bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes Research: The History, Debate, and Implications for the Field of Occupational Therapy
Authors: Ellenberg Dale B. 
Published: April 2012

Abstract
The field of occupational therapy, as with all facets of health care, has been profoundly affected by the changing climate of health care delivery. The combination of cost-effectiveness and quality of care has become the benchmark for and consequent drive behind the rise of managed health care delivery systems. The spawning of outcomes research is in direct response to the need for comparative databases to provide results of effectiveness in health care treatment protocols, evaluations of health-related quality of life, and cost containment measures. Outcomes management is the application of outcomes research data by all levels of health care providers. The challenges facing occupational therapists include proving our value in an economic trend of downsizing, competing within the medical profession, developing and affiliating with new payer sources, and reengineering our careers to meet the needs of the new, nontraditional health care marketplace.
Managing the Occupational Environment of Managed Care
Authors: Brayman Sara J. 
Published: April 2012

Abstract
The emergence of managed care has resulted in a practice environment buffeted by rapid and sweeping changes. Shifts in philosophy and approach to payment for health care affect the nature of the service and the method of its delivery. The occupational adaptation frame of reference is used to illustrate the challenges imposed by the physical, social, and cultural components of the changing occupational environment. Perceptions, observations, and concerns of middle level occupational therapy, physical therapy, social work, and nursing managers illustrate the impact of this new environment. Therapists are challenged to understand their own changing work setting and to apply the same effort to mastering its challenges as they would to examining the context of their patient’s occupational performance and to designing and implementing an appropriate clinical intervention.
Education and Training of Occupational Therapists for Neonatal Intensive Care Units
Authors: Dewire Andrea , White David , Kanny Elizabeth , Glass Robin 
Published: April 2012

Abstract
Objective. The neonatal intensive care unit (NICU) is an area in which occupational therapists require specialized advanced training and skills. The purpose of this study was to evaluate the nature of current practice among occupational therapists in NICU settings, their training, and their opinions regarding educational experiences necessary for NICU work.
Method. One hundred seventy-four NICU occupational therapists completed a survey questionnaire designed to elicit information about these issues.
Results. The majority of respondents were engaged in similar practice duties in NICUs, most of which had been using therapy services for less than 10 years. Most of the respondents (83%) reported that their primary source of training was on the job rather than through formal course work or training programs. Many of the respondents (40%) lacked training in the use of any infant assessments, and 50% had 2 years or less of pediatric work experience before entering practice in the NICU. The respondents indicated that mentored experience, on-the-job training, pediatric work experience, extended continuing education courses, and formal internships could prove helpful to future occupational therapists who wish to acquire the knowledge and skills to become competent in the NICU.
Conclusion. Results of the survey indicate that current training and education to work in an NICU is inadequate and needs to be addressed. Occupational therapists working in NICUs desire and express the need for specialized training to work in this practice area. A more aggressive effort toward standard NICU education and training is necessary to ensure that occupational therapists are competent members of the NICU team.
The Effects of an Occupationally Embedded Exercise on Bilaterally Assisted Supination in Persons with Hemiplegia
Authors: Nelson David L. , Konosky Kathy , Fleharty Kathleen , Webb Ruth , Newer Kristin , Hazboun Virginia P. , Fontane Cheryl , Licht Brian C. 
Published: April 2012

Abstract
Objectives. Occupationally embedded exercise is a central idea in the profession of occupational therapy. This experiment compared the effect of an occupationally embedded exercise involving a simple dice game with a rote exercise in persons with stroke with pronator spasticity. Both exercise conditions involved bilaterally assisted supination, consistent with the neurodevelopmental model of practice.
Methods. The sample consisted of 14 men and 12 women post-cerebrovascular accident with a mean age of 68.4 years (SD = 11.2) at six clinical sites in California, Texas, and Michigan. Subjects had pronator spasticity, full passive range for supination after a brief warm-up, and no functional supination. After random assignment for experimental condition, the subjects engaged in two sets of 10 repetitions of bilaterally assisted supination in either the occupationally embedded condition (dice game) or the rote condition (no game). A pen recorder electronically documented degrees of rotation of the handle that was grasped during the exercise.
Results. The occupationally embedded exercise resulted in significantly more handle rotation (requiring more supination) than the rote exercise, t (24) = 2.28, P (one tailed) &lt; .05. The effect size was large.
Conclusion. This study advances the experimental analysis of therapeutic occupation in the area of occupationally embedded exercise. Clinicians are urged to consider the multidimensional nature of occupationally embedded exercise.
Art: An Occupation With Promise for Developing Empathy
Authors: Peloquin Suzanne M. 
Published: April 2012

