bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Functional Outcome Among Adolescents and Young Adults With Psychotic Disorders
Authors: Henry Alexis D. , Coster Wendy J. 
Published: April 2012

Abstract
Adolescents and young adults who experience the onset of a psychotic disorder often demonstrate major disruptions in occupational and social functioning. Yet, certain persons appear to be at a greater risk for impaired functioning after an episode of psychosis than others. This review of the psychiatric research literature on outcomes in psychotic disorders identifies several variables predictive of occupational and social functioning among young persons with both affective and nonaffective psychoses. Variables predictive of functional outcomes include diagnosis, symptom severity, duration of onset of symptoms, age of onset of symptoms, gender, stressful life events, premorbid functioning, and social supports. A model for conceptualizing the relationships of these variables to functioning is presented, and the implications for occupational therapy practice and research are discussed.
Clients’ Perceptions of Discharge Housing Decisions After Stroke Rehabilitation
Authors: Unsworth Carolyn 
Published: April 2012

Abstract
Objective. The purpose of this research was to examine the perceptions of older persons with stroke concerning the discharge housing decisions made during their rehabilitation program. The research explored clients’ locus of control, their perceptions of the role of the rehabilitation team and their family in the decision, and their perceptions of their activities of daily living skills.
Method. Sixty-two subjects with stroke completed four measures: (a) the Functional Independence Measure (FIM), (b) a housing information questionnaire, (c) a semistructured interview, and (d) the Bialer Locus of Control Scale. Rehabilitation team members also completed the FIM and housing information questionnaire for each subject. These instruments were used to collect data relating to clients’ perceptions of their functional status, discharge from the hospital, housing options available, and locus of control.
Results. Despite the team or family opinions on discharge housing, subjects saw housing decisions as primarily their own. The majority of subjects were reluctant to consider alternatives to returning home, even though they have self-care deficits and frequently reported that the presence of a spouse and family members were important to support their return home. Subjects generally seemed unaware of the influence of team and family opinions and the impact of their functional status on their discharge housing. Subjects’ locus of control seemed unrelated to satisfaction with the discharge decision process.
Conclusion. Clients who have had a stroke could use assistance to determine housing that is appropriate for their living skills. Discussions with clinicians concerning accommodation options may lead to a smoother transition from the hospital to longer term housing for clients after stroke.
Metaphor and Meaning in a Clinical Interview
Authors: Mallinson Trudy , Kielhofner Gary , Mattingly Cheryl 
Published: April 2012

Abstract
This study examined the narrative features of 20 life histories gathered from psychiatric patients with the Occupational Performance History Interview. The aim was to identify how narrative features were present in the patient interview responses and to illustrate how such narrative features can be located. We found that the patients organized their interview responses with deep metaphors that served to “emplot, ” or give meaning to, the life story. This article illustrates how patients used the deep metaphors to both circumscribe and frame possible solutions to the problems in their lives. Deep metaphors are consistent, recurring images of a life story that give coherence to, and aid in, the interpretation of the events of that life. Moreover, we explored how metaphors can be located in patient life histories and their implications for occupational therapy.
Soft Versus Hard Resting Hand Splints in Rheumatoid Arthritis: Pain Relief, Preference, and Compliance
Authors: Callinan Nancy J. , Mathiowetz Virgil 
Published: April 2012

Abstract
Objectives. This study compared soft versus hard resting hand splints on pain and hand function in 39 persons with rheumatoid arthritis. Splint preference was also evaluated to determine its effects on splint wear compliance.
Method. A repeated measures research design was used to compare the two experimental conditions, wearing a soft splint versus a hard splint on the dominant hand for 28 days at night only, and an unsplinted control period of 28 days.
Results. Arthritis pain was considerably less during both splinted periods when compared with the pretest. Subjects identified fewer joints as being painful during the soft splint condition than during the unsplinted condition. There were no significant differences among conditions on hand function measures. Splint preference was 57% for the soft splint, 33% for the hard splint, and 10% for no splint. Splint wear compliance was significantly better with the soft splint (82%) than with the hard splint (67%).
Conclusion. The findings indicate that resting hand splints are effective for pain relief and that persons with rheumatoid arthritis are more likely to prefer and comply with soft splint use for this purpose. Individualized splint prescription that focuses on client comfort and preference may enhance splint wear compliance.
Minimal Forces to Move Patients
Authors: Zelenka John P. , Floren Andrew E. , Jordan J. J. 
Published: April 2012

