bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiskilling: A Survey of Occupational Therapy Practitioners’ Attitudes
Authors: Collins Amy Linn 
Published: October 2011

Abstract
Objective. Multiskilling has been identified as one means of reducing the cost of health care. This study examined occupational therapy practitioners’ knowledge of multiskilling, how it is affecting service delivery and quality of care, and how therapists believe the addition of skills should occur.
Method. A questionnaire was constructed for the survey and mailed to a random sample of 200 occupational therapists and occupational therapy assistants, all of whom were members of the American Occupational Therapy Association.
Results. The 117 respondents had a moderate understanding of multiskilling. They responded that multiskilling is beneficial to both the occupational therapy profession and the clients it serves, but they were also aware of its potential risks or disadvantages. According to respondents, multiskilling occurs formally through defined protocol and, more commonly, informally, driven by necessity and the desire to treat the client most effectively.
Conclusion. The results indicate a need for the occupational therapy profession to define multiskilling and cross training; develop ways of serving clients that respond to administrative needs and constraints while preserving the uniqueness of occupational therapy; and monitor treatment outcomes of all service delivery methods to provide information regarding efficiency, effectiveness, and client satisfaction.
Effects of Object Affordances on Reaching Performance in Persons With and Without Cerebrovascular Accident
Authors: Wu Ching-yi , Trombly Catherine A. , Lin Keh-chung , Tickle-Degnen Linda 
Published: October 2011

Abstract
Objective. This study investigated whether affording objects with different levels of functional support would have an impact on reaching performance in patients after cerebrovascular accident (CVA) and in adults who were neurologically intact. Reaching performance was quantitatively analyzed, using several kinematic variables.
Method. Two groups, 14 participants after CVA and 24 age-matched adults who were neurologically intact, performed a food chopping task under two conditions: enriched affordances and impoverished affordances. Enriched affordances involved reaching forward to a chopper and pushing down on the handle to chop afresh mushroom. Impoverished affordances involved reaching forward to a simulated chopper (i.e., a chopper covered with cardboard) without anything in it and then pushing the handle down. Reaching movement was measured by a three-dimensional motion analysis system.
Results. For the CVA group, the enriched condition of reaching to chop the mushroom resulted in more efficient, direct, smooth, and preplanned movement than the impoverished condition of reaching to push on the chopper handle. The neurologically intact group responded similarly except that the participants’ movement was equally smooth, as measured by movement unit, between the two testing conditions. Force generation, as characterized by peak velocity, was similar for both conditions for both groups.
Conclusion. The finding that enriched affordances had a positive effect on movement kinematics in both CVA and neurologically intact groups suggests that providing natural objects for completing a task and providing functional information on the objects may enhance the functional performance of persons who have had a CVA. These findings should be replicated and extended to confirm the validity of these effects and allow for generalization.
An Outcome in Need of Clarity: Building a Predictive Model of Subjective Quality of Life for Persons With Severe Mental Illness Living in the Community
Authors: Chan Peiying Sarah , Krupa Terry , Lawson J. Stuart , Eastabrook Shirley 
Published: October 2011

Abstract
PURPOSE. The study purpose was to construct a predictive model of subjective quality of life for persons with severe mental illness living in the community with particular attention to participation in occupations.
METHOD. Persons with severe mental illness (N = 154) rated their subjective quality of life. Several measures for each of the following categories of variables were completed: demographics, clinical, social participation, and self-measured well-being. Regression analysis was used to determine the significant predictors for each category and then to build the predictive model from these significant variables.
RESULTS. Symptom distress accounted for the most variance (33%) in subjective quality of life, followed by psychological integration (3%) and physical integration (2%).
CONCLUSIONS. The study suggests that occupational therapists should attend to subjective experience of symptoms to influence quality of life. Therapists are also in a good position to address their clients’ sense of belonging to their communities and to enable community participation.
A Comparative Analysis of Case Presentation Modalities Used in Clinical Reasoning Coursework in Occupational Therapy
Authors: Lysaght Rosemary , Bent Margaret 
Published: October 2011

Abstract
This study used mixed methods to compare four different styles of case presentation in a course designed to develop the clinical reasoning skills of master’s level occupational therapy students. Modalities used to present cases were printed text, videotape, live interview, and CD-ROM movies delivered on an Internet platform. The researchers sought to determine the relative merits and limitations of each modality from both pedagogical and practical standpoints. Results indicate that the choice of modality does not compromise the ability of students to meet learning objectives related to clinical reasoning; however, several advantages and disadvantages with respect to practical aspects of presentation and learning were identified from instructor and student perspectives. The strength of the overall instructional format, and decisions concerning the amount and type of information provided in the cases were found to be more relevant to the quality of the learning experience than the modality of presentation. Recommendations are provided for structuring clinical reasoning learning experiences that combine the best features from the case modalities examined in this study.
A Conceptual Framework To Increase Usability of Outcome Research for Evidence-Based Practice
Authors: Sudsawad Pimjai 
Published: October 2011

