bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fishy Tales: Experiences of the Occupation of Keeping Fish as Pets
Authors: Langfield Janaya , James Carole 
Published: April 2015

Pet ownership is an occupation that has benefits for human health and wellbeing. However, research on pet ownership mainly addresses the benefits of interactive pets, such as dogs and cats. Some individuals are unable to participate in the occupation of interactive pet ownership and, therefore, may be deprived of the benefits that pets can bring to their lives. This research used a qualitative, phenomenological methodology to explore the ownership of fish as pets. Data were collected using in-depth semi-structured interviews and were analysed inductively. Nine participants were interviewed and the following themes were identified from the data collected: the reasons for owning fish as pets; the fish environment; caring for fish; and the benefits of owning fish as pets. It was discovered that pet fish ownership is a meaningful occupation that provides purpose and enjoyment in life. The findings of this study suggest that pet fish may be an alternative to interactive pets, and one that therapists can recommend to clients who wish to own a pet.
Space at Home for Families with a Child with Autistic Spectrum Disorder
Authors: Pengelly Sue , Rogers Phil , Evans Kerri 
Published: April 2015

The interrelationship between the home environment, occupations and wellbeing was explored in relation to the lived experiences of three families with a child diagnosed with autistic spectrum disorder (ASD). Each family had acquired an extra downstairs room through moving or adapting their home, which they dedicated to their child with ASD. This project used diary records and narrative interviews to gain an in-depth understanding of how the room was used, the meaning that the family attached to this additional space and its impact on their occupational engagement. The findings reflected the complexity of problems experienced by children with ASD and their families. They revealed that dedicated physical space was experienced as important personal, emotional and occupational space for all family members. This study helps to develop a theoretical understanding of the importance of establishing a good fit between individuals with developmental disabilities and their home environment. It argues that space at home influences the behaviour of children with ASD, the stress levels of their parents and the occupational engagement of all members of their family, and emphasises the importance of adequate space at home for children with ASD and their families.
From Practice to Praxis: Reconnecting Moral Vision with Philosophical Underpinnings
Authors: Wilding Clare , Whiteford Gail 
Published: April 2015

In this article, it is argued that in order to meet the profession's ethical and moral obligations, occupational therapists need to ensure that they are connected to the philosophical foundations of occupational therapy. By making occupational therapy practice occupation-focused, therapists guarantee that they provide a unique and valuable contribution to multidisciplinary teams and that they help to meet all the needs of patients. The findings from an action research study of 15 occupational therapists' practice in an urban Australian acute hospital setting are used to illustrate that occupational therapy practice can and should be occupation-focused. Research data were gathered through audio-recording and transcribing individual interviews and research group meetings. The data were analysed qualitatively using non-linear formal and informal processes. The findings were as follows: having a clear professional vision increased the confidence of co-researchers; attending to patients' occupational needs increased the therapists' motivation to engage in more occupation-focused practice; and therapists felt increased satisfaction when their practice was occupation-focused. The article concludes by advocating that occupational therapists can be wiser and more ethical practitioners by engaging in praxis, a form of moral, reflective practice scholarship, particularly through participating in communities of practice that focus on understanding and developing ways of enabling occupation.
Effectiveness of Work Injury Prevention Education and Safety Training by an Occupational Therapist
Authors: Fisher Thomas F , Brodzinski-Andreae Brandi , Zook Stacy 
Published: April 2015

Limiting or eliminating work-related musculoskeletal disorders (WRMSDs) is a goal of many employers. Understanding risk factors associated with WRMSDs assists workers in avoiding these factors. The purposes of this study were to determine employees' awareness of risk factors of WRMSDs and their knowledge for avoiding such risks and to evaluate the effectiveness of injury prevention of WRMSD education by an occupational therapist. Sixty-one employees (both supervisors and employees) at a university animal research laboratory participated. They were given a pre-test survey before the injury prevention education. They were next provided with an hour's training and then given a post-test survey. There was statistical significance with four of the five items on the test instrument when comparing the pre-test and the post-test results. This demonstrates knowledge gained from the training. The conclusion supported injury prevention training from an occupational therapist on risk factors associated with WRMSDs and employers should consider such training.
Using Social Judgment Theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations
Authors: Unsworth Carolyn , Harries Priscilla , Davies Miranda 
Published: April 2015