Abstract
Empathy is central to the interactions of occupational therapists who value personal dignity. Persons from various sectors of the behavioral sciences and the medical humanities have proposed that engagement with the arts can develop empathy, an assumption that prompted this inquiry. The observations of artists and art philosophers suggest that the assumption that art may develop empathy is grounded in the kindred natures of the two practices and in the actions that occur when a person engages with a work of art. The assumption that art may develop empathy is grounded in the kinship of the actions common to both practices: response, emotion, and connection. Artists and art philosophers’ observations of human practices have uncovered three rules of art that may dispose one toward empathy: reliance on bodily senses, use of metaphor, and occupation by virtual worlds. Analysis of art’s potential suggests that a person who would derive empathy from art must (a) use the senses to grasp feeling, (b) stretch the imagination to see a new perspective, and (c) invite an occupation that enhances understanding. Persons who hope to develop empathy must pursue an experience that evokes the fellow feeling that inspires it. Art can offer this experience.
Analysis of the Orthopedic Content in an Occupational Therapy Curriculum From a Clinical Reasoning Perspective
Authors: Neistadt Maureen E. , Atkins Allison 
Published: April 2012

Abstract
Objectives. Recent studies have suggested that occupational therapists working with adults with physical disabilities do not use narrative reasoning in practice as much as they use procedural reasoning. This focus on procedural reasoning may be partially shaped by the occupational therapy educational process. The purpose of this analysis was to see whether one accredited occupational therapy curriculum was promoting narrative reasoning relative to its information on adult orthopedics.
Method. An accredited occupational therapy undergraduate and certificate curriculum was analyzed from both student and faculty perspectives to see what types of clinical reasoning were most emphasized relative to treatment of adults with orthopedic injuries. The student analysis, done by a senior as part of an independent study, looked at the clinical reasoning content of journal articles, an occupational therapy textbook, and occupational therapy lectures relative to adult orthopedic injuries. The faculty analysis, part of a curriculum revision process and independent of the student analysis, looked at the clinical reasoning content of all courses in the curriculum.
Results. The student and faculty analyses concurred that although narrative reasoning is taught in this curriculum, narrative reasoning concepts are not well integrated into the adult physical dysfunction course that deals with adult orthopedic injuries.
Conclusion. Occupational therapy educators may not be integrating narrative reasoning into more procedurally oriented physical dysfunction courses as fully as possible and may, therefore, be fostering procedurally oriented practice in physical dysfunction settings. Curricula evaluations, like the one described in this article, can be a mechanism for examining the types of clinical reasoning emphasized in a given curriculum for a given diagnostic group.
What Do We Need To Know To Practice Occupational Therapy in the Community?
Authors: McColl Mary Ann 
Published: April 2012

Abstract
One of the main challenges to occupational therapists in community practice is applying our existing knowledge base to support a different kind of practice in the community. This article explores the theory base in occupational therapy that informs three models of community practice: client centered, community-based rehabilitation, and independent living. It defines these three preferred models of service delivery for community practice and looks at the knowledge requirements for each. Using a taxonomy developed to classify occupational therapy theory, the article examines existing theory and gaps in the theory base for occupational therapy in community practice. Finally, the article challenges practicing therapists, educators, and researchers to examine their use of theory and their underlying assumptions for meeting the challenge of community practice.
The Community Adaptive Planning Assessment: A Clinical Tool for Documenting Future Planning With Clients
Authors: Spencer Jean Cole , Davidson Harriett A. 
Published: April 2012

Abstract
Objectives. The objectives of this article are to (a) identify features needed in a clinical tool in order to organize collaborative planning for the future between therapist and client; (b) describe the structure and procedures for use of the Community Adaptive Planning Assessment (CAPA), which was developed to meet these needs; (c) summarize research on the usability, trustworthiness, and clinical effectiveness of the CAPA; and (d) consider future work to further evaluate qualitative tools like the CAPA for clinical and research purposes.
Method. Initial and revised versions of the CAPA were evaluated through several studies. Usability was examined through questionnaires completed by therapists who used the CAPA in acute care, rehabilitation, home health, and community programs with a total of 105 clients who had a variety of acute and chronic disabilities. Trustworthiness was evaluated through comparison of information gathered from 21 clients with that from their family members. Clinical effectiveness was evaluated for discharge planning through content analysis of community outcomes of goals and plans established before discharge.
Results. Initial studies indicate that the CAPA has sound usability, trustworthiness, and clinical effectiveness for a variety of service delivery systems and with a variety of clients when used by experienced therapists. Findings support use of these three criteria for evaluation of tools designed to document qualitative consultation-based practice.
Conclusions. Results are related to broader issues in the profession, including a need for further study of collaborative planning for the future between clients and therapists, ways in which qualitative aspects of practice can be documented efficiently, ways in which outcomes of consultation-based practice can be evaluated, and establishment of criteria for evaluation of emerging qualitative assessments and intervention tools.
Independent Living Skills and Posttraumatic Stress Disorder in Women Who Are Homeless: Implications for Future Practice
Authors: Davis Janis , Kutter Catherine J. 
Published: April 2012

