in leisure and the factors hindering participation in leisure. The range of leisure occupations was similar to that noted in the literature. The main enabling factor was having an adequate network of people to provide support, while the main hindering factors were physical limitations, lack of finances and lack of transport. In the absence of paid employment, leisure was important to the clients. Occupational therapists need to recognise that enhancing the factors enabling participation in leisure and assisting clients to overcome the factors hindering participation in leisure will lead to the increased wellbeing of people with enduring mental health problems.
The International Classification of Functioning, Disability and Health provides a Model for Adaptive Seating Interventions for Children with Cerebral Palsy
Authors: McDonald Rachael , Surtees Robert , Wirz Sheila 
Published: April 2015

Children with severe types of cerebral palsy use adaptive seating systems to encourage function and assist in delaying the development of deformity. These systems are often assessed for and provided by occupational therapists. However, there has been no unifying policy or theoretical basis on which these systems are provided and research evidence is lacking, with studies tending to be small and non-controlled. The International Classification of Functioning, Disability and Health (World Health Organisation 2001a,b) aims to establish a common language for clinical practice as well as research, while bringing together the opposing social and medical models of health care delivery. This paper suggests that the ICF model is an ideal theoretical basis for adaptive seating system assessment and provision, given that these systems often conflict between the medical model of reducing or delaying impairment of body functions and structures and the social model of children and families accessing life and environmental situations through mobility and seating equipment. The paper considers all the domains of the ICF with regard to the current literature. It concludes that using the model in the context of providing adaptive seating gives occupational therapists both a powerful tool for communicating with children and families as well as managers and a basis for evaluating practice.
Images of Occupational Therapy among Secondary Schoolchildren
Authors: Wilkinson Jeremy , Chard Gill 
Published: April 2015

There has been no published research in the United Kingdom specific to the promotion of occupational therapy as a career among secondary schoolchildren. A two-part questionnaire was administered to 110 schoolchildren (age 14–16 years) at three schools in England. The questionnaire investigated awareness about occupational therapy as a potential career and opinions about various promotional materials: a video, radio advertisements and careers leaflets issued by the College of Occupational Therapists. The findings indicate that awareness of occupational therapy is low; careers teachers are the first choice and the Internet the second choice when finding out about a career in occupational therapy. All participants chose the video as the best promotional material. Schoolchildren need to be informed about occupational therapy before the age of 14 years if they are to consider it as a career; careers teachers need ready access to promotional materials; and the College of Occupational Therapists' web pages need to be developed specifically for secondary school-age children.
Cultivating Wildness: Three Conservation Volunteers' Experiences of Participation in the Green Gym Scheme
Authors: Birch Matt 
Published: April 2015

The Green Gym – a free scheme run by the British Trust for Conservation Volunteers – encourages people to become fitter and counter the negative impact of increasingly sedentary lifestyles through carrying out practical conservation tasks. This study aimed to identify what participation in one newly established Green Gym meant to three volunteers. A qualitative research design was used owing to the small sample available – two unemployed adults and a part-time community worker – at the time that the research was undertaken. Data were collected through participant-observation over four sessions, semi-structured interviews and the participants' visual notebooks. An iterative process of data coding, display in concept maps and interpretation generated themes and subthemes. In addition to improving fitness, the participants valued the scheme as a means of enhancing mental wellbeing, being stimulated by nature and enjoying social contact, and as a flexible way in which to attain a valued productive role. The findings suggest that Green Gyms can represent a form of mainstream volunteerism to which appropriate occupational therapy clients might be referred in the process of meeting a range of occupational needs. In particular, the flexibility and diversity of tasks at the Green Gym suggest that it has the potential to enable occupationally deprived individuals, including those who have experienced social exclusion through mental ill-health, to access a productive occupation in the community.
Hard Complexities – Soft Complexities: An Exploration of Philosophical Positions Related to Evidence in Occupational Therapy
Authors: Blair Sheena E E , Robertson Linda J 
Published: April 2015

