bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Patient–Therapist Relationship: Beliefs That Shape Care
Authors: Peloquin Suzanne M. 
Published: April 2012

Abstract
The results of a previous inquiry suggest that three images of occupational therapists dominate patients’ stories about them: the images of technician, parent, and collaborator or friend. These ways of being in practice can be said to reflect the various understandings that therapists have about how to enact the profession’s commitment to both competence and caring. When therapists act as technicians or authoritarian parents, patients register their disappointment over a valuation of competence that excludes caring actions.
In a more current inquiry into the climate of caring, patients and caregivers reflect about the current health care system and identify three societal constructs that shape a preference for competence over caring: (a) emphasis on the rational fixing of the health care problem, (b) overreliance on methods and protocols, and (c) a health care system driven by business, efficiency, and profit. Occupational therapists who are concerned about complaints that the health care system is increasingly uncaring might benefit from a consideration of the extent to which societal beliefs shape the manner in which they care.
Contingent Interaction During Work and Play Tasks for Mothers With Multiple Sclerosis and Their Daughters
Authors: Crist Patricia 
Published: April 2012

Abstract
Occupational therapy has focused on activity as a catalyst for understanding human roles and interactions, regardless of whether disability or chronic illness is present. Parenting is an important interactional activity accompanied by specific role expectations. This investigation examined the interaction patterns of mothers with multiple sclerosis and their daughters. Thirty-one mothers with multiple sclerosis and their daughters aged 8 to 12 years were compared with 34 mothers without disabilities and their daughters aged 8 to 12 years. Videotaped mother–daughter interactions during a work task and a play task were scored by two raters for 11 different behaviors. These behaviors were collapsed into three behavioral composites–receptiveness, directiveness, and dissuasiveness–for statistical analysis. Statistical analysis revealed no significant differences between the two groups on the behavioral composites for either mothers or their daughters. The two tasks stimulated a different pattern of mother–daughter interactions. For both members of the dyad, interactions during the work task were more directive and less dissuasive than those in the play task. The clinical implication of this finding indicates the importance of understanding the influence of the task selected when observing interaction. Because of recent social and legal changes, understanding parenting and chronic illness is critical.
An Analysis of a Board Game as a Treatment Activity
Authors: Neistadt Maureen E. , McAuley Debra , Zecha Donna , Shannon Robyn 
Published: April 2012

Abstract
Occupational therapists often use tabletop board games in treatment to help adult clients with physical disabilities improve the perceptual, cognitive, sensory, and fine motor skill components of occupational behavior. Detailed activity analyses of these types of activities, including performance norms, are not available in the occupational therapy literature. Such analyses would help therapists consider the multiple skill demands of tabletop games and allow more systematic grading of these treatment activities. This paper presents a model for analyzing therapeutic activities in relation to relevant motor learning and cognitive–perceptual literature. Included in this analysis are a description of the activity, examination of its component skills and of the qualitative features of activity performance, suggestions for grading and for treatment goals, and some preliminary performance standards derived from a pilot study of 18 adults without physical disabilities. The issue of transfer of skills between games and functional activities is also discussed.
Incorporation of Ethnographic Methods in Occupational Therapy Assessment
Authors: Spencer Jean , Krefting Laura , Mattingly Cheryl 
Published: April 2012

Abstract
Many constructs of interest to occupational therapists can only be studied through qualitative methods. Such constructs include meaning of activity or the illness experience and the context in which these occur. The purpose of this paper is to describe how ethnographic methods used in research can be generalized and applied to clinical practice. Ethnography is compared with other qualitative research approaches and a model clinical ethnographic assessment process is described.
The Assessment of IADL Motor Skills: An Application of Many-Faceted Rasch Analysis
Authors: Fisher Anne G. 
Published: April 2012

Abstract
Traditional methods of developing tests have been driven by item content specification and have relied on the use of summed ordinal scores in an attempt to create a quantitative index of ability. There are fundamental problems with this approach to test development. The first problem is that the summing of qualitative ordinal counts to create a total score does not result in a number that is a valid means of making quantitative comparisons of performances. The second problem is that reliance on content experts does not ensure that the test items indeed test the construct in question. As a result, the development of functional assessments based on Rasch measurement models is becoming a preferred method among rehabilitation professionals for constructing tests. Rasch measurement models offer an alternative approach to instrument development that results in unidimensional linear measures based on additive numbers. Rasch analyses also generate goodness-of-fit statistics that can be used to perform confirmatory construct validity analyses of the constructed scales based on (a) formulating expectations about what should happen when a group of persons take a test, and then (b) confirming that the test items fit that model.
This paper describes how the many-faceted Rasch model was used to develop the motor scale of the Assessment of Motor and Process Skills (AMPS) (Fisher, 1992). The process of beginning test development with a theory of expectations related to a constructed scale and then confirming that the scale conforms to these expectations also is demonstrated.
Prediction of Behind-the-Wheel Driving Performance in Patients With Cerebral Brain Damage: A Discriminant Function Analysis
Authors: Galski Thomas , Bruno Richard L. , Ehle Holly T. 
Published: April 2012

