bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Self-Report versus Observation of Performance Using the Assessment of Living Skills and Resources (ALSAR) with an Older Population
Authors: Hilton Kate , Fricke Janet , Unsworth Carolyn 
Published: April 2015

This study assessed the capacity of 15 older people to report their instrumental activities of daily living (IADL) function accurately. The Assessment of Living Skills and Resources (ALSAR) (Williams et al 1991) was used to measure IADL function in the clinical and home environments. The subject's self-reported function was also compared with performance-based measurement of three IADL tasks from the ALSAR (use of the telephone, meal preparation and medication management) in the subject's home environment. The sensitivity of the ALSAR 3-point scale was examined through comparison with the Medical Rehabilitation Follow Along scale (Granger et al 1995). The findings highlighted problems associated with the use of self-reporting for the assessment of IADL in the older population. The ALSAR 3-point scale was shown to be sufficiently sensitive to detect IADL function when used with performance observation; however, further research is required to ascertain sensitivity when it is used as a self-report tool. The findings suggest that occupational therapists attain more accurate results when carrying out IADL assessment procedures by using performance-based measures.
Support Groups for People Who Have Experienced Psychosis
Authors: Hyde Paula 
Published: April 2015

Support groups are not usually provided for people who have experienced psychosis. Ten clients who had been admitted to hospital following a psychotic episode were invited to take part in a support group session each week for 10 weeks. This study aimed to examine the participants' experience of this type of intervention by using observation and interview. Qualitative research techniques were used and the information was gathered by in-depth interviews with clients and by the writing of fieldwork notes about the group and the post-group peer supervision. The transcribed interviews and fieldwork notes were subjected to content analysis where emerging themes were identified and the findings were confirmed by respondent validation. The findings suggested that this type of therapy enabled the members of the group to offer support to each other and to help with reality testing. They were able to mitigate, to some extent, the damaging effect of being diagnosed ‘psychotic’ by validating the experience in a personal sense. The group members shared coping strategies and, in some cases, were able to shift away from using non-coping strategies. They were therefore able to take a more active part in their own treatment. The occupational therapists found the experience to be positive in terms of their own professional development: it improved their listening skills and encouraged their use of reflection to evaluate their own contribution. They also felt that the availability to them of immediate post-group peer supervision was beneficial. This support seemed to be reflected back into the group experience for the clients. This type of support group was found to be appropriate where clients had been admitted to hospital and were preparing for discharge.
Applying Research Evidence to Practice
Authors: Roberts Anne E K , Barber Graeme 
Published: April 2015

One of the important factors in the process of clinical governance is the use of research evidence to inform practice. However, it is not enough to search for and appraise research evidence. Once the information has been appraised, it may be necessary to change practice in order to implement the knowledge. This paper considers the responsibility of occupational therapists to address this change. It is widely accepted that it is notoriously difficult to bring about change in established professional practice. Strategies to help to effect change in practice are discussed and recent research regarding the most effective strategies is considered. The value of combined strategies, including continuing education, clinical guidelines and opinion leaders, is addressed.
Supervision in Occupational Therapy, Part 1: The Supervisor's Anxieties
Authors: Sweeney Grace , Webley Paul , Treacher Andy 
Published: April 2015

Supervision, as a research field, has received a considerable amount of attention within counselling psychology, social work and psychotherapy. Although there is no lack of theoretical writings on supervision within these disciplines, the theories themselves have provided little guidance for continuing research and practice. This has resulted in confusion concerning the purpose of supervision, its distinctiveness from other similar activities, the role and function of the respective participants in the process, and the tasks and methods to be employed. This paper, the first of three on the experience of supervision in occupational therapy, describes a grounded theory study which set out to investigate the processes underlying supervision in the discipline of occupational therapy from the perspective of the supervisor. The data were collected by interviewing 30 occupational therapy supervisors in the South West of England. The results suggest that supervision is frequently experienced as an uncomfortable and relatively unproductive process within this occupational group. In addition, the data lend support to the possible existence of an egalitarian relationship which operates between supervisor and supervisee, with associated payoffs and risks for each participant in the relationship. A second paper reporting the supervisee's perspective will be published as part 2, together with recommendations for future practice in part 3.
Occupational Therapy in Mental Health: Managing Stress and Burnout
Authors: Bassett Hazel , Lloyd Chris 
Published: April 2015

