bluuebunny/crossref_metadata_2025_split huggingface dataset:
The comparative impact of conservative treatment versus superficial venous surgery, for the treatment of venous leg ulcers: A systematic review of the impact on patients’ quality of life
Authors: Tollow Philippa , Ogden Jane , Whiteley Mark S 
Published: April 2015

Objectives Leg ulcers are known to have a profound effect on patients’ quality of life; however, the influence of different treatment approaches is unclear. This review aims to evaluate the comparative impact of conservative treatments and superficial venous surgery, for venous leg ulcers, on patients’ Quality of Life. Data sources Three electronic databases (PsycInfo, Medline and CINAHL), and reference lists of relevant articles, were searched. A total of 209 articles were initially identified, and 16 articles were included in the review. Results The results lend cautious support to the suggestion that all treatments have a positive effect on quality of life, regardless of type, whilst wound status also appears to be an important factor. Conclusions Some evidence suggests that surgical treatment methods may lead to greater improvements in patients’ quality of life than compression bandaging alone; however, future research may focus on the psychological mechanisms underlying such changes.
The Importance of Pretend Play in Child Development: An Occupational Therapy Perspective
Authors: Stagnitti Karen , Unsworth Carolyn 
Published: April 2015

Play is a complex behaviour and is defined as being more internally than externally motivated, transcending reality as well as reflecting reality, controlled by the player, involving more attention to process than product, safe, usually fun, unpredictable, pleasurable and spontaneous and involving non-obligatory active engagement (Bundy 1997, Stewart et al 1991). Pretend play, which occurs between the ages of 18 months and 6 years, reflects these qualities of play. Using the World Health Organisation's classification of body functions and structures, activities and participation (ICIDH-2, WHO 1999), this paper outlines the skills that are essential for pretend play ability and asserts that if there are any impairments in these skills the child experiences a reduced ability to pretend play. This leads to possible participation restrictions in the child's life, such as difficulties in fulfilling usual social roles. Cognitive, social and emotional skills are presented as having the biggest impact on pretend play development, while the motor and sensorimotor skills that enable the child to manipulate objects in the environment are presented as being of secondary importance. Two models are offered which illustrate the importance of pretend play to child development and the sequence of play development. The paper concludes by recommending that occupational therapists address and reduce the participation restrictions that some children experience in learning and social situations by enabling a child to increase activity in pretend play.
True to Our Philosophy? Sexual Orientation and Occupation
Authors: Kingsley Penny , Molineux Matthew 
Published: April 2015

Occupational science and occupational therapy suggest that people engage in occupations that are meaningful and relevant to them on personal and cultural levels. Sexual orientation is one theme of meaning in a person's life which influences his or her choice of occupations and the meaning and relevance those occupations hold. Sexual orientation, as it is conceptualised here, encompasses far more than a person's choice of sexual partner and is, therefore, an important area for an occupational therapist to consider. It is, however, an often neglected area in both curricula and the literature. This paper presents the results of a qualitative study which investigated the perspectives of basic grade occupational therapists regarding working with clients of gay, lesbian or bisexual sexual orientation. Six basic grade occupational therapists were interviewed using a semi-structured format and four themes emerged. The findings included that the basic grade occupational therapists interviewed did not consider occupation in its complexity and so did not appreciate how sexual orientation might be expressed in a person's occupations. The interviews also indicated that the subject of sexuality is still taboo in occupational therapy.
Policy Changes in the National Health Service: Implications and Opportunities for Occupational Therapists
Authors: Godfrey Alice 
Published: April 2015

Recent changes in the philosophy and structure of the National Health Service give greater emphasis to the prevention of ill health within locally defined communities. Occupational therapists, by virtue of their unique philosophy, have an opportunity to influence primary care strategy and practice by highlighting the links between environment, occupation and health. The recent changes in the structure of the National Health Service are described and the philosophy of occupational therapy is discussed in relation to these changes. This description provides the basis for recommendations as to how occupational therapists can work to build a recognition of the fundamental importance of adaptive occupation to individual health and, hence, to health at a community and population level. Working at a community and population level will require occupational therapists to strengthen links with health promotion and public health in order to help promote health through meaningful occupations within local settings.
Occupational Therapists: Is Our Therapy Truly Occupational or are We Merely Filling Gaps?
Authors: Fortune Tracy 
Published: April 2015

