bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complex Interventions and Complex Systems in Occupational Therapy: An Alternative Perspective
Authors: Duncan Edward A S , Paley John , Eva Gail 
Published: April 2015

In recent years, there have been numerous discussions of complex interventions and complex systems in the health care literature. The cue for many of these discussions was the publication of an influential document on complex interventions by the Medical Research Council in 2000, and the appearance of an equally influential series of articles on complex systems in the British Medical Journal in 2001. However, it is not always clear that the work published during the intervening period recognises that complex interventions and complex systems are not, in fact, the same thing. This paper discusses a recent contribution to the occupational therapy literature, in which the confusion between complex interventions and complex systems drives the argument. It identifies six claims made by Creek et al (2005) and suggests that only one of them is accurate. Specifically, it argues that, although occupational therapy is sometimes a complex intervention, there is no reason to suppose that it is a complex system; nor is there any good reason to believe that occupational therapy outcomes are intrinsically unpredictable. The paper concludes with an explanation of why this topic is important, and why confusing the two (very different) kinds of complexity risks compromising the idea of evidence-based practice.
Art and Recovery in Mental Health: A Qualitative Investigation
Authors: Lloyd Chris , Wong Su Ren , Petchkovsky Leon 
Published: April 2015

Arts programmes are provided as part of the psychosocial rehabilitation for consumers with a mental illness. Consumers have reported that involvement in the arts has facilitated their recovery. This qualitative study was conducted to explore the ways in which involvement in an Australian community arts programme contributed to the recovery process. It also aimed to gain an understanding of intrinsic recovery, which focuses on personal satisfaction and meaning. Eight consumers with a mental illness who were members of a community-based arts programme participated in in-depth semi-structured interviews. The themes that were analysed thematically from the interviews included art as a medium of expression and self-discovery, and changes in internal conditions (spirituality, empowerment and self-validation). The findings revealed the usefulness of arts programmes in providing the external environment that facilitates internal recovery.
Who's Carrying the Baby?
Authors: Evans Nina , Orpwood Roger 
Published: April 2015

Parents who are wheelchair users face the practical problem of manoeuvring a wheelchair at the same time as pushing a pushchair. The Bath Institute of Medical Engineering (BIME) has designed a pushchair to attach to a manual wheelchair. This paper describes the rationale behind the project and how disabled parents have been integral to the design process. The process and findings of the evaluation programme are reported. Evaluation is important to designers to understand the outcomes of their work. ‘It's as simple as needing to know whether assistive technology works’ (Smith 1998, p20). This process also provides insights to occupational therapists to guide them in their professional judgements about whether an equipment solution can meet user requirements.
Occupational Therapy for Children with Attention Deficit Hyperactivity Disorder (ADHD), Part 1: A Delineation Model of Practice
Authors: Chu Sidney , Reynolds Frances 
Published: April 2015

An occupational therapy delineation model of practice is presented, which guides a multidimensional understanding of the psychopathology of attention deficit hyperactivity disorder (ADHD) and its management. Previous research has established that occupational therapists lack detailed training or theory in this field. The delineation model of practice is based on a literature review, clinical experience and a consensus study carried out with occupational therapists to determine their priorities for the evaluation of, and intervention with, children with ADHD. Part 1 of this article presents the model and examines its implications for evaluation and intervention at the levels of child, task and environment. A family-centred assessment and treatment package, based on the delineation model, is described. Part 2 of this article will report the results of a multicentre study, which was designed to evaluate the effectiveness of this package.
Occupational Therapy for Children with Attention Deficit Hyperactivity Disorder (ADHD), Part 2: A Multicentre Evaluation of an Assessment and Treatment Package
Authors: Chu Sidney , Reynolds Frances 
Published: April 2015

A family-centred occupational therapy assessment and treatment package for children with attention deficit hyperactivity disorder (ADHD) was evaluated. The package involves a multidimensional evaluation and a multifaceted intervention, which are aimed at achieving a goodness-of-fit between the child, the task demands and the environment in which the child carries out the task. The package lasts for 3 months, with 12 weekly contacts with the child, parents and teacher. A multicentre study was carried out, with 20 occupational therapists participating. Following a 3-day training course, they implemented the package and supplied the data that they had collected from 20 children. The outcomes were assessed using the ADHD Rating Scales, pre-intervention and post-intervention. The results showed behavioural improvement in the majority of the children. The Measure of Processes of Care – 20-item version (MPOC-20) provided data on the parents' perceptions of the family-centredness of the package and also showed positive ratings. The results offer some support for the package and the guiding model of practice, but caution should be exercised in generalising the results because of the small sample size, lack of randomisation, absence of a control group and potential experimenter effects from the research therapists. A larger-scale randomised controlled trial should be carried out to evaluate the efficacy of an improved package.
An Investigation of the Number and Cost of Assistive Devices Used by Older People Who Had Fallen and Called a 999 Ambulance
Authors: Logan P A , Murphy A , Drummond A E R , Bailey S , Radford K A , Gladman J R F , Walker M F , Robertson K , Edmans J A , Conroy S 
Published: April 2015