Abstract
Although evidence-based practice is the current practice approach recommended for use in occupational therapy, practitioners often report difficulties in using research evidence because of its content and presentation. This paper discusses a conceptual model that researchers can use to create research evidence that is easier for practitioners to understand and use. The Diffusion of Innovations Theory is used as a framework to identify desirable characteristics that may facilitate practitioners’ adoption and utilization of research evidence. The concepts of social validity, ecological validity, and clinical significance are presented and discussed as ways to create those desirable characteristics that could make research information more usable for evidence-based practice. Examples for implementation of the conceptual model are also discussed.
Reliability and Validity of the Test of Visual-Perceptual Skills (Non-Motor)–Revised for Chinese Preschoolers
Authors: Chan Phoebe L. C. , Chow Susanna M. K. 
Published: October 2011

Abstract
OBJECTIVE. The reliability and validity of the Test of Visual-Perceptual Skills (Non-Motor)–Revised (TVPS–R) were examined for its usefulness on Hong Kong Chinese preschoolers.
METHOD. Content validity was evaluated by six experts. Test–retest reliability, construct validity, and criterion validity were examined on 66 typically developing preschoolers while concurrent validity was examined on these preschoolers plus 52 preschoolers with visual-perception difficulties.
RESULTS. Test–retest reliability was high for the total score (intraclass correlation coefficient [ICC] =.88), but not for all subtests (ICC ranged .38 to .77) or for individual items (mean kappa = 0.32). The standard error of measurement (SEM; 1.53) and internal consistency (Cronbach’s alpha = .90) were satisfactory. Evidence supporting the test’s validity included a significant developmental trend (F = 4.99, p &lt; .001), a lack of gender bias (F = .04, p = .84), and positive known-group differentiation (Wilks’s lambda = 52.42, p &lt; .001). The correlation between the Motor-Free Visual-Perceptual Test–Revised composite score and the TVPS–R composite was moderate at r = .60.
CONCLUSIONS. When based on the total scores, the TVPS–R was reliable and valid. The use of subtest scores and item scores for decision making or treatment planning is not recommended.
The Effects of Peer-Play Level on Initiations and Responses of Preschool Children With Delayed Play Skills
Authors: Tanta Kari J. , Deitz Jean C. , White Owen , Billingsley Felix 
Published: October 2011

Abstract
The potential impact of peer-play opportunities on the overall development of young children has been welldocumented in the social development, occupational therapy, and special education literature. However, the effect of peer characteristics on the manifestation and facilitation of specific types of play roles and behaviors has received little attention. This topic is of key importance to occupational therapists who are striving to develop interventions that enhance the development of social participation and play in preschool children.
The purpose of this study was to examine the differences in initiation and response exhibited by preschoolaged children with social-play delays when participating in free-play dyads with peers of differing developmental levels. A single-subject alternating treatments design was replicated across five preschool-aged children with developmental play delays. Each child was paired with one peer who had lower developmental play skills and one peer who had higher developmental play skills. The arranged dyads were given the opportunity to play together in a specially designed playroom at their school. Their interactions were videotaped and later coded. All five children generally showed more initiation and response to initiation during play with higherlevel peers, although one participant showed less differentiation for initiation than the other four children. An occupational therapist working with a preschool child with play delays and wanting to facilitate the child’s initiation and response in play situations should consider pairing the child with play delays with a child who has higher play skills.
Comparison of Test of Infant Motor Performance (TIMP) Item Responses Among Children With Cerebral Palsy, Developmental Delay, and Typical Development
Authors: Barbosa Vanessa Maziero , Campbell Suzann K. , Smith Everett , Berbaum Michael 
Published: October 2011

Abstract
Impairment of children’s motor performance might limit participation in family and community life. Therefore, identification of motor impairments is important in support of early intervention to prevent limitations in children’s occupational performance. The purpose of this paper is to examine item performance on the Test of Infant Motor Performance (TIMP) in a group of infants later diagnosed as having cerebral palsy (CP), developmental delay, or typical development. Particularly, we aimed to determine if specific TIMP items have a strong relationship at particular ages with the presence of a later diagnosis of CP. Exploratory graphic representation and Rasch differential item analysis were employed to investigate each individual TIMP item’s behavior in discriminating among children with different outcomes. Items discriminating among the three outcome groups included: hand to mouth, neck control, rolling, and pull to sit items, particularly at ages term, 9 weeks, and 12–13 weeks corrected age. Children with CP presented “advanced” performance in items using extension patterns and slow development or regression in items requiring antigravity and balanced used of flexion-extension patterns of muscle activity.
The Conceptualization, Formative Evaluation, and Design of a Process for Student Professional Development
Authors: Ledet Lana , Esparza Christina Kaufman , Peloquin Suzanne M. 
Published: October 2011