Abstract
Objective. Service delivery through community-based programs is the future of occupational therapy. This study examined independent living skills, traumatic experiences, and symptoms of Posttraumatic Stress Disorder (PTSD) in a sample of women residing in a supportive housing program for women and families who are homeless in order to determine the needs of this population and the possible role of occupational therapy in such a community-based program.
Method. Twenty-four women residing in a supportive housing shelter in Kansas City, Missouri, volunteered to participate in this study. The participants were evaluated for independent living skills with the Kohlman Evaluation of Living Skills. A structured interview format was used to determine whether participants experienced a trauma and whether they met diagnostic criteria for PTSD.
Results. Results indicated that women who are homeless have deficits in independent living skills, especially in the area of money management. Results also indicated that traumatic experiences and PTSD are more prevalent among women who are homeless than among women in the general population. The relationship between independent living skills and PTSD among women who are homeless was not made clear by this study.
Conclusion. The information gathered in this study underscores the importance of identifying and addressing occupational and mental health issues of women who are homeless. Results suggest that occupational therapists have a major role to play, evaluating and facilitating independent living skills, as members of multidisciplinary treatment teams in supportive housing programs for persons who are homeless.
Patterns of Sensory Integration Dysfunction: A Confirmatory Factor Analysis
Authors: Mulligan Shelley 
Published: April 2012

Abstract
Objective. This study evaluated a five factor model of sensory integration dysfunction on the basis of scores of children on the Sensory Integration and Praxis Tests (SIPT).The purpose of the study was to determine a plausible model for understanding sensory integration dysfunction.
Method. The hypothesized model of sensory integration dysfunction tested was derived from previous multivariate analyses and consisted of five patterns of dysfunction, including: bilateral integration and sequencing, somatosensory, somatopraxis, visuopraxis, and postural ocular motor. Confirmatory factor analysis (CFA) of the SIPT scores of 10,475 children and the scores of a subgroup of 995 children with learning disabilities were used to evaluate the model.
Results. The CFA of the hypothesized model indicated numerous weaknesses with it and, therefore, was rejected. Exploratory factor analysis (EFA) was then performed with the same data set to identify a better-fitting, more parsimonious model o/sensory integration dysfunction. A second-order, four-factor model using generalized practic dysfunction as the second-order factor and four first-order factors (dyspraxia, bilateral integration and sequencing deficit, visuoperceptual deficit, somatosensory deficit) were pro-posed. The CFA supported this model as the better-fitting model. The proposed model held true when tested with the subgroup of children with learning disabilities.
Conclusions. The modified model of sensory integration dysfunction proposed indicated that it was a good fit for the data and improved on the initial model. Clinical implications of the findings relate to the interpretation of SIPT scores and provide suggestions for test development measuring sensory integration functions. The proposed model has applications for occupational therapy intervention using sensory integration as the primary frame of reference.
Rater Reliability and Internal Scale and Person Response Validity of the School Assessment of Motor and Process Skills
Authors: Atchison Bradley T. , Fisher Anne G. , Bryze Kim 
Published: April 2012

Abstract
Objective. The purpose of this study was to examine the internal scale and person response validity as well as intrarater reliability of the School Assessment of Motor and Process Skills (School AMPS).
Method. Fifty-four students were assessed with the School AMPS while they performed routine school work tasks in their classrooms. The students’ ages ranged from 3 to 7 years (M = 4.0 years, SD = .7). Twenty-two students were identified as “typically developing,” and 32 were identified as having a developmental or learning disability.
Results. The School AMPS Motor and Process scale items and tasks (scale validity), the participants (person response validity), and the rater (intrarater reliability) all demonstrated acceptable goodness-of-fit to the many faceted Rasch model (MnSq &lt; 1.4, z &lt; 2).
Conclusion. Results supported the validity and reliability of the School AMPS. With additional research and development, the School AMPS has the potential to become the first functional, unobtrusive, reliable, and valid assessment designed by occupational therapists for use by school-based occupational therapists.
Working Well With Others: The Prediction of Students’ Clinical Performance
Authors: Tickle-Degnen Linda 
Published: April 2012