Abstract
Rehabilitation specialists, particularly occupational therapists, are often involved in evaluating clients’ fitness to resume driving after cerebral damage due to head injury or stroke. Their available methods include separate or combined administration of predriver, simulator, and behind-the-wheel evaluations. However, use of these methods without a theoretical model on which to base test selection has yielded some criticism and little research about the effectiveness of these methods in predicting driving performance.
Using the authors’ Cybernetic Model of Driving as the basis for assessing abilities and behaviors relevant to driving outcome, this study sought to determine the effectiveness of the evaluation methods by discriminant analysis and measurements of sensitivity in predicting behind-the-wheel failures. Comprehensive evaluations of 106 patients revealed that residual deficits in cognition per se did not render a person unfit to drive and underscored the importance of considering behaviors in determining fitness. The methods of evaluation were shown to be relatively sensitive in predicting outcome; off-road and on-road evaluation reached sensitivities of 90% and 92% with the inclusion of behavioral measures. Formulae for predicting outcome based on methods of evaluation are provided and reasons for failures in behind-the-wheel evaluations are discussed.
The Effects of Options on Performance of an Art Project in Adults With Mental Disabilities
Authors: LaMore Kathy L. , Nelson David L. 
Published: April 2012

Abstract
The relationships among the presence of options, interest, preference, choice, meaning, purpose, and performance in occupation are central to occupational therapy knowledge. This Study examined whether giving adults with mental disabilities options at the beginning of an art occupation would motivate them to paint more than when not given options. The Sample consisted of 13 men and 9 women; ages ranged from 24 to 76. The subjects were yoked in pairs. One subject from each pair was given a choice of which of five ceramic objects to paint. The second subject was instructed to paint the same type of object that the first subject had chosen. Three days to 1 week later, roles were reversed. The number of times the subject applied the paint to the object after dipping the brush into paint was recorded by the researcher. Each subject was also timed with a stopwatch from the first time paint was applied to the time the subject indicated completion of the activity. The Wilcoxon matched-pairs signed-ranks test revealed that subjects painted significantly more (Z = 2.9, p &lt; .01) when they had a choice than when they did not have a choice.
Perceiving Patients and Their Nonverbal Reactions
Authors: Svidén Gunilla , Säljö Roger 
Published: April 2012

Abstract
The topic of interest underlying the present study concerns cognitive and conceptual development in adulthood. Specifically, we examined the ways in which professional education affects occupational therapy students’ perceptions and descriptions of patients’ nonverbal behavior. Thirteen subjects viewed 3 videotapes of patients in treatment and then described the patients’ responses. They viewed the videotapes twice. at the beginning of student training and one and a half years later. Results indicated that at the second viewing, the subjects’ accounts became more differentiated, more complex, and less conclusive. Also on the second viewing, subjects were more likely to corroborate their inferences concerning patients’ emotional reactions with concrete observations, but did not describe patients in common theoretical categories. This result indicates that subjects find it difficult to discuss individual cases in relation to newly acquired theoretical knowledge. We conclude that, rather than increased instruction in theory, students need increased opportunity to analyze individual cases by means of theoretical knowledge.
Handwashing Practices Among Occupational Therapy Personnel
Authors: Marcil William M. 
Published: April 2012

Abstract
Handwashing is the most effective method of preventing the spread of nosocomial infection. Despite its simplicity, handwashing is frequently omitted by health care personnel. To date there have been no studies of the handwashing practices of occupational therapists. A telephone survey of 50 occupational therapy personnel indicated that the majority (60%) washed their hands with a liquid, antimicrobial soap 9 or more times during the work day with a wash duration of 10 seconds or less. Analyses revealed no statistically significant differences between handwashing frequency and duration and age, years in practice, position, academic degree, or work setting. Overall, handwashing technique was found to be lacking.
All respondents stated that handwashing was important to occupational therapy practice and most agreed that it was just as important for therapists as it was for physicians and nurses. Most agreed that hands should be washed both before and after each patient contact. However, few respondents actually did so regularly. Most respondents indicated that they received their knowledge of handwashing from inservice training at their place of employment. Their occupational therapy educational programs did not provide basic information on handwashing techniques.
Outcome Analysis of Work-Hardening Programs
Authors: King Phyllis M. 
Published: April 2012

