bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing Upper Limb Hypertonicity: Factors Influencing Therapists' Decisions
Authors: Rassafiani Mehdi , Ziviani Jenny , Rodger Sylvia , Dalgleish Lenard 
Published: April 2015

This study employed social judgement theory to identify and determine the relative importance of factors influencing occupational therapists' subjective decision making when managing children and adolescents with cerebral palsy and upper limb hypertonicity. An extensive literature review was conducted to identify potential factors that might be used. Two clinical experts were then asked to review and refine these factors. Finally, 12 experienced occupational therapists who had worked with people with cerebral palsy for at least 5 years were asked to add or exclude factors and then to rank them. Thirty-seven factors that might influence therapists' decision making were identified and ranked. The reason for referral and family's goals were ranked as the first and second most important factors respectively. Agreement among therapists was significant, but low (Kendall's W = 0.38; p<0.0001). When participants were divided into two groups, those who were very experienced (mean = 13 years, SD = 6.95) and those with less experience (mean = 5.6 years, SD = 0.55), the ranking of the factors did not differ significantly. These findings are discussed with respect to research in clinical decision making, the training of occupational therapists and the education of students.
Client-Therapist Relationships: Experiences of Occupational Therapy Clients in Rehabilitation
Authors: Palmadottir Gudrun 
Published: April 2015

The relationship between a therapist and his or her client has been recognised to be an important determinant of the success or failure of occupational therapy. The purpose of this qualitative study was to explore clients' perceptions of the relationship that they formed with their occupational therapist in the context of rehabilitation. Twenty clients with varied health problems were interviewed. The analysis of data revealed three main categories, therapist role, power and connection, as pertaining to the characteristics of the client-therapist relationship. From these categories, seven different relationship dimensions were identified and arranged hierarchically. The dimensions were described as concern, direction, fellowship, guidance, coalition, detachment and rejection. Relationships were generally experienced as positive; however, there were also examples of negative and detrimental experiences. The findings are discussed in relation to the definition of the therapeutic relationship and to client-centred practice. Occupational therapists are encouraged to consider their own attitudes, needs and boundaries when it comes to establishing close connections and to share power with their clients. Furthermore, therapists must explore which form of relationship and participation each client prefers in order to establish an effective collaborative relationship.
Occupational Performance of People Diagnosed with Schizophrenia in Supported Housing and Outreach Programmes in Australia
Authors: Fossey Ellie , Harvey Carol , Plant Gillian , Pantelis Christos 
Published: April 2015

This study compared the occupational performance in activities of daily living (ADL) of people diagnosed with schizophrenia in two settings: 25 people in residential rehabilitation facilities and 18 people receiving intensive outreach support in their homes in urban Australia. All participants were assessed with structured interviews, the Assessment of Motor and Process Skills (a performance-based measure of ADL ability) and the Life Skills Profile (an informant-report measure of disability). Hypothesised differences in ADL performance between the two settings were not supported. Mean ADL process ability, based on the AMPS process skills subscale, indicated that the majority (58%) of the 43 participants needed some assistance in community living, irrespective of where they lived and the types of support received. Many participants (42%) performed ADL tasks with relative ease, efficiency, safety and independence as measured by AMPS, indicating that they could live in housing arrangements with outreach support. However, the ADL process ability measures for two-thirds of these participants indicated that they would struggle in community living in the absence of outreach support. Given these findings, the eligibility criteria and screening for residential and outreach support services need re-examination and performance-based assessments of ADL ability could improve the identification of housing-related support needs. Occupational therapists have expertise in this area to develop individualised supports that enable a greater choice of living arrangements for people diagnosed with schizophrenia.
Occupational Therapists' Perceptions of Equality, Diversity and Career Progression in the National Health Service
Authors: Bogg Jan , Gibbons Charles , Pontin Eleanor , Sartain Samantha 
Published: April 2015