Abstract
This article describes a process for student professional development and the efforts of faculty over almost 2 decades to conceptualize, formatively evaluate, and refine it. Initiated in 1987, the process underwent numerous changes to address both conceptual and pragmatic concerns derived from faculty and student ad hoc feedback. Currently in place is a process that addresses these concerns while lending itself to effective use among master’s level students. The development and iteration of the process is offered as a case for consideration by other educators engaged in similar efforts.
The Problem With Prevention: The Case of Spina Bifida
Authors: Neville-Jan Ann 
Published: October 2011

Abstract
In this paper, I present a viewpoint about prevention and spina bifida that is not usually expressed within the occupational therapy literature. Using an autoethnographic account, I convey my experiences as a person with impairments from spina bifida in order to problematize current preventive efforts undertaken to eradicate this birth defect. This self-reflexive account connects my personal experiences to historical and medical views about spina bifida. The messages inherent in preventive efforts are discussed from a disability rights perspective. Occupational therapists are challenged to examine their attitudes toward disability, act as advocates in their practice, and, in a more informed manner, support or contest policy initiatives.
Therapists I Have Known and (Mostly) Loved
Authors: Paikoff Holzmueller Roberta L. 
Published: October 2011

Abstract
This manuscript embeds the author’s firsthand experiences with pediatric occupational therapy with her expertise as a developmental psychologist interested in families and their collaborations with service professionals. The author’s own experiences are used to illustrate points made in literature regarding parent–professional collaborations, as well as points made in interviews of other parents of young children with special needs. It is hoped that the article can serve as a “starting off” point for discussions and partnership building between pediatric occupational therapists and the children and families they serve.
Outcomes Associated With a Summer Handwriting Course for Elementary Students
Authors: Marr Deborah , Dimeo Sandra B. 
Published: October 2011

Abstract
OBJECTIVE. The purpose of this study was to examine the benefits of a summer handwriting instruction course offered to community elementary-age students.
METHODS. Twenty-six students participated in the study and attended instruction for 1 hour per day for 2 weeks. Pre- and posttesting with the Evaluation Tool of Children’s Handwriting (ETCH) were conducted. Parents were also asked to rate their child’s handwriting at pretest, posttest, and 3 months posttest.
RESULTS. Participants made significant improvement in two subtests of the ETCH and in parent ratings between pretest and posttest. Parent ratings remained significantly improved 3 months posttesting. Additional results suggest that children who received special education during the previous school year improved their handwriting scores on the ETCH to a greater degree than those who did not receive special education.
CONCLUSION. A new service delivery model for handwriting instruction has the potential to benefit students. Occupational therapists should consider offering handwriting training to students in the summer especially if deterioration of performance is anticipated.
Managing Usual and Unexpected Pain With Physical Disability: A Qualitative Analysis
Authors: Dudgeon Brian J. , Tyler Erica J. , Rhodes Lorna A. , Jensen Mark P. 
Published: October 2011

Abstract
OBJECTIVE. With physical disabilities, persons often experience secondary pain that adds to restrictions in activity and participation. We investigated pain-management strategies used by those with physical disabilities.
METHOD. Qualitative phenomenological inquiry was used in multiple interviews with (N = 28) adults with physical disabilities (9 with amputation, 7 with cerebral palsy, and 12 with spinal cord injury) and subsequent thematic analysis.
RESULTS. Among those with physical disabilities, a distinction is made between usual and unexpected pains. Usual pain is experienced consistently or as a consequence of not getting adequate rest, exercise, or stress-free time. Managing usual pain involves uses of prevention (e.g., exercise/fitness) and/or pragmatic actions through scheduling and pacing daily activities and taking interim retreats. Unexpected pain is experienced periodically and requires an immediate response and change of activity. To manage, persons describe making efforts to create a mind and body disassociation, activating safety nets to support function and alleviate pain, and making decisions to persevere with activity and participation.
CONCLUSION. Advising those with physical disabilities to do proactive planning for both usual and unexpected pain may help them to use varied pain-management strategies to enhance function and minimize negative impacts on participation.
Level I Fieldwork Today: A Study of Contexts and Perceptions
Authors: Johnson Caryn R. , Koenig Kristie P. , Piersol Catherine Verrier , Santalucia Susan E. , Wachter-Schutz Wendy 
Published: October 2011