Abstract
Objectives. Health care workers who have patient transfer duties are at risk for back injury. Transferring patients between beds and gurneys is a rigorous pulling task that requires back, leg, and arm strength. This study analyzed the efficiency of commercially available transfer devices, namely a patient roller, patient shifter, and draw sheet.
Method. With the use of one or two force scales attached to each transfer device, the amount of force needed to transfer 15 participants, weighing from 101 lb to 240 lb, back and forth between a bed and a gurney was measured. Ten transfers per device per participant were performed.
Results. The patient roller was superior to the patient shifter and draw sheet in reducing transfer forces. Additionally, gurney-to-bed transfers tended to be more demanding for all transfer devices and for heavier participants.
Conclusions. The patient roller was the most efficient transfer device in moving participants compared with the draw sheet and patient shifter. Transfer forces can be estimated with the use of linear equations, with patient weight, direction of transfer and transfer device as the independent variables. These estimated forces can assist occupational therapists in the returning their injured health care coworkers to patient transfer duties. The results further indicated that high forces are required to transfer patients; therefore, patient-transfer personnel should obtain assistance when moving patients.
Use of Electronic Music as an Occupational Therapy Modality in Spinal Cord Injury Rehabilitation: An Occupational Performance Model
Authors: Lee Brenda , Nantais Tom 
Published: April 2012

Abstract
This article describes an electronic music program that allows clients with spinal cord injury (SCI) to form musical bands and play songs while performing therapeutic exercise in an occupational therapy program. Clients create the music by activating upper extremity exercise devices that are connected to a synthesizer through a computer. The bands choose the songs they would like to play and meet twice a week for 1 hr to practice. The 8-week program often concludes with a public performance.
The music program is intended to motivate client participation in physical rehabilitation while promoting self-esteem, emotional expression, and peer support. It is based on the model of occupational performance and the theory purposeful activity. To date, 33 persons have taken part. Client, therapist, and public response has been positive because this program highlights the abilities of persons with SCI, thereby encouraging their reintegration into the community.
Development of Critical Paths for Postacute Brain Injury Rehabilitation: Lessons Learned
Authors: Abreu Beatriz C. , Seale Gary , Podlesak Joyce , Hartley Leila 
Published: April 2012

Abstract
One important tool for case management is critical path analysis. This article explains four critical pathways developed by an interdisciplinary team for a postacute brain injury rehabilitation program. The heterogeneity of the brain injury population mandates the need for systematic coordination of direct care services. Yet, variations in the neurobehavioral consequences of brain injury necessitate differing goals and treatment tracks for individual clients. The critical pathways in this setting define and describe the procedures and services to be rendered from admission to discharge to achieve optimal goals for four treatment program tracks: Return to Work, Return to School, Functional Independence, and Neurorehabilitation. The tracks reflect a hierarchy of expectations for information processing and functional performance. Critical pathways provide a tool for enhancing communication among service providers and external case managers and for determining the extent to which a client’s course of treatment compares with a clinical standard considered to be ideal. This article compares the four critical pathways, provides representative case samples, and discusses lessons learned in the development and implementation process.
Managed Mental Health Care: Reflections in a Time of Turmoil
Authors: VanLeit Betsy 
Published: April 2012

Abstract
This article reviews the history, growth, and evolution of managed care in mental health and substance abuse treatment. Specific issues described are stigma, the important social dimensions and chronicity of some types of mental illness and chemical dependency, and reliance on the public sector for care. Opportunities and challenges for occupational therapists in the rapidly changing mental health system are discussed, including the use of interdisciplinary teams, the importance of measuring functional outcomes of interventions, the need to develop clinical guidelines, the importance of the community setting and a continuum of services, ethical dilemmas, and the importance of assertive occupational therapy advocacy and involvement in health care reform.
Right-Hemispheric Activation Approaches to Neglect Rehabilitation Poststroke
Authors: Lin Keh-chung 
Published: April 2012

Abstract
Unilateral neglect is a common neurological syndrome resulting from right-hemisphere strokes and has important prognostic value for functional outcome. This article identifies three approaches to neglect rehabilitation that are based on right-hemispheric activation mechanisms: (a) the lateralized task approach, (b) the controlled sensory stimulation approach, and (c) the limb activation approach. Their theoretical bases, experimental findings, and practical implications for neglect remediations are discussed. Meta-analytic procedures were used to critically review and statistically combine the results from potentially relevant studies, including 9 group design studies and 22 single-subject studies. An overall mean effect size r of .77 was found for the group design studies. For the studies with individual subjects as units of analysis, an overall mean r of .89 was obtained. This review provided empirical support for intervention in cases of unilateral neglect on the basis of brain activation mechanisms. Some appropriate areas for further research include evaluating treatment efficacy against functional criteria, refining intervention procedures in keeping with the advances in brain activation research, and identifying the optimal conditions for promoting generalized training.
The Volitional Questionnaire: Psychometric Development and Practical Use
Authors: Chern Jen-Suh , Kielhofner Gary , de las Heras Carmen Gloria , Magalhaes Livia C. 
Published: April 2012