This article is concerned with role identity and its relationship to the professional thinking and action of occupational therapists. In this informed viewpoint, the notion that occupational therapists could be perceived as gap fillers is explored, based on empirical data that focused on the roles adopted and the guiding philosophies enacted by occupational therapists working in child and adolescent mental health. Following the presentation of interview data from four occupational therapists, two cogent issues are presented and discussed. The first issue posits that a failure to ground practice in occupational philosophies contributes to perpetuating an incoherent role identity. The second issue discusses whether the recovery of an occupational paradigm in practice can liberate occupational therapists from role incoherence and enable them to reclaim their identity as therapists of occupation.
Occupational Therapy for Stroke Patients: A Survey of Current Practice
Authors: Walker M F , Drummond A E R , Gatt J , Sackley C M 
Published: April 2015

A survey was carried out in order to ascertain the treatment approaches used in stroke care by senior I occupational therapists in the Trent Region of the United Kingdom. A random selection of these therapists was subsequently interviewed using semi-structured interviews and a case vignette in order to obtain more detailed information. Of the 83 questionnaires sent, 61 (73%) were returned; 14 therapists were interviewed. The two most common approaches identified were the functional approach and the Bobath approach. The main indications for the choice of approach were the age of the patient, progress with other approaches and discharge date. Of concern in the current climate of evidence-based practice was the high number of occupational therapists who were unfamiliar with standardised assessments and unable to describe adequately the theoretical basis for the treatment used.
Football and Tin Cans: A Model of Identity Formation Based on Sexual Orientation Expressed through Engagement in Occupations
Authors: Williamson Peter 
Published: April 2015

Occupational therapy is grounded in the use of purposeful activity. Current practice standards insist that such activity be meaningful for the participant. What makes an activity meaningful is a combination of an individual's identity, life experiences, intrinsic characteristics and the physical, social and cultural environments in which the person finds himself or herself. Sexuality is one of the frameworks that provide scaffolding for identity formation, developed alongside and because of engagement in occupations. This paper presents a six-stage model, developed by a psychologist in Australia, of identity formation based on sexual orientation. This model is illustrated using the oral history of a gay man. The influence of occupation at crucial moments in the developmental stages for this individual is illustrated. The meaning of this model for occupational therapy practice, education and theory is discussed.
Advertising for and Recruiting Basic Grade Occupational Therapists in the United Kingdom
Authors: Ferguson Marian , Rugg Sue 
Published: April 2015

Occupational therapy managers engage in fierce continuing staff recruitment competition, knowing that the outcome influences both patient care and contractual obligations. Professional experience suggests that many such individuals receive little or no formal training to complete this process. An extensive literature review found no research on recruitment advertising among British occupational therapists. This study explored the factors attracting newly qualified occupational therapists to job advertisements and identified the timing of their initial search. It also investigated the success of various methods of advertising, in terms of their cost-effectiveness, efficiency and effectiveness. The data were gathered using two postal questionnaires, sent to a random sample of 200 occupational therapy managers and 200 of their most newly qualified staff. The results showed that most recruitment advertisements addressed applicants' practical concerns, but were less than comprehensive. Recruitment activity was greatest between February and July, with the British Journal of Occupational Therapy proving the most popular vehicle. The findings suggested that well-timed, well-placed and well-targeted advertisements could save all much time and effort. By increasing the number of successful appointments, they could also reduce costs. The study concluded that managers seemed largely aware of when and where to advertise, but could focus their advertisements more closely on the needs of potential applicants.
The Role of Computer Simulation in the Development of Clinical Reasoning Skills
Authors: Stewart Lisa S P 
Published: April 2015

A multidisciplinary project is under way to develop a computer model which will simulate the hip fracture care process in both a large teaching hospital and a district general hospital (Currie et al 1998). This paper describes the occupational therapy contribution to the project. The complex process of care will be simulated by integrating each clinical group's patient intervention (strategy) at each point of the patient's journey. As part of this research, the literature was referred to for evidence to support current occupational therapy and to form a structure for simulation. The occupational therapy strategy is represented as a flow chart which leads the patient from admission to the acute orthopaedic ward, through to assessment, rehabilitation and, finally, discharge. The literature suggested that the way in which each occupational therapist individualised this strategy (based on Hagedorn's [1997] model) was influenced by his or her own clinical reasoning, which might in turn affect outcome. The notion that mental modelling (clinical reasoning) might be simulated has led to the suggestion that computer simulation could be used as a learning tool to develop clinical reasoning skills in the novice, with the aim of improving patient care.
Don't Despise the Fluffy Bunny: A Reflection from Practice
Authors: Perrin Tessa 
Published: April 2015