The objective of this study was to evaluate occupational therapists' perceptions of equality, diversity and career progression in the National Health Service (NHS). A quantitative national survey was undertaken and 396 occupational therapists responded. The findings were assessed in relation to the respondents' own beliefs about equality and diversity. The key findings included that although the NHS is actively attempting to address equality and diversity issues, it is apparent that occupational therapists working within the NHS still perceive that problems exist. For example, 57% of respondents thought that women generally experienced some barriers to career progression, 71% perceived that people with disabilities experienced barriers to career progression, 73% thought that black and minority ethnic groups were not well represented in the occupational therapy profession, 62% thought ethnic minorities were not well represented in senior NHS positions and 36% thought that people with a different sexual orientation would experience barriers to career progression. The article concludes that policy and procedures are making a difference in the NHS. However, staff at all grades and levels must be empowered to feel motivated and to be able to take policy and ‘make it real’, that is, to ensure that policies and guidelines link to employee perceptions of workplace reality. It is imperative to recognise and address current workforce perceptions in order to achieve change within the NHS workforce. The successful implementation of equality and diversity in the NHS is related to a (CARING) framework, developed from study findings. The framework promotes culture change and obligations underwritten.
Defining an Occupational Therapy Intervention for People with Psychosis
Authors: Cook Sarah , Birrell Mel 
Published: April 2015

The purpose of the study was to define occupational therapy in its entirety for people with psychotic conditions in community settings, in order to produce an intervention schedule for piloting in a randomised controlled trial. Initially, a draft schedule was designed using Creek's (2003) definition of occupational therapy as a complex intervention and other literature regarding psychosis. Consensus methods provided a systematic and transparent process for refining the schedule: the Delphi method was used with 20 local mental health occupational therapists followed by a modified nominal group technique with occupational therapists attending a national conference. This paper focuses on the process of gaining consensus and the practice-related issues that arose. The results identified 82 components that detailed occupational therapy actions under 11 stages. The preferred approach was client centred, with models of practice, goals and actions chosen collaboratively with the individual client. Occupational therapy was defined as separate to care management but incorporated some generic tasks. The discussion of this study's implications includes setting a finite length of intervention; barriers to practice; the importance of activity analysis and doing activities together with clients; and how defining practice may help to clarify the role of the occupational therapist in multidisciplinary team work.
Sustaining a Focus on Occupation in Community Mental Health Practice
Authors: Pettican Anna , Bryant Wendy 
Published: April 2015

Occupational therapists working in community mental health teams (CMHTs) are often challenged to justify their unique approach to health through occupation, within an environment that tends to press for generic working. Such a challenge requires practitioners to identify and communicate evidence that supports their unique occupational contribution. In the absence of extensive robust and relevant research evidence, it is suggested that the contribution of theoretical evidence be considered. This paper, therefore, explores the potential of occupational justice and its related concepts to provide the profession with a theoretical justification for occupational therapists adopting an occupation-focused role in CMHTs. It begins with an overview of how CMHTs, generic working and occupational science have evolved. The concept of occupational justice and its related occupational risk factors are then analysed in relation to practice. The potential conflict between the professional commitment to client-centred practice and the generic worker model is also discussed. The paper concludes with recommendations for further exploration and consideration.
Occupational Therapy in Forensic Psychiatry: A Review of the Literature and a Call for a United and International Response
Authors: O'Connell Marita , Farnworth Louise 
Published: April 2015

A review and critique of the literature on occupational therapy in forensic mental health settings was conducted. The results indicate that the evidence base supporting occupational therapy in a forensic mental health setting is relatively weak. Much of the literature describing the role of occupational therapy in a secure setting is over 10 years old and lacks currency, and many of the research-based articles lack methodological rigour. Research has often been conducted in isolation and over a diverse range of topics, which means that important research questions have not been studied systematically. This paper argues that to enhance the credibility and efficacy of occupational therapy in forensic practice, a coordinated international network of therapists needs to be established. Using the strength of multi-site studies, such a group can build the evidence base for occupational therapy practice in forensic settings. In addition, better links between occupational therapy services and local universities should be formalised in order to promote ongoing research that meets rigorous research standards.
Occupational Therapy with Women and Children Survivors of Domestic Violence: Are We Fulfilling Our Activist Heritage? A Review of the Literature
Authors: Cage Anthea 
Published: April 2015

The aim of this literature review was to examine the work of occupational therapists with women and children survivors of domestic violence. The review notes a dearth of research and literature by occupational therapists in this field. The articles by occupational therapists working with survivors of domestic violence document a gap in the profession's knowledge and skills in identifying and working with victims of violence, emphasising the importance of and need for the education of occupational therapists and occupational therapy students in this area. The occupational therapy profession has a long history of activism. This article seeks to raise critical awareness of this heritage in relation to women and children survivors of domestic violence, and to explicate the theoretical underpinning for occupational therapists to work with survivors of domestic violence through a discussion of occupational apartheid and occupational justice. It explores occupational therapy's social vision and core principles in relation to survivors of domestic violence to demonstrate the crucial role that occupational therapists could play in this area, and calls for occupational therapists to be advocates for women and children and occupational justice. It is postulated that further research is needed to inspire and underpin practice.
Evidence for Occupational Therapy Interventions: Effectiveness Research Indexed in the OTseeker Database
Authors: Bennett Sally , McKenna Kryss , McCluskey Annie , Tooth Leigh , Hoffmann Tammy , Strong Jenny 
Published: April 2015