Introduction As people with a range of disabilities strive to increase their community mobility, occupational therapy driver assessors are increasingly required to make complex recommendations regarding fitness-to-drive. However, very little is known about how therapists use information to make decisions. The aim of this study was to model how experienced occupational therapy driver assessors weight and combine information when making fitness-to-drive recommendations and establish their level of decision agreement. Method Using Social Judgment Theory method, this study examined how 45 experienced occupational therapy driver assessors from the UK, Australia and New Zealand made fitness-to-drive recommendations for a series of 64 case scenarios. Participants completed the task on a dedicated website, and data were analysed using discriminant function analysis and an intraclass correlation coefficient. Results Accounting for 87% of the variance, the cues central to the fitness-to-drive recommendations made by assessors are the client’s physical skills, cognitive and perceptual skills, road law craft skills, vehicle handling skills and the number of driving instructor interventions. Agreement (consensus) between fitness-to-drive recommendations was very high: intraclass correlation coefficient = .97, 95% confidence interval .96–.98). Conclusion Findings can be used by both experienced and novice driver assessors to reflect on and strengthen the fitness-to-drive recommendations made to clients.
The Place of Psychology in the Professions Allied to Medicine, with Particular Reference to Occupational Therapy
Authors: Smith-Rose M. 
Published: April 2015

So much interest has been expressed in the following article by Miss M. Smith-Rose, T.M.A.O.T., of Exminster Hospital, Devon, that Part I of the article which originally appeared in our June issue is reprinted with Part II. Apologies are offered to Miss Smith-Rose for errors in referencing which appeared in our June issue. These errors have been amended to accord with those of Part II.
Remember How the World Has Changed
Authors: Hume Clephane A. 
Published: April 2015

This article discusses some of the problems encountered during the author's work on the rehabilitation team at the Royal Edinburgh Hospital. The facilities there include a ladder of transistional care, ranging from the token economy ward to group games within the hospital and group tenancies for patients discharged to day care (in all, 97 beds). Gradual reduction in supervision is accompanied by increased demands in the work situation. The occupational therapist is responsible for planning work programmes and advising on other aspects of care, organising individual assessments and programmes as required.
High-Risk Elderly Patients in Acute Care Institutions: A Canadian Perspective
Authors: Beckingham Ann C , Westmorland Muriel G 
Published: April 2015

Hospitalised elderly patients institutionalised for prolonged periods present a significant challenge to health professionals, but relatively few acute care hospitals provide specialised programmes designed to address their unique and individual needs. This article presents a review of relevant from 1978 to the present related to the needs of high-risk elderly patients in acute care institutions and comments on hypothesis versus reality. The literature indicates that when an active team approach is used with the elderly patient, focusing on rehabilitation and activities of daily living, a decreased length of stay can result. However, no studies were found that tested the results of a dynamic ‘enriched programme of care’. After a review of inpatient data on two acute orthopaedic wards at two Ontario medical centres, the authors set out to establish if it was feasible to conduct a pilot study. The proposed study included a detailed outline of an enriched programme of care utilising the resources of occupational therapists, ward nursing staff and volunteers. Over a period of 6 months there were several multidisciplinary of health professionals and volunteers, who reviewed the demographics of this population which indicated that acute elderly orthopaedic patients over 65 are being discharged fairty quickly from hospital. This reality appears to contradict the literature which suggests that this group of patients are hospitalised for long periods and therefore require more functionally focused physical rehabilitation orientated programmes. It also begs the important question regarding adequate preparation of this population for return home and continuity of care between hospital and community.
The Magic of Mentoring with Part-Time Students
Authors: Ilott Irene , Allen Sarah 
Published: April 2015

Mentorship was an intrinsic part of the South Trent In-Service Diploma Course. The scheme was intended to optimise experiential learning and provide an outreach support network for students undertaking the 4-year part-time course. This article describes the evolvement of mentorship as a new concept for occupational therapists. The process culminated in the production of specific guidelines which clarified the role and set an agreed minimum standard without prescribing what is essentially a personal relationship. At the end of the first and final years, the scheme was evaluated using questionnaires to ascertain the views of both mentors and students. The results identified the benefits and the problems associated with such a scheme. Although costly in terms of commitment and time, the benefits derived from support for individuals and the encouragement of a learning culture within sponsoring organisations.
Snoezelen: Its Effects on Concentration and Responsiveness in People with Profound Multiple Handicaps
Authors: Ashby Mark , Lindsay William R , Pitcaithly Deborah , Broxholme Sarah , Geelen Nicola 
Published: April 2015

