bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prevocational and Early Employment Needs of Adolescents with Juvenile Idiopathic Arthritis: The Adolescent Perspective
Authors: Shaw K L , Hackett J , Southwood T R , McDonagh J E 
Published: April 2015

The purpose of this study was to explore the prevocational needs of adolescents with juvenile idiopathic arthritis (JIA) from their own perspectives. A focus group discussion was undertaken with eight adolescents with JIA (14.2–16.6 years) attending one United Kingdom hospital. The topics of interest were (i) attitudes towards education, prevocational readiness and employment in relation to JIA; (ii) perceived barriers; (iii) coping strategies; and (iv) preferred sources of support. The data were analysed according to standardised procedures that included data reduction, data display, conclusion drawing and conclusion verifying. The provision of vocational support for young people with JIA was reported to be uncoordinated, limited and unresponsive to individual needs. A recurrent theme was that professionals generally underestimated adolescents' educational and vocational potential. This was felt to be true of teachers, careers advisers, admissions personnel at colleges and universities and potential employers. Most adolescents worried about discrimination and those in whom the JIA was not visible felt a dilemma about disclosure to potential employers. The current framework of careers advice appeared to have failed the adolescents in this study who, in the absence of satisfactory support, found themselves consulting health professionals instead. Greater careers advice support for adolescents and professionals is warranted.
Use of Standardised Tests in Paediatrics: The Practice of Private Occupational Therapists Working in the United Kingdom
Authors: Diamantis Andreas D 
Published: April 2015

This study is part of a larger research investigating the assessment methods used by occupational therapists working with children in independent practice in the United Kingdom. The focus of this paper is on the use of standardised tests. 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 eligible. The findings demonstrated that 34 (71%) of the 48 respondents used standardised tests. The most common tests used regularly were the Movement Assessment Battery for Children (79%) and the Developmental Test of Visual-Motor Integration (74%). Standardised tests were used mainly to measure outcomes. The main reason that the participants did not use standardised tests or used them cautiously was the lack of suitable tests for the client. Most of the study's findings were consistent with those of previous studies. The limited use of occupation-centred standardised tests and the necessity of critiquing standardised tests, especially when used as outcome measures, are discussed. It is suggested that further research on whether the standardised tests contribute to or do not contribute to an occupation-centred practice would be of great value.
Occupational Therapy and Vocational Rehabilitation: An Audit of an Outpatient Occupational Therapy Service
Authors: Main Lynne , Haig Jane 
Published: April 2015

In response to an increase in requests for vocational interventions to an outpatient occupational therapy department, an audit was carried out over a 6-month period to determine the size and nature of this demand and the outcome of the service provided. The department provided rehabilitation principally to patients aged 16 to 65 years and, of 118 consecutive referrals, 76 (64%) included requests for work-related interventions. By the end of the audit period, 46 had returned to work, 21 were receiving ongoing vocational input and 9 had decided not to pursue employment. The value of addressing vocational issues within a general rehabilitation programme at an early stage after injury or illness is discussed.
The Influence of Managers on Job Satisfaction in Occupational Therapy
Authors: Moore Katherine , Cruickshank Mary , Haas Marion 
Published: April 2015

Promoting job satisfaction in a workplace can make a positive contribution towards the recruitment and retention of staff. The aim of this study, using a hermeneutical phenomenological approach, was to investigate what occupational therapy managers did to have a positive and a negative influence on the job satisfaction of their staff. It was clear that managers played a key role in influencing job satisfaction through their actions and behaviours. In particular, managers who demonstrated care and support towards their staff, while at the same time demonstrating that they were strong advocates and able to make decisions for the good of the department rather than for the benefit of the individual, influenced job satisfaction positively. Job dissatisfaction was strongest when managers were seen to treat staff differently, which was construed as a demonstration of bias stemming from favouritism. The results from this study suggest that staff access to benefits, such as flexible working conditions and educational funding, should be transparent and guided by clear policies.
Impairments in Sensory Modulation in Children with Autistic Spectrum Disorder
Authors: Adamson Amanda , O'Hare Anne , Graham Catriona 
Published: April 2015