The aim of this study was to determine the overall quantity and quality of randomised controlled trials and the quantity of systematic reviews relevant to occupational therapy practice. The content of OTseeker ( www.otseeker.com ) was surveyed in June 2006. There were 3401 randomised controlled trials and 939 systematic reviews in OTseeker (total = 4340), published mostly in non-occupational therapy journals. The diagnostic areas of stroke (n = 458) and back or neck conditions/injuries (n = 391), and the intervention categories of exercise (n = 1262) and consumer education (n = 1098), were the most frequently listed. Although the quantity of evidence available about the effectiveness of occupational therapy interventions is rapidly increasing, some areas require greater research effort. Occupational therapists also need to search more broadly than occupational therapy journals for research to support clinical decision making.
The Impact of Participating in a Poetry Workshop
Authors: Hilse Christine , Griffiths Sue , Corr Susan 
Published: April 2015

Poetry writing is a creative activity and, as such, may contribute to intervention. The aim of this study was to explore the impact of poetry writing on individuals who had experienced mental health problems in the past. A qualitative approach, that of grounded theory, was used, including observations of a poetry writing group and in-depth semi-structured interviews with two group participants who had a previous history of mental health problems. The main categories that emerged during data analysis were creation, communication, connection and awareness; these categories were unified by a central concept of personal meaning. The findings suggest that poetry writing creates and communicates meaning. In addition, internal connection (with self) and external connection (with others) may be facilitated through the communication of poetry. Communication and experiences of connection can lead to a greater awareness of self and others. Personal meaning is central to human life in symbolisation processes, which contribute to identity building. The positive and negative impacts on mental health through the writing of poetry and participating in a group were identified. This is a small study and the findings are valid only in the immediate context of the study, but it provides a basis for further research.
The Integration of Clinical and Managerial Supervision: A Critical Literature Review
Authors: Kleiser Helen , Cox Diane L 
Published: April 2015

The introduction of a new development review process, the Knowledge and Skills Framework (KSF), has placed a greater demand on occupational therapists within the health service to be more accountable for practice. It has been proposed that the KSF may provide a useful structure for supervision in order to ensure continual development. Therefore, this literature review looked at the appropriateness of addressing both clinical and managerial issues within the supervisory process. The results indicate that despite many professions being unsure of how best to deliver supervision, there is a common understanding that a structure combining clinical and managerial supervision, such as the KSF, may be useful. It is, however, recommended that the roles of appraiser and supervisor remain separate, because many researchers found conflict within this duality of role as having an impact upon the effectiveness of supervision. It is also recommended that further research be undertaken in order to evaluate formally the effectiveness of integrating the KSF into supervision.
Paediatric Application of Individualised Client-Centred Outcome Measures: A Literature Review
Authors: Tam Cynthia , Teachman Gail , Wright Virginia 
Published: April 2015

A literature review was conducted to identify and compare the clinical utility of client-centred, individualised outcome measures for paediatric rehabilitation. Five measures were identified: the Canadian Occupational Performance Measure (COPM) (28 studies); Goal Attainment Scaling (GAS) (34 studies); Perceived Efficacy and Goal Setting System (PEGS) (2 studies); Target Complaints (TC) (1 study); and the Paediatric Activity Card Sort (PACS) (instruction manual only). The COPM and GAS have been used with children across a wide age range and variety of clinical settings. The PEGS and PACS provided young children direct involvement in the goal-setting process. Little evidence supports the use of TC in paediatrics. Clinicians need to use individualised measures in a way that facilitates the maximal participation of children and families in goal setting and outcome evaluation. Clinicians should document their own role in goal setting. The use of individualised and client-centred measures can motivate children and families and focus their attention on therapy goals.
Sleep, Occupation and the Passage of Time
Authors: Green Andrew 
Published: April 2015