Some assistive devices, such as walking frames and bath boards, are provided by health and social services, but some are bought by people through shops, the internet and magazines or second hand. Using a face-to-face interview, the number and cost of assistive devices bought by people who had fallen and called a 999 ambulance were investigated. Two hundred and four older people (mean age 83 years, 72/35% men) who had fallen and called an emergency ambulance were interviewed at home by a research occupational therapist. A structured questionnaire about the cost and use of assistive devices was completed. Functional ability was measured using the Barthel Index and the Nottingham Extended Activities of Daily Living Scale. One hundred and ten people (54%) had bought their own devices, spending a median of £700 each. People with multiple sclerosis, cancer, heart conditions and Parkinson's disease had spent over twice as much as those with osteoarthritis, stroke, diabetes and dementia. Many older people buy their own assistive devices at a considerable cost to themselves. As social services direct payments allow people to manage their own care packages, more people will be buying direct and may be looking for advice.
Early Psychosis: Treatment Issues and the Role of Occupational Therapy
Authors: Lloyd Chris , Waghorn Geoff , Williams Philip Lee , Harris Meredith G , Capra Carina 
Published: April 2015

Research has demonstrated that the establishment of early intervention services within mental health organisations is an effective method of reducing the impact of psychosis on a young person's life. The research literature and available clinical practice guidelines describe key intervention areas that have an impact on the effectiveness of the early intervention service. These include: comprehensive assessment, social functioning, weight control, substance misuse and vocational recovery. Early intervention services can develop effective programmes to address these areas. The occupational therapist can have a defined role in this setting, primarily across the three domains of assessment, intervention and advocacy. Effective assessment by an occupational therapist provides information on the occupational role functioning of a young person. Intervention services provide consultative and direct treatment to assist the young person in engaging in developmentally and culturally appropriate occupational roles. Advocacy involves educating members of the multidisciplinary mental health team about the role and potential outcomes of occupational therapy. By assessing, intervening and advocating for young people with early psychosis, individual therapists can contribute to developing a central role for occupational therapy in the field of early psychosis.
Achieving Optimal Functional Outcomes in Community-Based Rehabilitation following Acquired Brain Injury: A Qualitative Investigation of Therapists' Perspectives
Authors: Doig Emmah , Fleming Jennifer , Kuipers Pim 
Published: April 2015

The aim of this study was to explore therapists' opinions about the rehabilitation approaches that they perceived contributed to positive outcomes for people with acquired brain injury in community-based rehabilitation settings in order to develop a set of practice principles for clinicians working in this area. Semi-structured interviews were conducted with eight Australian and three British therapists, with a mean of 5.2 years' experience of working with people with acquired brain injury in community-based rehabilitation settings. The interviews were analysed thematically. A summary of the themes was presented to a larger group of acquired brain injury service providers (n = 35) for validation. The participants emphasised the importance of environmental factors, such as collaboration with and inclusion of others in rehabilitation, especially those in the person's support network. Strategy use, client-centred goal setting, the provision of education and the development of a therapeutic relationship were identified as facilitators in community-based rehabilitation. Problems with self-awareness and motivation, drug and alcohol use, and behavioural difficulties were commonly identified barriers to optimal outcomes. The key practice principles derived from the findings were the need for community-based rehabilitation for people with acquired brain injury to be (1) environment focused and contextually appropriate, (2) collaborative and (3) goal directed and client centred.
Retired People's Experience of Participation in Art Classes
Authors: Bedding Sarah , Sadlo Gaynor 
Published: April 2015