The Short Sensory Profile was used to measure a caregiver report of sensory reactivity in a group of children with an autistic spectrum disorder (ASD). Fifty-six of 78 (72%) families invited to participate returned the questionnaires and the data were complete for 44 children. These 44 children represented a stratified sample out of a total of 443 children, identified through nine different data sets maintained for children affected by ASD from a total geographical region in South East Scotland. Clinical information was collected retrospectively from contemporaneous paediatric community child health medical notes and also cross-sectionally from caregivers. Sensory reactivity was outside normal limits in over 70% of the children, with the highest percentage of sensitivities occurring in the auditory filtering and the underresponsiveness and seeking sensation domains. Logistic regression analysis showed no significant relationship between sensory reactivity and the child's age at presentation with autism or parental report of regression. The severity of autism was measured by the Gilliam Autism Rating Scale and related to the Short Sensory Profile (r = 0.39, p = 0.001). These findings suggest that all children affected by ASD, regardless of clinical features or age, may potentially be affected by sensory reactivities and may benefit from appropriate occupational therapy assessment and management. ASDs are relatively common among neurodevelopmental conditions and confer lifelong disabilities. As the majority of affected children will have sensory modulation difficulties, this has significant implications for paediatric occupational therapy services.
Self-Esteem and Coping in Children with Developmental Coordination Disorder
Authors: Watson Lindsey , Knott Fiona 
Published: April 2015

This study investigated self-esteem in children with developmental coordination disorder (DCD). Fifteen children between the ages of 8 and 12 years diagnosed with DCD were compared with a typically developing group comprising 30 children with average and good motor abilities, using measures of perceived competence, social support and self-esteem. The types of coping strategy generated in response to example vignettes were also compared. There was no significant difference between the groups in global self-esteem, but the children with DCD reported lower athletic and scholastic competence than their typically developing peers. No difference was found between the groups in level of perceived social support. The DCD group generated fewer coping strategies overall, but more passive and avoidant strategies than the typically developing children. The implications of the study are discussed with regard to future research directions, such as the investigation of the effects of motor skill intervention on self-esteem and the development of strategies to protect children's self-esteem.
Challenges to Measuring Outcomes in Occupational Therapy: A Qualitative Focus Group Study
Authors: Bowman Julia 
Published: April 2015

The aim of this study was to explore the process used by occupational therapists to measure the effect of their interventions. A second aim was to explore the challenges associated with this process. Stroke rehabilitation was chosen as the focus for the study. This qualitative study was conducted in Sydney, Australia. Ten occupational therapists from both hospital and community-based services participated in one of three focus groups. The data were analysed using constant comparison techniques. The participants struggled when describing the process used to measure outcomes. They focused more on the challenges to measuring outcomes, which were described as focusing on occupation, deconstructing occupation and lacking knowledge, skills and assistance. The participants in this study had difficulty in articulating and setting measurable goals linked to interventions. As a result, they could not easily select appropriate outcome measures. Education is needed to help such occupational therapists to develop the required skills and to begin to measure clinical outcomes. Further research should determine if similar experiences and challenges are faced in other areas of practice and by occupational therapists in other countries.
Occupational Disruption: Living with Motor Neurone Disease
Authors: Brott Tamzin , Hocking Clare , Paddy Ann 
Published: April 2015

Little is known of the day-to-day experience of living with motor neurone disease from the perspective of those who have it, apart from what can be found in personal accounts such as those published on web pages. In this study, which was informed by phenomenology, seven people living in an urban setting in New Zealand were asked to describe their experiences. This report focuses on the study findings that related specifically to disruption to occupation. It describes how early changes in occupational performance alerted the participants to the fact that something was wrong. The findings also showed the pervasive impact of an awkward and unreliable body on participation in occupations that gave meaning to life, expressed identity and filled time. Issues of how the family's world was changed, the introduction of assistive devices into their homes and the betrayal of trust were also powerfully evident in participants' stories. Although the findings are broadly consistent with those of previous studies, the disruption to occupation and the consequent role losses are new findings. Further research into the impact of the loss of participation in occupation, the ways in which people are perceived when occupations are disrupted and the experience of having occupations taken away prematurely is recommended.
The Importance of Vocation in Recovery for Young People with Psychiatric Disabilities
Authors: Lloyd Chris , Waghorn Geoff 
Published: April 2015

Young people with psychiatric disabilities are particularly disadvantaged when it comes to participating in vocational training or higher education or to seeking and maintaining employment. A review of the literature reveals that this is due to a number of factors, including low expectations by health professionals, stigma and discrimination, symptomatology and the lack of a clear responsibility for promoting vocational and social outcomes. A useful approach for occupational therapists to use is a recovery framework combining evidence-based employment and educational assistance with mental health care, provided in parallel with brief vocational counselling, illness management skills, training in stigma countering and disclosure strategies, context-specific social skills and skills in social network development. It is concluded that there is an urgent need to link evidence-based vocational practices with quality mental health care, in order to restore hope among young people of ever realising their vocational goals and once again feeling included as valued members of society.
Occupational Therapists' Perceptions and Management of Aggression Related to Adults with a Brain Injury
Authors: Beaulieu Karen 
Published: April 2015