Abstract
The competitive marketplace and the demand for accountability by health care payers are strongly influencing the need for work hardening programs to participate in program evaluation and produce outcome data. This study compiled program performance data on 22 work programs in Wisconsin over an 11-month period. Client data related to demographics of gender, age, occupation, insurance coverage, diagnosis, services clients received, patterns of attendance, and outcomes upon discharge were collected. Results described the majority of the clients treated in the work hardening programs to be men, aged 26 to 46 years, with occupations classified in the miscellaneous category according to the Dictionary of Occupational Titles. The reimbursement source for the majority of work program clients was worker’ s compensation. The most frequent condition treated was injury to the lumbar spine. Most clients were treated and discharged within a 3-week period. More than half of the clients served returned to their usual and customary jobs.
Clinical Reasoning in Occupational Therapy: An Integrative Review
Authors: Schell Barbara A. , Cervero Ronald M. 
Published: April 2012

Abstract
The occupational therapy literature has been comprehensive reviewed to identify various theoretical answers to the question of what is clinical reasoning. Authors to date have two primary answers to this question, which we labeled scientific reasoning and narrative reasoning. Additional literature addresses the influence of personal and practice Contexts on clinical practice. These are labeled pragmatic reasoning and are proposed to be an integral part of clinical reasoning. Pragmatic reasoning considers issues such as reimbursement, therapists’ skills, and equipment availability. To be comprehensive, further study of clinical reasoning should include these contextual issues as an inherent part of the clinical reasoning process.
Use of Uniform Terminology by Occupational Therapists
Authors: Borst Michael J. , Nelson David L. 
Published: April 2012

Abstract
Uniform Terminology for Occupational Therapy – Second Edition (American Occupational Therapy Association, 1989b) was published to foster consistency in terminology among occupational therapists. In this study, agreement between occupational therapists and Uniform Terminology about the definition and categorization of 15 terms was examined. Agreement was measured on 113 responses from a randomly selected sample of 180 occupational therapists. Low levels of agreement were found on both definition of terms (71.9 mean percentage of agreement, SD = 12.4) and categorization of terms into larger conceptual categories (34.9 mean percentage of agreement, SD = 11.7). Therapists selected an alternative definition more often than the one given by Uniform Terminology on 2 of 15 terms and selected an alternative categorization more often than the one given in Uniform Terminology on 8 of 15 terms. These results indicate that therapists do not agree with many Uniform Terminology definitions and categorizations.
Age Differences in Functional Performance
Authors: Dickerson Anne E. , Fisher Anne G. 
Published: April 2012

Abstract
We compared the functional performance of 20 young adult women and 20 older adult women on two types of tasks. One type of task was normal instrumental activities of daily living (e.g., meal preparation, home maintenance) that were meaningful, familiar, and well practiced. The other type was a contrived, relatively unfamiliar task of wrapping a package. Although young and old women did not differ significantly in their familiarity with the two tasks, results from two repeated measures MANOVAs revealed a significant age difference in both activities. This finding suggests that older adults show age-related decline with tasks even when those tasks are familiar, practiced, and ecologically valid.
Combining Practice and Research
Authors: Colborn Anne Pas 
Published: April 2012

Abstract
Although many authors advocate research involvement for occupational therapists involved in clinical practice, no formal studies existed of the personal, educational, and workplace environmental factors thought to affect therapists’ ability to integrate clinical research with practice. This exploratory, descriptive study surveyed 103 occupational therapists reporting work functions of both direct patient care and research. Major findings included: (a) workplace learning circumstances focusing on performance and application of clinical research were important for adopting a dual practice–research role, (b) research activities reflected the evolving character of the role, (c) administrative support and a personal commitment to research were critical for success, and (d) formal research courses were important, but so were informal discussions regarding application and problem solving. The findings have implications for university curricula, continuing education, and clinical environments.
Improvement in Upper Extremity Function and Trunk Control After Selective Posterior Rhizotomy
Authors: Beck Alison J. , Gaskill Sarah J. , Marlin Arthur E. 
Published: April 2012

Abstract
Selective posterior rhizotomy is being increasingly used in the treatment of spasticity associated with cerebral palsy. Anecdotal reports in the literature note that this procedure results in improved upper extremity function and trunk control. We present a systematic analysis of the results of selective posterior rhizotomy performed on patients with cerebral palsy at Santa Rosa Children’s Hospital. Patients were videotaped before surgery and one year postoperatively. These videos were reviewed blind by an occupational therapist who graded patients’ performance on three tasks: assumption of side sitting, maintenance of side sitting, and block building. Statistically significant improvements were noted in all three categories with p values of .0003, .0001, and .0044 respectively. These results support the anecdotal reports of improvement in upper extremity function and trunk control with selective posterior rhizotomy.
The Effect of Upper Extremity Trauma on Handedness
Authors: Walsh William W. , Belding Nancy N. , Taylor Eve , Nunley James A. 
Published: April 2012