The role that different activities play in contributing to retired people's wellbeing is not well understood, a situation that needs to be addressed now that a long period of retirement is becoming the norm for millions of people in western societies. Research carried out over the last decade has explored some aspects of participation in various activities, such as exercise, but only a few studies have explored retirees' own perspectives. This qualitative research used phenomenological methods to explore art class activity as experienced by six retired people living in the community. The participants' perspectives were explored using unstructured interviews. The data were analysed using a phenomenological approach, as outlined by Van Kaam (1959, and described by Streubert and Carpenter 1995), and the participants then confirmed the findings. Painting added a special dimension to the particpants' retirement: it gave satisfaction, challenge, time transformation, a sense of achievement, productivity and a boost to confidence. These results confirm and extend previous studies that link creative activities to wellbeing, including those that reveal how positive emotions contribute to health. Actual attendance at an art class was also seen as valuable, because working in a group was experienced as an inspiration and an opportunity to be encouraged by and to learn from others. The activity and the socialising seemed to be equally important aspects of attending an art class, which supports Wilcock's (2007) latest theories of the benefits of belonging. This research may contribute to the justification for participation in art or craft activity within the community, in occupational therapy practice or in settings such as residential homes, by providing further understanding of its meaning and value for retirees and its potential for promoting their health.
Content Validity, Clinical Utility, Sensitivity to Change and Discriminant Ability of the Swedish Satisfaction with Daily Occupations (SDO) Instrument: A Screening Tool for People with Mental Disorders
Authors: Eklund Mona , Gunnarsson A Birgitta 
Published: April 2015

A screening tool for assessing satisfaction with daily occupations among people with mental illness has been devised — the Swedish version of the Satisfaction with Daily Occupations (SDO) instrument — comprising a satisfaction scale and an activity level scale. The aim was to investigate the SDO for content validity, clinical utility, sensitivity to change and discriminant ability. Nine occupational therapists evaluated the content validity of the SDO. Sensitivity to change was assessed on a sample of 36 clients in psychosocial occupational therapy. Discriminant ability was evaluated by comparing four samples: (1) 103 clients with a diagnosis of severe mental illness, (2) 55 clients attending an outpatient mental health clinic, (3) 36 women with a diagnosis of systemic sclerosis and (4) 40 healthy women. The SDO rendered positive ratings regarding content validity, but some rewording of items was indicated as well as clearer instructions. Both the satisfaction scale and the activity level scale were found to be responsive to change. Discriminant ability was shown in that, in particular, the activity level score distinguished the mentally ill participants from the other samples. The SDO was shown to reflect the targeted phenomenon satisfactorily and to be sensitive enough to detect change following an occupational therapy intervention. However, so far only the Swedish version of the SDO has been studied, but an English version is available whose cross-cultural validity should be examined.
Use of Assessment Methods in Paediatrics: The Practice of Private Occupational Therapists
Authors: Diamantis Andreas D 
Published: April 2015

This study is part of a larger research project investigating the assessment practices of paediatric occupational therapists in independent practice in the United Kingdom. The focus of this paper is the identification of the assessment methods used and the factors influencing respondents' satisfaction with them. The research design was a cross-sectional descriptive survey using a postal questionnaire as the data collection tool. Out of 89 questionnaires sent, 66 (74%) were returned and 48 (54%) were deemed usable. The findings demonstrated that the respondents used a combination of assessment methods, with interviewing being used by all of them. The majority of the respondents were satisfied with the methods that they used. The most frequently mentioned factors influencing the respondents' satisfaction level were issues concerning standardised tests and the quality and quantity of the information gathered about the client. The implications for clinical practitioners include the benefits of using a combination of assessment methods and their selection after extensive clinical reasoning. Moreover, the use of interviewing is stressed and its multiple purposes are pointed out.
Moving into Housing: Experiences of Developing Specialist Occupational Therapy Posts in Local Authority Housing Departments
Authors: Grisbrooke Jani , Scott Saffron 
Published: April 2015

The pathways for the delivery of adaptations to the homes of people with disabilities are complex, incorporating social care expertise together with funding and building experience from housing professionals. Integrating the housing and social care departments does not necessarily lead to smoother working. A number of authorities have taken the option of moving or seconding occupational therapists from social care into housing to have better coordination of the delivery of adaptations and improvement of working practice between the disparate professionals involved. This qualitative study aimed to explore, through semi-structured interviews, the experiences of nine occupational therapists establishing and developing these new posts. Background information about the establishment of these posts was collated. The thematic analysis of data by two researchers taking an interpretive phenomenological perspective identified five themes: practitioner freedom versus isolation, strategic versus operational roles, professional cultural differences, learning and development, and evaluation and aspiration. For managers founding such posts and for practitioners moving into them, the findings of this study offer insights into what helped and hindered these practitioners, what surprised them and how their development needs were identified, which informed their intentions for the future of their posts.
Graduates' Reflections on their Preparation for Practice
Authors: Robertson Linda J , Griffiths Sian 
Published: April 2015