In response to an increasing level of aggression experienced by health care staff in the workplace, the then Secretary of State for Health launched a campaign tackling violence against staff in the National Health Service (Dobson 1998). Occupational therapists recognise aggression as a symptom often following a brain injury and as a potential barrier to rehabilitation. This study explored how occupational therapists perceived and managed aggression with adults post brain injury. A grounded theory qualitative research methodology was used. A purposive sample of 15 occupational therapists working with adults with a brain injury participated in semi-structured audiotaped interviews. The data analysis identified that the participants experienced and perceived aggression as verbal, physical and gestural. The findings suggest that occupational therapists need to increase their awareness of the problems associated with aggression. The study identified that in the presence of the elements of close physical contact or fear, and where adults with a brain injury were unsure about what was going to happen next, aggression was more likely to take place. It appears necessary to explore further why this is and to establish strategies to reduce the perceived threat to adults with a brain injury and the potential risks to therapists.
Before Preceptorship: New Occupational Therapists' Expectations of Practice and Experience of Supervision
Authors: Morley Mary , Rugg Sue , Drew Julie 
Published: April 2015

Newly qualified health care practitioners generally have high expectations of practice. Stress, value conflict and role uncertainty (‘reality shock’) can result where such expectations remain unmet. Good quality professional supervision can mitigate the deleterious effects of such change. Agenda for Change initiatives have the potential to improve the new practitioners' lot in this area by mandating a year-long period of ‘preceptorship’ support. Such support pairs newly qualified individuals (preceptees) with senior colleagues as role models and resources (preceptors). This article reports a questionnaire-based survey conducted with 45/74 (61%) newly qualified occupational therapists based in London. The respondents reported high initial expectations of their first posts, particularly with regard to professional supervision and client care, which varied according to their age and education. Most (76%) received weekly professional supervision, focused on primarily clinical issues, although this did not always reflect the respondents' desired time use. Although varied development opportunities were cited, the respondents spent little time with their senior colleagues. This study showed that the respondents' expectations and experience of supervisory practice varied. A structured approach to the respondents' personal and professional development, and/or supervision, was not always apparent. Given this, preceptorship seemingly has much to offer newly qualified occupational therapists in the United Kingdom.
Early Perspectives of Patients, Practice and the Profession
Authors: Hocking Clare 
Published: April 2015

This article draws on an analysis of the British Journal of Occupational Therapy and texts published in England from 1938 to 1951 to describe the ways in which early British occupational therapists perceived themselves and their practice. To give context, the impact of World War II, the medical advances of the time and the profession's overarching goals are outlined. Three themes are presented. First, therapists' use of craft activities, the knowledge that they held about the therapeutic application of craft and the demands of using craft activities in hospital environments are described. The therapists' efforts to articulate a theory base and to demonstrate the efficacy of occupational therapy are the second and third themes. The analysis reveals the circumstances that brought about a shift from craft activities to rehabilitation and workplace technologies, and how the diversional activities that characterised practice in mental health and long-stay physical settings lost ground to remedial and vocational outcomes.
The Challenge of Working in Mental Health Settings: Perceptions of Newly Graduated Occupational Therapists
Authors: Lloyd Chris , King Robert , Ryan Liz 
Published: April 2015

Working in mental health settings is a growing area of practice for occupational therapists. The work nowadays is mostly within the community, where occupational therapists may be found in a wide variety of teams. This study investigated the specific challenges that new graduate occupational therapists are faced with when commencing work in a mental health setting. One-to-one semi-structured interviews were carried out with 15 newly graduated occupational therapists, working in mental health settings in south-east Queensland. The interview transcripts were analysed using a consensual qualitative research approach. Three domains were identified from the transcripts. The first related to the ideas of the participants about the skills and knowledge needed by new graduates commencing mental health practice; the second related to the extent to which undergraduate studies had prepared them for practice; and the third related to the means by which they acquired capacity to practise and overcame deficits in skills and knowledge. The core ideas and themes associated with these domains are examined and the implications of the findings for education and training and for orientation to practice are discussed.
An Audit of an Integrated Care Pathway for a Crisis Resolution/Home Treatment Team
Authors: Rigby Lindsay , Hannah Jeannette , Haworth Katharine , Molloy Lynn , Scutts Kerry 
Published: April 2015