Abstract
The last comprehensive examination of the Level I fieldwork experience was performed 15 years ago (Shalik, 1990) and addressed the different types of settings in which fieldwork occurred; amounts and types of supervision; structure and scheduling of the Level I experiences; and the effects of supervising Level I students on productivity. Although every occupational therapy and occupational therapy assistant student encounters a number of Level I fieldwork opportunities, little is available describing the process and contexts of the Level I fieldwork experience today. This study, which examines 1,002 student reports on Level I fieldwork experiences, finds that Level I fieldwork today occurs in a wide variety of physical disability, pediatric, mental health, and emerging practice settings. Findings also indicate that, whereas most fieldwork educators are occupational therapy practitioners, more fieldwork educators are non–occupational therapists than in the past. Furthermore, although students reported opportunities to practice observation and communication across all settings, practice of other clinical skills was specific to type of settings, and opportunities to practice were limited. Student perceptions about opportunities for experiencing occupation-based practice, observation of theory in practice, and how students value different types of fieldwork experiences are addressed. In addition, this study explores the expansion of Level I fieldwork into emerging practice arenas and how students perceive those experiences.
Perception of Client-Centered Practice in Occupational Therapists and Their Clients
Authors: Maitra Kinsuk K. , Erway Frances 
Published: October 2011

Abstract
OBJECTIVE. The purpose of this study was to comparatively analyze the perceptions of clients and occupational therapists regarding their involvement in the process of client-centered practice.
METHOD. Participants (11 occupational therapists, 30 clients) in adult/geriatric health care facilities were each engaged in a semistructured interview to determine their perceptions of client-centered practice, specifically in the goal-setting process. Descriptive statistics were used to analyze the item data. In addition, one-way analysis of variance was computed to identify the differences of opinions in clients and occupational therapists on the process of client-centered practice in four facilities: long-term-care or rehabilitation, hospital outpatient, hospital inpatient, and nursing homes.
RESULTS. The occupational therapists in this study indicated use of the principles of client-centered practice in their delivery of occupational therapy services. Their clients, however, displayed mixed perceptions about their role as active participants in client-centered practice and all responded in the negative when asked if they were aware of the approach. Perceptual differences existed between the occupational therapists and their clients in relation to the use of client-centered practice, because their responses to similar questions varied. Last, type of facility significantly influenced clients’ knowledge of certain aspects of their treatment processes in the following four areas: (a) treatment goal selection, (b) encouragement provided in setting clients’ goals, (c) clients’ perception of the importance in the goal-setting process, and (d) education of clients about their participatory role in the goal-setting process.
CONCLUSION. Results suggest that a perceptual gap exists between occupational therapists and their clients in relation to their stated use of and participation in client-centered practice. In light of the results, development of a systematic strategy by occupational therapists to elicit the roles that their clients desire to play in the therapeutic process may be an effective intervention to ensure that occupational therapists and their clients are able to fulfill their roles in client-centered practice.
Perceived Risk: Effects on Reaching and Placing Performance in Persons With Cerebrovascular Accident
Authors: Fuller Holly M. , Thomas Julie Jepsen , Rice Martin S. 
Published: October 2011

Abstract
OBJECTIVE. Developing useful movement with the affected extremity in persons with cerebrovascular accidents (CVAs) is a common occupational therapy goal. The purpose of this study was to examine the effects of perceived risk in an occupational form on upper-extremity movement dynamics in persons who have had CVAs.
METHOD. Twenty-eight persons (M = 69.6 years, SD = 15.6 years) with post-CVA participated in the randomly assigned, repeated measures counterbalanced study. In the higher risk condition, participants reached for and grasped a raw egg in an egg carton, transported it, and placed it in a bowl with other raw eggs. The same procedure was completed in the lower risk condition with weight-matched plastic eggs. Participants completed both conditions with their affected and unaffected upper extremities. Dependent variables included total movement time and movement units.
RESULTS. The higher risk condition produced statistically significantly longer movement times (p ≤ .001), but no difference in movement units (p &gt; .05) compared to the lower risk condition. The affected extremity had significantly longer overall movement times (p ≤ .001), but no difference in movement units (p &gt; .05) compared to the unaffected extremity.
CONCLUSION. When higher levels of perceived risk are present in an occupational form, slower movements are elicited among persons who have had a CVA. The occupational therapist can grade tasks from relatively lower risk to tasks with relatively higher risk to help patients achieve desired variability in their movement patterns. By doing this, the patient will be better prepared for everyday situations that vary widely in degree of risk.