Stress and burnout for human service workers has received increasing attention over a number of years. It has been suggested that health care professionals may be particularly at risk of stress and burnout because of the amount and type of direct client contact that makes up their work. For workers in the field of mental health, additional stressors are present owing to organisational restructuring and new models of care. Mental health occupational therapists may be vulnerable to stress and burnout owing to the nature of their work, the types of client they see, the changed work environment and professional issues. It is recommended that occupational therapists become aware of the factors contributing to stress and burnout and develop strategies to maintain their wellbeing in the workforce.
Occupational Therapists' Perspectives of the Needs of Women in Medium Secure Units
Authors: Baker Sonia , McKay Elizabeth A 
Published: April 2015

The Department of Health and Home Office (1992) formally acknowledged women in forensic provision as being a vulnerable group, with neglected needs in terms of care and treatment. It also clearly identified a role for occupational therapy in meeting these needs through involvement in multi-agency cooperation. The aim of this investigation was to ascertain if, from an occupational therapy perspective, the needs of women in medium secure care were being met. A postal questionnaire was administered to 62 therapists working in medium secure provision in England, with a response rate of 73%. The data generated identified occupational therapists' perceptions of female client needs and the intervention available to women in medium secure care and provided a snapshot of therapists' views in relation to current issues in secure care. The findings demonstrated that occupational therapists working in medium secure care had a good understanding of female client needs and tailored their intervention to be as gender-sensitive as possible within the limitations imposed by the environment. The study also highlighted the requirement for further research to investigate the needs of women in forensic environments from their own perspectives.
The World Wide Web as a Patient Education Resource for Occupational Therapy Personnel
Authors: Sharry Renee , McKenna Kryss 
Published: April 2015

Occupational therapists educate patients and clients to equip them to become active participants in their own care and to provide them with specific knowledge, skills and training. To make informed decisions about their health and wellbeing, patients need high quality information. The World Wide Web is growing as a source of health information. For this information source to be effective, its content must be accurate and the way it is written must be appropriate to facilitate patients' understanding. The aim of this paper is to raise awareness of the World Wide Web as a resource for occupational therapists when educating patients. It reviews the literature regarding the benefits and potential pitfalls of using the World Wide Web for patient education and outlines some guidelines that will help occupational therapists, students and support workers to provide patients with or direct them to sources of reliable web-based health information.
Perspectives on Widening University Access: Critical Voices of Newly Qualified Therapists
Authors: Ryan Susan 
Published: April 2015

Widening university access became a priority in the 1990s. Arguments in favour of this proposition have included: increasing the percentage of the population in the higher education sector; extending university opportunities to those not normally deemed eligible; and providing avenues for those wishing to change careers. Many falling into these categories were mature-aged people from varied backgrounds. Few studies have addressed the actual experiences of those mature-aged students as they have entered the higher education sector for the first time in access courses and then, subsequently, their eventual qualifying route. This qualitative study listened to the voices of these newly qualified therapists. In telling their educational and practice stories in a multiple layer methodology, their varied experiences provided critical incidents. These gave insights into the way that they felt, the way that they perceived they were treated, some actual experiences with staff and colleagues and, finally, the way that they felt on successfully completing their chosen programme. Their reflections were both analysed and interpreted by the method of analysis of narratives (Polkinghorne 1995). The powerful stories and incidents that arose convey lessons for all those working in the higher education sector, whether they be vocational counsellors, access staff or lecturers in professional qualifying programmes.
Self-Evaluation and Occupational Therapy Fieldwork Educators: Do they Practise what they Preach?
Authors: Reid Alistair , McKay Vincent J 
Published: April 2015