Abstract
Objective. The purpose of this study was to determine whether multivariate measurement at the initiation of students’ training in occupational therapy could predict clinical performance in Level II fieldwork.
Method. Forty-five students in their first semester were videotaped in pairs and completed personality and emotional communication measures related to the potential for working well with others. Two years later, the students’ clinical performance was rated by Level II fieldwork supervisors.
Results. In the physical rehabilitation fieldwork setting, students who were conventional and quietly concerned were rated higher than students who were unconventional, talkative, and less other-centered. In the pediatric rehabilitation setting, students who were autonomous and nonverbally perceptive were rated higher than students who were interdependent and less perceptive. In the psychiatric rehabilitation setting, students who were emotionally reactive to facial but not body cues of emotion were rated higher than students who had low emotional reactivity and were less perceptive to facial but not body cues.
Conclusion. The varying institutional cultures, types of patients, and roles of occupational therapy across fieldwork settings may require different sets of attributes for working well with others. Educators and supervisors should be aware of these possible differences when fashioning Level I fieldwork experiences.
Test–Retest Reliability of the Evaluation Tool of Children’s Handwriting-Manuscript
Authors: Diekema Susan M. , Deitz Jean , Amundson Susan J. 
Published: April 2012

Abstract
Objective. This study examined the test–retest reliability of the legibility portion of the Evaluation Tool of Children’s Handwriting-Manuscript (ETCH-M).
Method. The sample consisted of 31 first-grade and second-grade students with handwriting dysfunction. The ETCH-M was administered two times,1 week apart, to participants. The primary investigator acted as sole rater and followed standard scoring procedures.
Results. The reliability coefficients were .63 for total numeral legibility, .77 for total letter legibility, and .71 for total word legibility. Individual task reliability coefficients were generally lower and ranged from .20 (near-point copy) to.76 (alphabet uppercase).
Conclusion. Total letter, total word, and uppercase letter legibility were more stable than total numeral legibility scores and other individual tasks scores. When evaluating handwriting for a child, it is important to consider ETCH legibility scores as only one aspect of a comprehensive evaluation.
Occupational Therapy and Rehabilitation: An Awkward Alliance
Authors: Friedland Judith 
Published: April 2012

Abstract
This article argues that although occupational therapy and rehabilitation are often considered synonymous, the latter is but one aspect of the former. Early influences on occupational therapy are briefly reviewed, and some philosophical ideas about activity are described. The rationale for the use of occupations as treatment in the early part of this century, both in Canada and in the United States, is examined and contrasted with the development of physical medicine and rehabilitation after World War II. This discussion demonstrates that the origins of occupational therapy and rehabilitation in North America had little in common. As occupational therapy became incorporated into rehabilitation, the profession’s core values eroded, and although current definitions of rehabilitation offer a more appropriate fit for occupational therapy, rehabilitation continues to see engagement in occupations as a separate and subsequent step. The article concludes by considering future directions and the tasks that lie ahead.
Continuing Competence in the Health Professions
Authors: Grossman Judy 
Published: April 2012

Abstract
The health professions are confronted with external pressures to assure the public of the continuing competence of health care providers and internal pressures for self-regulation. This article describes the forces driving continuing competence, the difficulty defining the scope of professional competencies for experienced practitioners, the difficulty creating valid measures to evaluate continuing competence, and the need for shared responsibility and collaboration among regulation boards, professional associations, and specialty certification programs. The article presents findings from the Study of Professions, which was based on literature review, document review, and telephone interviews with key informants from 13 regulated health professions.
Transitional Portfolios: Orchestrating Our Professional Competence
Authors: Crist Patricia , Wilcox Bonita L. , McCarron Kelly 
Published: April 2012

Abstract
Reflective professional development results from thoughtful planning of goals and meeting learning objectives. With rapid changes in health care resulting in major reevaluation and even modification of the role and functions of an occupational therapy practitioner, producing a historical record of competencies in order to learn from one’s own experience and to plan for change is essential. A new use of the portfolio is presented to show that a portfolio can be more than the typical repository of completed projects. The transitional portfolio is introduced as a tool for one to self direct professional development through thoughtful engagement with artifacts created during one’s career in relationship to professional goals and desired roles. The transitional portfolio process is holistic, flexible, and reflective. It can serve as a way to document accumulated knowledge and skill acquisition as well as facilitate thoughtful, planned reflection on one’s career development in occupational therapy. This article describes the use of transitional portfolios to connect professional development learning experiences, accomplishments, and future opportunities for occupational therapy practitioners.