Have occupational therapists lost the art of using occupations as therapy? This article proposes that in moving away from its art and craft roots towards an increasingly scientific paradigm over the past 50 years or so, the profession has jettisoned one of its core values ± creativity. The loss of awareness of and appreciation for creativity in the therapeutic dynamic has radically altered and constrained the practice of many occupational therapists and engendered a shift away from using occupations in healing. An illustration drawn from continuing care for older people demonstrates how occupational therapy is failing the field of chronic disability. It suggests that the profession must urgently consider the establishment of a new kind of practitioner for chronic disability settings, allied to but independent from occupational therapists.
The Use of Evidence-Based Practice by Occupational Therapists Who Treat Adult Stroke Patients
Authors: Sweetland Jeanette , Craik Christine 
Published: April 2015

The study identified the extent to which members of the National Association of Neurological Occupational Therapists (NANOT) who treated adult stroke patients used evidence-based practice (EBP). A random sample of NANOT members (n = 200) was surveyed by a postal questionnaire on the use of EBP and the results were analysed for the 125 therapists who worked with adult stroke patients. The principal factor that ‘greatly’ influenced the choice of intervention of three-quarters of the respondents was working with other therapists, followed by attendance at postgraduate courses; gaining postgraduate qualifications had the least influence. Although over 90% of the respondents considered that they used EBP at some time, the most frequently reported levels of evidence used were custom and practice and expert opinion, which were at the lower end of the hierarchy. Therefore, although the respondents who treated adult stroke patients did use EBP, they did not use the higher levels recommended. The respondents who used the higher levels of evidence were those who were most recently qualified. The factors influencing the use of EBP were the relevance of research to practice, time, lack of therapists' knowledge and lack of support.
The Management of Altered Body Image: A Role for Occupational Therapy
Authors: Shearsmith-Farthing Karen 
Published: April 2015

While historically a number of approaches and disciplines have proved to be effective in the management of altered body image, there is little evidence within the occupational therapy literature to suggest that this is an area actively pursued outside the realm of eating disorders. The concept of altered body image in relation to occupational therapy is explored, within the context of life-threatening disease. A review of multidisciplinary input in this area indicates that a number of factors contribute to the difficulty in identifying, assessing and treating this complex concept. This article suggests that occupational therapists, with their unique perspective of activity as a facilitator of change in occupational performance, are well placed to address altered body image concerns. Education and training in this area are required if occupational therapists are to do so with confidence and competence, irrespective of clinical condition or setting, in order to contribute positively to the rehabilitation process and the individual's overall quality of life. Further research in the management of altered body image by occupational therapists is recommended.
Activity Use in Occupational Therapy: Occupational Therapy Students' Fieldwork Experience
Authors: Drew Julie , Rugg Sue 
Published: April 2015

This article explores the results of a small quantitative study conducted with 54 occupational therapy students. The data, gathered using a purpose-designed questionnaire, were based on respondents' reports of the 662 activities seen during their fieldwork education. These were categorised using headings from the Canadian Occupational Performance Measure (Law et al 1994). The findings showed that client-related leisure activities were the most frequently seen in all practice settings (physical disability, mental health and learning disability). The activities seen most often consisted of those in the ‘quiet recreation’ category. Activities aimed at productivity, and particularly at household management, were also widely spread. Such activities formed a smaller but consistent percentage of those seen in all fields of practice. Self-care, and in particular personal care, activities were most prevalent in physical disability settings, but formed a lower percentage of the activities seen elsewhere. This article discusses these findings in relation to previous research in the field and considers the continuing place of activity in occupational therapy and in undergraduate occupational therapy education.
Some Factors influencing Occupational Engagement for People with Schizophrenia Living in the Community
Authors: Chugg Amanda , Craik Christine 
Published: April 2015