New graduates are the life blood of the occupational therapy profession. It is important that they are equipped to practise in the current health care environment and are confident about their professional contribution. This New Zealand study explored new graduates' perceptions of how well they had been prepared for practice, using three focus groups of graduates from one occupational therapy programme. The findings confirmed that the biggest issues for new graduates were searching for role clarity, inadequate supervision, an insufficient grasp of skills and uncertainty in team responsibility, underpinned by a lack of confidence. Conversely, they felt confident about their ability to research and find information in response to gaps in their knowledge. This study demonstrates that learning how to ‘be’ an occupational therapist is as important as receiving formal supervision, and suggests that learning how to contextualise and reconstruct knowledge is essential in preparation for graduation. The stressful situations experienced in the first months of practice could be minimised through opportunities to learn how to repackage knowledge, observe role models and have supervision that provides confirmation of plans and bridges the theory-practice divide.
Voluntary Work for Adults with Mental Health Problems: A Route to Inclusion? A Review of the Literature
Authors: Farrell Carol , Bryant Wendy 
Published: April 2015

Voluntary work is seen as a key component of promoting mental health through social inclusion. For many years, occupational therapists have worked in partnership with voluntary organisations to facilitate access for service users to voluntary placements. Yet there is little published evidence to support this aspect of occupational therapy or to indicate specific successful strategies, especially in establishing successful placements beyond mental health services. This review examined the existing evidence, discussing the implications for occupational therapy. The findings indicate a need for further research to ascertain the benefits of volunteering, the barriers and the ways to improve access for people with mental health problems. Occupational therapists, with their unique synthesis of knowledge and skills concerning occupation, enabling and client-centred practice (Townsend and Wilcock 2004), should be well placed to be able to respond to these issues, yet the literature does not provide evidence that they have risen to the challenge.
What Helps and Hinders People with Psychotic Conditions Doing What They Want in Their Daily Lives
Authors: Cook Sarah , Chambers Eleni 
Published: April 2015

It is important for people to do what they want in their daily lives and this is embedded in concepts of recovery, rehabilitation, social inclusion and quality of life. To research what helps and hinders people with psychotic conditions to do what they want, 24 people already engaged in a trial of occupational therapy were interviewed by a service user researcher. The qualitative methods used framework analysis. The findings described what the participants appreciated about occupational therapy and how other workers sometimes delivered occupational therapy type interventions. As well as therapy, multifarious factors appeared to have an impact on people's choices and actions and these reiterated the findings from prior studies. These internal and external factors combined in complex relationships. People felt particularly vulnerable when staff behaved uncaringly and with disrespect because this replicated past traumas, stigmatisation and rejection. The participants revealed how important it was for staff to pitch their interventions right for them at the time. The study led to suggestions that occupational therapists refine their artistry in order to hone their interventions to suit the individual, follow guidance on developing therapeutic relationships and recovery-focused capabilities, enhance caring by getting support themselves and employ critical thinking to challenge organisational barriers and their profession's rhetoric.
A Review of Non-Traditional Occupational Therapy Practice Placement Education: A Focus on Role-Emerging and Project Placements
Authors: Overton Amber , Clark Michele , Thomas Yvonne 
Published: April 2015

Practice placement education has been recognised as an integral and critical component of the training of occupational therapy students. Although there is an extensive body of literature on clinical education and traditional practice placement education models, there has been limited research on alternative placements. This paper reviews the literature on various practice placement education models and presents a contemporary view on how it is currently delivered. The literature is examined with a particular focus on the increasing range of practice placement education opportunities, such as project and role-emerging placements. The drivers for non-traditional practice placement education include shortages of traditional placement options, health reform and changing work practices, potential for role development and influence on practice choice. The benefits and challenges of non-traditional practice placement education are discussed, including supervision issues, student evaluation, professional and personal development and the opportunity to practise clinical skills. Further research is recommended to investigate occupational therapy graduates' perceptions of role-emerging and project placements in order to identify the benefits or otherwise of these placements and to contribute to the limited body of knowledge of emerging education opportunities.