This article explores the extent to which sleep has been considered in occupational therapy and occupational science and finds that the coverage of the subject is patchy: many authors do not mention it whereas some provide comprehensive and useful information. One reason for this variability could be that it is unclear whether sleep is an occupation and this question is debated. Although it is widely acknowledged that sleep is essential to the performance of daytime activity, most definitions of occupation and activity exclude sleep unless occupation is defined in the context of time use. A brief review of the social history of sleep and the timing of occupations suggests that modern life and the natural sleep-wake cycle might be out of synchrony. The science of sleep is explored and the factors necessary for initiating sleep are examined, with aspects of daily occupation being found to influence sleep. It is suggested that, given the range of conditions affecting sleep that are seen by occupational therapists, it may be helpful to have a better understanding of sleep and the measures that might improve it. Because sleep occupies so much time, research in occupational science is recommended.
Occupational Therapy Led Health Promotion for Older People: Feasibility of the Lifestyle Matters Programme
Authors: Mountain Gail , Mozley Caroline , Craig Claire , Ball Linda 
Published: April 2015

The aim of this feasibility study was to see if an occupation-based health-promoting intervention for community-living older people could be delivered successfully and also to provide some information to guide a future trial of clinical effectiveness. The participants' ages ranged from 60 to 92 years. Twenty-eight participants commenced the 8-month programme and 26 completed it; they have continued to meet independently following facilitator withdrawal. The participants were interviewed qualitatively before and after the 8-month programme. Additionally, pre-programme and post-programme measurements of cognition, depression, functional dependency and quality of life were conducted with each participant before and after the intervention. The post-intervention interviews illustrated the individualised benefits experienced by the participants, with greater self-efficacy being a significant theme. A comparison of the pre-intervention and post-intervention scores on the quantitative measures showed an upward trend on all dimensions of quality of life. The measurement of cognition, depression and dependency proved useful for screening purposes and for identifying individuals at risk, but not as an outcome measure. The delivery of the programme was feasible and its benefit to participants was observed, but there is a need for further research to test the intervention rigorously and to explore applicability in a range of settings.
An Exploratory Study of the Differences between Unidisciplinary and Multidisciplinary Goal Setting in Acute Therapy Services
Authors: Thomson Clare , Black Linda 
Published: April 2015

The purpose of this preliminary study was to examine the differences between unidisciplinary and multidisciplinary therapy goal setting in an acute trust. The ideal goal is thought to be SMART (specific, measurable, achievable, realistic and timely) and related to functional activity. Twenty-one therapists from one acute trust participated in the study. One group of therapists used a unidisciplinary approach to goal setting and one group of therapists used a multidisciplinary approach. Goals were collected over an 8-week period. The goals were scored as SMART and functional by three independent therapists blind to the method of working. Compared with the unidisciplinary goals, the multidisciplinary goals were more frequently SMART (66/76 multi v 11/50 uni, p<0.001) and related to functional activity (64/76 multi v 31/50 uni, p<0.005). Multidisciplinary working seems to result in goals that are more likely to be SMART and functional. Nevertheless, it remains to be discovered whether setting SMART, functional goals improves patient outcomes.
The Reliability of Performance of Healthy Adults on Three Visual Perception Tests
Authors: Brown Ted , Mullins Erin , Stagnitti Karen 
Published: April 2015

Problems with visual perceptual skills have been shown to have a negative impact on the daily living skills of individuals and are, therefore, commonly assessed by occupational therapists. The purpose of this study was to examine two types of reliability (internal consistency and test-retest reliability) of three newly revised or developed adult visual perception tests. The participants were 50 healthy adults, aged 18 to 55 years, from Melbourne, Victoria, Australia. The participants completed the Developmental Test of Visual Perception — Adolescent and Adult (DTVP-A), the Motor-Free Visual Perception Test — Third Edition (MVPT-3) and the Test of Visual Perceptual Skills (non-motor) – Third Edition (TVPS-3). Internal consistency was examined using Cronbach's alpha calculations and test-retest reliability was analysed using Spearman rho non-parametric correlation coefficients. The results indicated that the DTVP-A, the MVPT-3 and the TVPS-3 had total scale internal consistency correlation scores of 0.60 or higher (0.60, 0.69 and 0.63 respectively). The majority of the subscales of each test had lower correlation coefficients than the overall scores (ranging from 0.22 to 0.49). For the DTVP-A, MVPT-3 and TVPS-3 total scale scores, the test-retest reliability correlation coefficients were statistically significant (rho = 0.46, p<0.05; rho = 0.62, p<0.01; and rho = 0.59, p<0.01, respectively). Overall, the three visual perceptual tests exhibited low to moderate levels of internal consistency and test-retest reliability.