The practice of occupational therapy rests upon the ontological assumption that there is a relationship between engagement in occupation and health. Different traditions of knowing about and investigating this relationship are evident within the literature. The professional link with biomedicine has led to an adherence to positivistic methodologies but, as the profession has begun to generate discipline-specific knowledge, inquiry approaches consistent with interpretative and critical theory have become evident. This paper explores the nature of inquiry underpinning current practice. It suggests that contemporary developments have been a reaction to a climate of uncertainty, generated by rapid political, fiscal, technological and ideological change in the delivery of health and social care in the last four decades. From these rapid changes, different views of ‘best practice’ have developed: evidence-based, reflective and reflexive practice, each with its own source of knowledge and method of inquiry. It is postulated that each of these views has implications for education, practice and research.
Paediatric Occupational Therapy University Programme Curricula in the United Kingdom
Authors: Brown G Ted , Brown Anita , Roever Carsten 
Published: April 2015

The paediatric curriculum component of entry-level occupational therapy education programmes in the United Kingdom was examined and comparisons were made with the practice literature to determine if students were being taught current best practices. Questionnaires were mailed electronically to the identified paediatric faculty members of the 27 universities with an entry-level occupational therapy education programme in the United Kingdom. Ten completed questionnaires were returned, giving a response rate of 37%. The survey results indicated that paediatrics constituted less than 5% of the total curriculum content of the respondent university programmes. The theory, assessments and treatment approaches taught in the education programmes were similar to those used in clinical practice with children. Some gaps in what was taught to students were apparent, notably in the key paediatric area of visual perceptual dysfunction. The theory, assessments and intervention methods were not always taught as a cohesive stand-alone unit, so gaps occurred in the education programmes. This could lead to graduates using an eclectic approach or using personal conceptual frameworks based on postgraduate learning and work experience.
Children in Vegetative State and Minimally Conscious State: A Survey of Sensory and Cognitive Intervention
Authors: Wales Lorna , Waite Claire 
Published: April 2015

There is little information available about the management of children in a vegetative state and a minimally conscious state (VS and MCS), including diagnosis, assessment and treatment. This study investigated the intervention of occupational therapists in VS and MCS in the United Kingdom paediatric population. A survey design was used and a postal questionnaire was sent to a group of 892 occupational therapists who were members of a paediatric or a neurological specialist section. Two hundred and seventy-one completed questionnaires were returned and the results of these were analysed. Two hundred and six (76%) of the respondents worked in a rehabilitation setting. Twenty-five occupational therapists who worked with children in VS and MCS completed further questions about their assessments and interventions. The results indicate that children in VS and MCS receive fragmented and inconsistent occupational therapy services. Adult assessments are used with a paediatric population and therapists are not wholly satisfied with their interventions. A core group of occupational therapists involved with this population was identified as a result of this survey. It is suggested that these therapists may be able to form a working party to investigate a consistent therapeutic approach for this complex group of children.
Using Video Assessment for Clients with Chronic Low Back Pain: Is it Reliable?
Authors: Trott Melony , Fisher Keren 
Published: April 2015

Clients with chronic back pain can benefit from learning strategies to manage their pain. In a 3-week pain management programme, the use of a videotaped assessment on admission and at discharge enables occupational therapists to score functional movement, as well as providing visual feedback for the clients, although evidence of reliability is necessary. This study investigated the reliability of intrarater and interrater scoring between four experienced occupational therapists who scored the video assessment. Forty clients and forty controls were chosen to complete the assessment. The assessment consists of tasks with 59 different items to score. Each task is scored on three factors: posture, problem solving and movement. The results demonstrated that interrater reliability for problem solving was not consistent. However, it was consistent for posture and movement in the client group, although less so for controls, showing increased difficulty in identifying the more subtle principles being used. Intrarater reliability was less convincing, with the therapist reporting fatigue at the number of items to be scored. However, this could be improved by reducing the number of items in the assessment because analysis showed that 39% of items did not meet the criteria for statistical significance of change. More clarification on the score measures will assist in measuring the efficacy of the treatment programme objectively. Discriminant validity of the scoring system was indicated by the improvement seen in the clients' performance but not in that of the controls. Further studies to improve reliability and demonstrate better validity are planned.
Description of an Occupational Therapy Intervention Aimed at Improving Outdoor Mobility
Authors: Logan P A , Walker M F , Gladman J R F 
Published: April 2015