In the current climate of lifelong learning and continuing professional development, the importance of self-evaluation is discussed. A cross-sectional survey was carried out to identify the strategies used by fieldwork educators to evaluate their own supervisory skills. It further examined the fieldwork educators' attitude towards, and understanding of, self-evaluation. One hundred self-administered questionnaires were posted to a random sample of Glasgow Caledonian University fieldwork educators. A response rate of 74.5% was obtained. The respondents claimed to use a wide range of self-evaluation techniques, with the majority using between three and five strategies. While the respondents were found, overall, to view self-evaluation positively, only 55.2% of them appeared to understand this concept fully. Statistical analysis of association indicated that those respondents who understood self-evaluation were more likely to have a positive attitude towards it than those who did not fully understand this concept. It is recommended that future fieldwork education update courses should focus on informing fieldwork educators about the concept of self-evaluation and reinforcing its benefits. Fieldwork educators should be encouraged to continue to use self-evaluation and be made aware of the advantages of using a variety of strategies. Conclusion The respondents in this study supported self-evaluation and used a range of strategies to evaluate their own abilities as fieldwork educators. While 44.8% of the respondents lacked a full understanding of self-evaluation, overall the respondents had a positive attitude towards it. More research is needed to confirm and expand on the results of this study. It is recommended that this study be replicated with a larger sample from a cross-section of universities. The chi-square tests of association carried out found the expected frequencies to be quite low in some cases. Had the sample been larger, these tests could, perhaps, have been put to more use. Further studies should also concentrate on fieldwork educators' understanding of other concepts taught to and used by students on placement, and on the relationship between the visiting lecturer and the fieldwork educators.
A Pilot Study of the Physiological and Behavioural Effects of Snoezelen in Dementia
Authors: van Diepen Erik , Baillon Sarah F , Redman Julie , Rooke Nan , Spencer David A , Prettyman Richard 
Published: April 2015

Recent interest in the use of Snoezelen as an intervention for agitated behaviour in patients with dementia remains supported by limited evidence of efficacy. This pilot study aimed to develop an approach for assessing the effects of Snoezelen on agitated behaviour in patients with dementia and its comparability with an existing control intervention. Ten patients with dementia were randomised to receive a 4-week course of either Snoezelen or reminiscence therapy. The therapeutic effects were assessed using the Agitation Behaviour Mapping Instrument (ABMI) and the Cohen-Mansfield Agitation Inventory (CMAI) and by heart rate recording. Differences in dementia severity between the two groups hindered direct comparison of outcomes. Both interventions were well tolerated and the majority of both Snoezelen and reminiscence sessions were rated positively. The ABMI ratings suggested that Snoezelen might have reduced agitated behaviour during and immediately after the session but that this effect was short-lived. The CMAI scores indicated reduced agitated behaviour during the intervention period. Heart rate data showed both decreases and increases during the sessions for different participants. With minor modifications, the measures used will be appropriate for a full-scale comparative trial. Both interventions may have helpful short-term effects and while for some patients the sessions are primarily relaxing, for others they may have a more stimulating effect.
Standardised Tests: An Appropriate Way to Measure the Outcome of Paediatric Occupational Therapy?
Authors: Payne Sally 
Published: April 2015

The advent of clinical governance has refocused clinicians on the need to use evidence-based practice, one aspect of which is the identification and measurement of intervention outcomes. Paediatric occupational therapists have traditionally used a variety of standardised tests in their practice and these are often cited as the means by which treatment outcomes are evaluated. However, the tests most frequently used may not be the most appropriate measures of the outcome of occupational therapy. This paper explores some of the issues surrounding outcome measurement in the field of paediatrics and highlights aspects of outcome measurement requiring further clinical and research consideration. It is suggested that there is a need to develop a conceptual framework for outcome evaluation which is both consistent with the occupational focus of practice and uses outcome tools that are objective, useful and appropriate.
Process Mapping Occupational Therapy Activity within a Medical Admissions Unit
Authors: Welch Amanda 
Published: April 2015

There are increasing demands on professionals within health care to provide a service that meets the needs and expectations of patients. This requires the patient to be placed at the centre of the care pathway. Occupational therapy is well placed to contribute to this change in emphasis because of its fundamental client-centred philosophy. Experience has shown, however, that the realisation of these aims has been a challenge for all health care professionals. Increasingly, the National Health Service is drawing upon expertise from outside and, in particular, the quality improvement tools that are used within industry. This article explores the use of the traditional quality tool of process mapping in the evaluation and review of occupational therapy processes. The use of this tool is explained in relation to a clinical audit within a medical admissions unit. The results of the process mapping exercise, and the associated audit that was undertaken, demonstrated the value of the approach. In particular, process mapping enabled the occupational therapy service to evaluate systematically the service being provided and to visualise the optimum pathway of care.
Informing Client-Centred Practice through Qualitative Inquiry: Evaluating the Quality of Qualitative Research
Authors: Hammell Karen Whalley 
Published: April 2015