This article is an initial investigation into the effects of Snoezelen on concentration and responsiveness in people who have profound and multiple handicaps. Eight subjects with profound learning disabilities took part. Ratings of concentration were recorded at each session using a simple task. The subjects were also assessed at every fifth session for responsiveness to the Snoezelen environment. The results suggest that all the subjects except one, who failed to score, responded In some way with improvements in scores. The improvements in concentration were significant for two subjects, moderate for four and minimal for one. The changes in concentration were not always related to the responsiveness/enjoyment in the Snoezelen environment. However, the two subjects who, in general, showed significant improvements in concentration were also rated as being the most responsive to the Snoezelen environment.
The Essential Elements of Professional Motivation
Authors: Creek Jennifer , Ormston Cathy 
Published: April 2015

This article explores how the continuing development of occupational therapy has been fuelled by three essential elements: philosophy, theory and practice. It examines how the interplay between these elements maintains and drives the profession and discusses the part that individual therapists play in sustaining the progress of the whole. The profession is vulnerable. Philosophy, theory and practice are becoming disconnected, leading to dampening of energy and distraction from our professional purpose. Possible explanations are suggested, including internal factors, such as the widening split between academics and clinicians, and external factors, such as changes in health policy. Strengthening the links between philosophy, theory and practice will ensure that occupational therapy remains healthy and progressive. The article concludes with some practical recommendations about what can be done to bring the philosophers, theorists and practitioners together, to fire individual motivations and re-energise the profession.
Client Confidentiality: Ethical Issues in Occupational Therapy
Authors: Sim Julius 
Published: April 2015

Confidentiality is a central ethical concern in occupational therapy practice and one that is emphasised in professional codes of ethics. This article examines the conceptual and moral basis of confidentiality, and relates it to the fundamental ethical principles of respect for autonomy, respect for persons and non-maleficence. The moral conflicts that may arise between the requirement of confidentiality on the one hand, and the need to safeguard the interests and welfare of others on the other hand, are explored with reference to the Tarasoff case. Both consequentialist (outcome-based) and deontological (duty-based) perspectives are examined. It is argued that confidentiality should be given a special status within the client-therapist relationship and, up to a certain critical threshold, should be protected from considerations of general welfare. It is argued that, whilst confidentiality may on occasions be breached in the interests of others, it Is rarely permissible to do so in the client's own Interest. In conclusion, occupational therapists are urged to give a high regard to confidentiality and to cultivate the virtue of discretion in their professional practice.
Applying Clinical Reasoning: A Caseload Management System for Community Occupational Therapists
Authors: Fortune Tracy , Ryan Susan 
Published: April 2015

This article presents a system of caseload management for community occupational therapists. Using the clinical reasoning work of Mattingly and Fleming as a framework, the perceived complexity of each case for a community occupational therapist was analysed and then paralleled with the type and amount of clinical reasoning required. Following an initial occupational therapy assessment, each case is given a numerical weighting, graded at 3 for complex cases and from 1 for non-complex or simple cases. The degree of complexity or weighting is recognised to be a subjective phenomenon dependent on the experience, knowledge and skills of the therapist. The cases held by an occupational therapist are able to be mixed so that the experienced therapist holds a varied caseload of complex and simple work. Beginning therapists can follow the same measured approach thus augmenting their background experience. This method promotes continuing education, assists experiential learning and provides variety. Using this system, it is proposed that occupational therapy services are enhanced by reducing unnecessary casework from therapists' active caseloads, allowing increased time to work on complex cases and using expertise more efficiently.
Environmental Challenges and Opportunities of Client-Centred Practice
Authors: Sumsion Thelma 
Published: April 2015

Environmental considerations are important aspects of client-centred practice. The cultural, economic, legal, physical, political and social environments must all be considered individually and as entitles that interact with each other and with the client. This article presents a brief discussion of client-centred practice, reviews the literature related to each of the six environments and discusses the impact of each environment on a client with AIDS. It is clear from the discussion of the case that all environments must be considered if the focus is to be truly client centred. There is frequently overlap between the environments and the focus shifts to meet the evolving needs of the client. The environment is not static and the skills of the therapist are required to ensure that the appropriate focus is maintained at all times.
A Comparison of the Snoezelen Environment and a Music Relaxation Group on the Mood and Behaviour of Patients with Senile Dementia
Authors: Pinkney Lesley 
Published: April 2015

Relaxation for elderly people is one of the more complicated activities to achieve with a client group who have limited cognitive abilities, particularly those with senile dementia. The deterioration in cognitive function and orientation may lead to agitation and frustration with their perceived situation. Consequently, this makes directed relaxation a difficult activity to facilitate. Following research of Snoezelen carried out at the King's Park Community Hospital, Bournemouth, the need to test the effectiveness of Snoezelen in manipulating mood had been identified. It was further identified that comparisons should be made between more conventional relaxation groups and Snoezelen. Three moderately demented female subjects were studied during a 9-week period. Observations were made on their behaviour and affect. The results indicated that the principles of Snoezelen could be used in many settings, making it a versatile medium. However, its effectiveness was dependent on the patient's cognitive skill level.
What is Evidence-Based Practice?
Authors: Taylor M Clare 
Published: April 2015