Abstract
The effect of severe trauma on handedness was studied through patient responses from 146 questionnaires that were correlated with individual chart review. Subjects were asked to designate their hand use preference, before and after injury, when performing 16 activities. The incidence of change in hand use was determined within four diagnostic types and five designated anatomical levels of injury. Results indicated a significant difference in the way subjects in different diagnostic types and anatomical levels of injury performed. Simple, short activities that did not require sustained fine motor coordination were reported as being performed more easily with a different hand after injury than complex, continuous activities that required sustained fine motor coordination. Significant differences in job duties and place of employment were found for the anatomical level of an injury but not for diagnostic type. Findings suggest that the diagnostic type, the anatomical level of an injury, and the complexity of a task should be considered before changes in hand use are recommended.
The Effect of Occupational Therapy Intervention on Mothers of Children With Cerebral Palsy
Authors: Case-Smith Jane , Nastro Mary Ann 
Published: April 2012

Abstract
Using the interviewing techniques and ethnographic methodology reported by Hinojosa, we explored the relationships between mothers of preschool children with cerebral palsy and their children’s occupational therapists. Data from two interviews with five mothers were transcribed, organized into topics, and, through constant comparative analysis, formulated into themes. One theme, “Is anybody listening?” suggested that professionals often disregard information provided by the mothers; a second theme, “Not another one,” revealed the importance of continuity of care and the patient hardship of frequently changing therapists. Consistent with Hinojosa’s study, all of the mothers sought duplicative therapy. All of the mothers had established positive relationships with their occupational therapists and described them as skilled agents of change who were effective in helping their children and who were valuable sources of information and support.
Successful Voluntary Grasp and Release Using the Cookie Crusher Myoelectric Hand in 2-Year-Olds
Authors: Meredith Judy M. , Uellendahl Jack E. , Keagy Robert D. 
Published: April 2012

Abstract
We examined the ability of two 2-year-old children with limb deficiency to demonstrate grasp and release while using the cable-operated voluntary opening hook-hand and the externally powered single-site myoelectric Cookie Crusher system. The Cookie Crusher circuit is an electronic package that causes the prosthetic hand to open in response to muscle contraction and closes (as if crushing a cookie) when the muscle is relaxed. Both children were consistently good prosthetic wearers, beginning with their initial passive devices and progressing through their cable-operated hooks and hands. However, before they began to use the Cookie Crusher (Subject 1 at 25 months, Subject 2 at 30 months), neither had developed voluntary grasp or release in spite of 3 to 12 months’ use of cable-operated voluntary opening prehensors. Both children developed a voluntary grasp and release for the first time within minutes of starting to use the Cookie Crusher. The more adept of the two children, a girl with a traumatic above-elbow amputation, showed prehensile function with the Cookie Crusher during play. The spontaneous use of the Cookie Crusher may be related to the predominance of associated reactions in young children. As children play bimanually, associated movements of the nondominant extremity often occur and, in the case of children with limb deficiencies fitted with Cookie Crusher prehensors, these associated reactions result in successful grasp and release. We will continue to follow the choice of effective control schemes in these children as they mature.
The Depersonalization of Patients: A Profile Gleaned from Narratives
Authors: Peloquin Suzanne M. 
Published: April 2012

Abstract
Occupational therapists who would better understand and advocate against depersonalization in health care can find specific references in narratives to the attitudes and behaviors that seem problematic. Patients argue that helpers fail to recognize that illness and disability are events charged with personal meaning. Instead of communicating with patients, helpers establish a distance that diminishes them. They withhold information in a manner that precludes hope, they use brusque manners, and they misuse their powers. Each of these behaviors seems unreasonable and impersonal, and each discourages patients. Together these narratives might inspire therapists to value interactive reasoning as central to practice, to recommit to their consideration of persons, and to enact a climate of caring.
Exploring Multicultural Competencies of Occupational Therapists: Implications for Education and Training
Authors: Pope-Davis Donald B. , Prieto Loreto R. , Whitaker Christina M. , Pope-Davis Sara A. 
Published: April 2012

Abstract
The purpose of this investigation was to explore the influence of demographic and educational variables on self-reported multicultural competencies of occupational therapists. A sample of 94 occupational therapists currently working in the field participated in this investigation. Multicultural course work, seminars and workshops, percentage of minority patients worked with, and highest degree held were found to correlate significantly with self-reported multicultural competencies. Regression analyses found that highest degree held, percentage of minority patients worked with, multicultural course work, and participation in multicultural seminars and workshops accounted for about half of the variance in multicultural awareness. These findings are discussed in terms of academic courses and continued professional training and education for occupational therapists.