After a stroke people can find outdoor mobility difficult, but a targeted occupational therapy intervention has been shown to help people to get out of the house more often. This study describes the intervention. The occupational therapists who provided the intervention kept records of the number and duration of therapy sessions, the goal of therapy and the activities undertaken. As part of the trial, functional and mobility outcome assessments were completed by the participants 4 and 10 months after recruitment and were used to compare the goals set with the goals achieved and the mobility performance. Eighty-six participants were randomised to, and 78 received, the intervention. They received a median of 6 (mean 4.7, SD 1.9) sessions, with an average of 40 minutes per session. Sixty (77%) of the participants achieved their primary goal. Those who did not had greater functional limitations at the start of the study than those who did. Walking was the most common goal (17/78, 22%) and the most performed activity (135 times, 33%). Thirteen participants achieved walking and 12 of these were still walking outside at the 10-month assessment. Three-quarters of people with stroke were therefore able to achieve their outdoor mobility goals after an occupational therapy intervention.
Profiles of Occupational Engagement in People with Schizophrenia (POES): The Development of a New Instrument Based on Time-Use Diaries
Authors: Bejerholm Ulrika , Hansson Lars , Eklund Mona 
Published: April 2015

Previous time-use research suggests that it is highly relevant for an occupational therapist to estimate time use and occupational engagement in order to understand some of the determinants of wellbeing for people with schizophrenia. This article describes the development and the testing of the psychometric properties of an instrument, Profiles of Occupational Engagement in people with Schizophrenia (POES), with the aim of helping to interpret and evaluate time-use diaries and thus providing a systematic description of status regarding occupational engagement. The first part of POES involves completion of time-use diaries and the second part, the assessment, is based on nine items that are rated on a four-point ordinal scale. The time-use diaries of 41 people with schizophrenia and the judgements from 12 occupational therapists were used in the study. A test of content validation involved experts from Sweden and the United Kingdom and resulted in two stages of revisions. The strength of agreement between two raters resulted in a mean weighted kappa of 0.70. Internal consistency was calculated for both raters separately and the alpha coefficients were 0.97 and 0.95. This study provides initial support for the content validity, interrater agreement and internal consistency of POES. Based on the judgements of the occupational therapists in this study, POES seems to have good clinical utility. However, further research on the clinical utility as well as the criterion validity of the construct is warranted.
Without Leisure … ‘It Wouldn't Be Much of a Life’: The Meaning of Leisure for People with Mental Health Problems
Authors: Craik Christine , Pieris Yvonne 
Published: April 2015

Previous research has explored the occupational engagement of people with mental health problems. This study set out to establish the meaning and value of leisure for people with enduring mental health problems living in the community. Using a mainly qualitative design, semi-structured interviews were conducted with 10 participants randomly selected from clients referred to a local assertive outreach service in South-East England. Initially, the data were analysed for content, phrases, language and words used; subsequently, emerging themes were identified which were confirmed by a second occupational therapist. Three themes are reported here: why certain occupations were considered to be leisure, the feelings expressed during leisure and the value of leisure. Although the participants had some difficulty in articulating their views, leisure was differentiated from other occupations, with the time available to complete a task in the absence of pressure being the distinguishing feature. Overall, the participants had positive views about leisure, which was valued in terms of meeting their individual and unique needs. The implications for occupational therapy are explored. In determining the meaning and value of leisure for people with mental health problems, more emphasis should be given to their actions and less to their skill in verbalising emotion.
Older People's Views about Community Falls Prevention: An Australian Perspective
Authors: Ballinger Claire , Clemson Lindy 
Published: April 2015

Although targets have been set for the establishment of falls prevention services, little is known about the views of older people in respect of such initiatives. The purpose of this study was to investigate the perspectives of the older participants in a community group falls prevention programme in Australia and to explore their views about the most and least useful aspects of the programme, using methods deriving from a grounded theory approach. Semi-structured interviews were carried out with nine women and two men who had attended a falls prevention programme. The multifaceted intervention comprised seven weekly meetings of 2 hours each. The key principle underpinning the programme was enhancement of self-efficacy. Four themes were identified through qualitative analysis: identity (focusing on participants as active elders); the salience of interventions (or the meaning attributed to different programme components); the social experience (the views about group interaction); and the consequences of participation. The participants were very positive about their experience of the programme and described a range of psychological and physical outcomes. A decrease in the likelihood of a fall did not feature prominently in these interviews. It may be more meaningful to older people to embed falls prevention within a wider context of wellbeing and independence.