Occupational therapists are increasingly embracing qualitative research methods yet little published advice exists in the occupational therapy literature to enable readers to gauge the quality and relevance of researchers' work. If qualitative research is to provide convincing evidence with which to inform theory and practice, it must be capable of withstanding critical scrutiny and practitioners must be given sufficient information with which to evaluate the strength and plausibility of the evidence reported. The process of undertaking qualitative research and of writing and critiquing subsequent reports is not about assessing adherence to rigid rules but of ensuring the appropriateness and thoroughness of data collection, analysis and reporting, given the nature and context of the issue. The espousal of a client-centred ethic also demands consideration of research relevance and usefulness to clients and the degree of consumer involvement throughout the research process. This paper examines an evaluative framework that may be used to assess the quality of qualitative evidence as this is both researched and reported. Recourse to a set of general strategies — used where appropriate – will serve to enhance the quality of qualitative research and assert its potential to inform the client-centred, evidence-based practice of occupational therapy.
Rehabilitation of Motor Control following Stroke: Searching the Evidence
Authors: Dickson Maria 
Published: April 2015

Evidence-based practice is becoming an increasingly important issue and occupational therapists are frequently reminded that they must search the literature to find evidence to support their interventions. However, in many areas of practice this evidence is simply not available to be found. An example of this is in the remediation of motor control following stroke. As new ideas about motor control have emerged, some occupational therapists have expressed concern about the approaches that are currently used, in relation to their efficacy and their appropriateness. This article considers the meaning of evidence-based practice and the advantages and difficulties that it presents. The literature is then reviewed to consider evidence for traditional and contemporary approaches to motor control by occupational therapists. The disturbing lack of evidence for traditional approaches and the limited amount of evidence for new approaches are discussed. Recent studies of current practice are then explored, revealing that many occupational therapists are continuing to use approaches for which there is no supporting evidence. The article concludes with the suggestion that, rather than asking occupational therapists to search for evidence that does not exist, they should be encouraged to produce the evidence by being involved in research studies that seek to demonstrate the efficacy of different approaches.
The Group Activity Form: Is it Valid and Reliable?
Authors: Thorgrimsen Lene , Kennedy Louise , Douglas Cathy , Garcia Chris , Bender Mike 
Published: April 2015

The Group Activity Form (GAF; expanded from Bender et al 1987), a tool for evaluating group members' participation in group sessions, has been successfully used, but its reliability and validity have not been established. This was the aim of the present study. In order to investigate the interrater reliability of the GAF, three independent raters used the GAF to score 96 people with dementia attending a reminiscence group. The group was conducted by the occupational therapy department in an assessment ward for people with dementia. To explore the concurrent validity of the GAF, it was hypothesised that, with this client group, a correlation could be expected between how successful the group members were in engaging in group activity, measured by the GAF, and their cognitive abilities. To measure the latter, the Clifton Assessment Procedure for the Elderly (CAPE; Pattie and Gilleard 1979), a measure well established and validated in this setting, was used. The results showed a significant interrater reliability on all the items of the GAF. There was some evidence for the hypothesised correlation between the GAF and the CAPE. This study is a useful starting point for further research to investigate other aspects of the validity and reliability of the GAF.
Community Care and Rehabilitation after Stroke in Japan
Authors: Butler Jenny , Smith Teresa 
Published: April 2015

The purpose of the research project was to determine, from a cross-cultural perspective, the care services and rehabilitation for elderly people with stroke living in the community in Japan. A written questionnaire and a semi-structured interview were used. The participants were a purposive sample of 21 elderly people and family/carer living in the metropolitan area of Tokyo, Japan. There were 11 men and 10 women with an average age of 70 years (range 42–86 years). The mean age at onset of stroke was 66.5 years (range 42–81 years) and the mean time since stroke was 3.2 years (range 3 months to 8 years). Varying levels of dependency were found, with an average Barthel Index score of 9.32 (range 0–18). Varying experiences of rehabilitation services were also reported: six people received physiotherapy only, six received physiotherapy and occupational therapy, and nine received no formal rehabilitation service either in hospital or in the community. Many participants were living in multi-generational households. Women had frequently given up jobs to care for their elderly relative, but were assisted in the caring role by community care workers (mainly nurses and home helpers). Environmental changes and disability equipment were evident in the homes. The project concluded that elderly people in Japan were supported by good community health care, although rehabilitation resources were limited. Cultural understanding as a key factor in rehabilitation processes is explored in the paper.