The development of crisis resolution/home treatment (CRHT) teams was outlined as a requirement in the National Health Service Plan (Department of Health 2000) and reiterated in the recent guidelines to have an impact on the provision of mental health care (Care Services Improvement Partnership [CSIP] 2006). The Home Option Service in Central Manchester, one of the first CRHT teams in the United Kingdom, provides support and a range of interventions, 24 hours a day, 7 days a week, for those service users experiencing a crisis in their mental health, as an alternative to hospital admission. The need for team working is explicit in the guidance statement to ensure fidelity and best practice for crisis services and it urges teams to provide clarity regarding their roles and responsibilities within the team approach (CSIP 2006). This paper illustrates a model for occupational therapists working within a crisis team in order to ensure that service users have access to occupational therapy when admitted to crisis care. Specific standards, in accordance with those outlined in the research and development strategic vision for occupational therapists in mental health (Association of Occupational Therapists in Mental Health 2006), have been identified to instigate a clear pathway for the stakeholders of crisis teams. A description of the development, implementation and evaluation of an integrated care pathway is provided, alongside a subsequent audit to measure the effectiveness of this model.
The Experience of Poor Sleep and its Consequences: a Qualitative Study involving People referred for Cognitive-Behavioural Management of Chronic Insomnia
Authors: Green Andrew , Hicks Jane , Wilson Sue 
Published: April 2015

Six patients seeking treatment for chronic insomnia participated in two focus groups as a first stage of questionnaire design. Despite the low attendance at the groups, the results are presented because they offer an illuminating insight into the experience of insomnia. The participants reported major disruption to their daytime activities, especially in terms of safety and reliability, which could affect their life choices and, they believed, could affect their health. They did not feel understood by others, especially doctors, and wanted better information about insomnia and its management. The study also highlighted practical problems involved in running focus groups as well as ethical considerations that arise when conducting research with current patients. These issues are discussed along with the implications of the research, which raise questions about the role of sleep in maintaining lifestyle balance. Further research with a larger and more varied group is recommended in order to consolidate the findings and it is suggested that further reflection is necessary to determine the extent to which sleep is a legitimate concern for occupational therapists.
The Professionalisation of Occupational Therapy: A Continuing Challenge
Authors: Clouston Teena J , Whitcombe Steven W 
Published: April 2015

Professions are socially constructed phenomena. Accordingly, an understanding of what is meant by a profession, with its associated social positioning and how that is interpreted, is governed by historical, temporal, cultural and ideological influences. For occupational therapy, such an understanding can be a real challenge. This is because of a dichotomy between its ontological, person-centred approach and the medically dominated constructs prevalent in the professionalisation of all caring professions and still inherent in health care arenas today (Etzioni 1969, Fairhurst 1981, Rivett 1997, Freidson 2001). As a consequence of this traditionally accepted dominance and the roles ascribed to or enabled by this positioning, the professional identity of occupational therapy can be limited by the politics of power at the organisational level. This can shape how occupational therapy is understood, not only by significant others but also by the profession itself. Professional consistency and cohesion, both inside and outside the profession, could therefore be challenged, unless individual actors, organisational attitudes and social constructs change. There is a need both to confront and to accept the ever-changing nature of professionalism and the meaning of occupation in the postmodern world.
Conceptualising Recovery in Mental Health Rehabilitation
Authors: Lloyd Chris , Waghorn Geoff , Williams Philip Lee 
Published: April 2015

Recovery as a concept has gained increased attention in the field of mental health. There is an expectation that service providers use a recovery framework in their work. This raises the question of what recovery means, and how it is conceptualised and operationalised. It is proposed that service providers approach the application of recovery principles by considering systematically individual recovery goals in multiple domains, encompassing clinical recovery, personal recovery, social recovery and functional recovery. This approach enables practitioners to focus on service users' personal recovery goals while considering parallel goals in the clinical, social, and role-functioning domains. Practitioners can reconceptualise recovery as involving more than symptom remission, and interventions can be tailored to aspects of recovery of importance to service users. In order to accomplish this shift, practitioners will require effective assessments, access to optimal treatment and care, and the capacity to conduct recovery planning in collaboration with service users and their families and carers. Mental health managers can help by fostering an organisational culture of service provision that supports a broader focus than that on clinical recovery alone, extending to client-centred recovery planning in multiple recovery domains.