With the emergence of occupational science, there has been renewed interest in the health benefits of occupational engagement and a call for more research into the occupational nature of humans. Engaging in occupations is known to have a positive effect on an individual's health and sense of wellbeing. A common feature of people with schizophrenia, however, is a decrease in volition and a reduction in the occupations performed. This study explored some of the influences on occupational engagement for people with schizophrenia living in the community. A qualitative approach was chosen, using semi-structured interviews. Four male and four female participants, aged 23 to 49 years, described the influences on their occupational engagement. Content analysis, primarily using coding and memoing, was employed to categorise the data. Four main themes emerged: health, routine, external factors and internal factors. Some specific factors identified within these themes were medication, daily schedules, staff, family, work, self-concept and challenges. The implications of the results are discussed, with particular reference to assisting occupational therapists to enable clients with schizophrenia to engage more successfully in occupations.
Changing Rooms: the Impact of Adaptations on the Meaning of Home for a Disabled Person and the Role of Occupational Therapists in the Process
Authors: Hawkins Rachael , Stewart Sandra 
Published: April 2015

Accessible housing is crucial both to enable the implementation of community care and to assist in giving disabled people equal rights to independent living. In order to meet these demands, occupational therapists often play a key role in recommending adaptations to the home environment. Although there can be important benefits in this process, the meaning of home to the disabled person and his or her family can be overlooked and compromised by the changes that occur to it. It is suggested that in order to redress this balance, the social model of disability should be applied to the assessment process. This would result in a more holistic view of the environmental barriers faced by the disabled person within his or her home and a deeper understanding of the wider meaning of home to the disabled person and the family. The provision of adaptable housing, such as Lifetime homes, is also considered as a way of minimising the need for home adaptations in the longer term. A broader role for the occupational therapist within the framework of the social model is discussed.
Generic and Specialist Interventions for People with Severe Mental Health Problems: Can Interventions Be Categorised?
Authors: Cook Sarah , Cook Sarah 
Published: April 2015

This study of a primary care based service investigated the type and frequency of occupational therapy and care management interventions delivered to people with severe mental health problems. The sample for the case study of one service was 25 people with enduring psychotic conditions who received 12 months' interventions from occupational therapy staff. The routinely recorded case data for each client were retrospectively analysed to generate intervention categories using content analysis and categorical aggregation. The total number of recorded interventions was then quantified using descriptive statistics. The most frequently recorded interventions are reported. It was found that 60% of the 1877 interventions were categorised as specialist therapy (54% occupational therapy and 6% psychological interventions) and 40% were categorised as generic care management. It is suggested that clients may be better served by increasing the proportion of specialist occupational therapy interventions delivered by occupational therapists. The case study design is limited because the results are not generalisable to other settings and several problems with the methods were found when attempting to analyse the interventions into separate and mutually exclusive categories. This small study contributes to debates about the role of community mental health occupational therapists and how to investigate what they do in routine practice.
Returning to Work after a Stroke: An Important but Neglected Area
Authors: Corr Susan , Wilmer Sorrel 
Published: April 2015

Work is key to participating in society. This paper reports two independent studies, which addressed different aspects of returning to work after a stroke. Study I, using the Canadian Occupational Performance Measure and the Role Checklist, established the perception of returning to work of 26 participants aged 34–55 years post-stroke. Study II, using interviews, established the support required and obtained for six participants who returned to work post-stroke. Both studies found that the participants considered work to be important, that they wished to return to work and that help was needed to do so. Study II found that occupational therapists had a limited role in providing support and recommends their greater involvement in work rehabilitation service provision for those who have had a stroke. The findings of these studies suggest that there is a gap in providing appropriate support to enable people to carry out an occupation that both they and society value.
Consulting Service Users: The Stroke Association Home Therapy Project
Authors: Gilbertson Louise , Ainge Sally , Dyer Rachel , Platts Gale 
Published: April 2015

In 1999, the Stroke Association set up a project to promote home-based occupational therapy for patients who had had a stroke and been discharged home from hospital. As part of the service evaluation, focus groups for service users and carers were set up in two of the sites to consult users about the changes in their quality of life during the period of the home therapy. A total of 11 service users and 9 carers attended the groups, representing 30% of the service users and 27% of the carers involved in the project. The group discussion was taped and transcribed and then analysed using a framework approach. The group members described their personal experiences of recovery from and limitations after the stroke and reported improvements in life issues during the period of their home therapy. The content and organisation of the service and the relationships with project staff were felt to influence the effectiveness of the occupational therapy. Other issues that affected the perceived outcome for the service users included individual choice, age, stroke consequences, other rehabilitation and community services and social limitations. This consultation process allowed the service users to describe the strengths and weaknesses of the service and provided valuable feedback that could be used to design the content and application of future home therapy services.