Evidence-based practice are the buzz words of current health care. This article explores what evidence-based practice actually means for occupational therapists. Evidence-based practice has two strands. The first strand involves using the best available evidence as part of the clinical decision-making process. The second strand involves drawing the evidence together in the form of systematic reviews. These reviews may then be used to help inform the development of clinical guidelines. This article outlines and discusses both strands of evidence-based practice and the relevance of each strand to practising occupational therapists. It explores how therapists can locate, evaluate and use evidence to inform their practice. The article focuses particularly on the development of critical appraisal skills. The role of systematic reviews and the relevance of clinical guidelines for occupational therapy are discussed.
Clinical Effectiveness: Systematic Reviews and Evidence-Based Practice in Occupational Therapy
Authors: Bannigan Katrina 
Published: April 2015

Evidence-based health care can be defined as an approach to health care that involves finding and using up-to-date research into the effectiveness of health care interventions to inform decision making (Entwistle et al, 1996). For many occupational therapists, the practicalities of keeping up to date with the best research evidence is difficult; however, through the National Health Service Centre for Reviews and Dissemination (NHS CRD), the NHS Research and Development (R&D) Programme is aiming to improve the availability of high quality research evidence to all health care professionals. The NHS CRD carries out and commissions systematic reviews. Systematic reviews are a means of pulling together large quantities of research information and are considered to be one of the most reliable sources of information about effectiveness (Chalmers and Altman, 1995). The NHS CRD also disseminates the findings of systematic reviews, one method of which is through the Database of Abstracts of Reviews of Effectiveness (DARE). The relevance of systematic reviews to the clinical practice of occupational therapists is explored in this paper using two examples: a poor quality and a high quality systematic review identified from the abstracting process for DARE. Both reviews are directly relevant to occupational therapy, being about sensory integration and falls in the elderly respectively. The implications of these reviews for evidence-based practice in occupational therapy are discussed.
The Reliability and Validity of the Safety Assessment of Function and the Environment for Rehabilitation (SAFER Tool)
Authors: Letts Lori , Scott Sheri , Burtney Jill , Marshall Linda , McKean Martha 
Published: April 2015

The Safety Assessment of Function and the Environment for Rehabilitation (SAFER Too)) was developed to assess people's abilities to manage functional activities safety within their homes. The results of a study to evaluate the instruments inter-rater and test-retest reliability and construct validity are reported. Reliability was evaluated using kappa for each dichotomous item. For inter-rater reliability, 59 of 66 items had acceptable reliability. For test-retest reliability, 63 of 70 items had acceptable kappa scores. For items where kappa could not be calculated because of limited variation between raters, percentage agreement was over 80%. For validity, higher SAFER Tool scores (that is, more safety problems) were hypothesised to be associated with less independence in activities of daily living (ADL) and instrumental activities of daily living (IADL) and more cognitive impairment. The correlation between SAFER Tool scores and cognitive impairment supported this hypothesis. The results of the correlations with ADL and IADL scores were less clear. This could be attributed to caregivers' assistance with activities which might have reduced risk, and generally limited variation in ADL scores. The reliability results from this study are positive. Further research to assure the SAFER Tools validity and predictive ability are needed.
Effectiveness in Wheelchair Service Provision
Authors: White Elizabeth , Lemmer Bill 
Published: April 2015

Services that provide wheelchairs to permanently disabled people have undergone fundamental changes following the recommendations of the McColl report in 1986. The devolution of centralised wheelchair services to the National Health Service (NHS) health districts in 1991 coincided with the implementation of the government's proposals for NHS reforms and community care initiatives. This paper describes a four-part research study, undertaken to identify and investigate key factors which propose effectiveness in the post-devolution wheelchair service. The sample comprised 125 wheelchair therapists as service providers and a total of 130 service users. The user sample consisted of 84 people issued with NHS manual wheelchairs, 27 indoor powered wheelchair users and 19 special seating users. An integrated methodology was employed, including questionnaires, interviews, participant observation and case studies. The research identified the development of client-centred referral and assessment procedures for wheelchairs and seating, and highlighted the need for increased therapist training. Close links between wheelchair services and local therapists were found, providing greater access to assessment for wheelchair users. An increased demand for wheelchairs outside the NHS range and a rising number of referrals for elderly people were recorded, although the management of finite resources resulted in eligibility criteria designed to control supply and provision variations between districts.