Abstract
This article describes the Volitional Questionnaire and presents recent empirical efforts to develop and validate this instrument. The Volitional Questionnaire is an observational method of gathering data on motivation that is designed for persons who are unable to self-report their own motives. Studies to date suggest that the instrument can provide a valid measure of volition, though a number of limitations of the tool are noted. Implications for use of the Volitional Questionnaire in practice and for further refinement and future research are discussed.
Continuity and Change: Past Experience as Adaptive Repertoire in Occupational Adaptation
Authors: Spencer Jean Cole , Davidson Harriett A. , White Virginia K. 
Published: April 2012

Abstract
Narratives are gaining recognition as important ways occupational therapists and other clinicians can think about the life stories of clients. The purpose of this article is to examine a conceptualization of how changes from one chapter to another occur in life stories, using the metaphor of an adaptive repertoire, and to consider how this notion can be useful in helping clients maintain continuity and a coherent life story in times of change. Three premises based on the concept of adaptation address (a) configurations of occupational forms embedded in particular local worlds, (b) cumulative development of an adaptive repertoire that allows one to perform both competently and appropriately, and (c) adaptive transitions and application of one’s repertoire to new circumstances. Implications for research and clinical practice in occupational therapy also are examined.
The Effect of Switch Control Site on Computer Skills of Infants and Toddlers
Authors: Glickman Lisa , Deitz Jean , Anson Denis , Stewart Katherine 
Published: April 2012

Abstract
Objective. The purpose of this study was to determine whether switch control site (hand vs. head) affects the age at which children can successfully activate a computer to play a cause-and-effect game.
Method. The sample consisted of 72 participants randomly divided into two groups (head switch and hand switch), with stratification for gender and age (9–11 months, 12–14 months, 15–17 months). All participants were typically developing. After a maximum of 5 min of training, each participant was given five opportunities to activate a Jelly Bean switch to play a computer game. Competency was defined as four to five successful switch activations.
Results. Most participants in the 9-month to 11-month age group could successfully use a hand switch to activate a computer, and for the 15-month to 17-month age group, 100% of the participants met with success. By contrast, in the head switch condition, approximately one third of the participants in each of the three age ranges were successful in activating the computer to play a cause-and-effect game.
Conclusion. The findings from this study provide developmental guidelines for using switches (head vs. hand) to activate computers to play cause-and-effect games and suggest that the clinician may consider introducing basic computer and switch skills to children as young as 9 months of age. However, the clinician is cautioned that the head switch may be more difficult to master than the hand switch and that additional research involving children with motor impairments is needed.
Theory Application by School-Based Occupational Therapists
Authors: Storch Beth A. , Eskow Karen Goldrich 
Published: April 2012

Abstract
Objectives. Recent literature indicates that there is an inconsistent use of theory to guide clinical actions by occupational therapists, including those working in pediatrics. The purpose of this study was to describe school-based therapists’ theory application by collecting information about what frames of reference they used and why.
Method. Of the 72 school-based therapists in the mid-Atlantic states who agreed to respond to a questionnaire, 51 (70.8%) returned the questionnaire. Information about demographics, what frames of reference were used, and why they were used was obtained from the questionnaire.
Results. Respondents reported using a multitheoretical approach, with sensory integration theory and neurodevelopmental theory being the predominate frames of reference applied but not the only ones used. The frames of reference were used on the basis of several factors, including the children’s needs and the respondent’s education.
Conclusion. Formal and continuing education seems to have a great effect on school-based occupational therapists as they develop their personal conceptual frameworks.
Collaborative Consultation: The Efficacy of Remedial and Compensatory Interventions in School Contexts
Authors: Kemmis Barbara L. , Dunn Winnie 
Published: April 2012

Abstract
Objective. This study examined the intervention success of weekly collaborative consultation between therapists and teachers.
Method. Ten therapist–teacher pairs consulted for 60 min weekly throughout the school year about students identified as having sensory integration dysfunction with learning problems. Each week, the pairs identified a specific functional classroom goal then designed either a remedial or compensatory intervention and set criteria for intervention success. At each successive weekly meeting, the pairs determined whether the goal was met. Intervention success was analyzed across 10 students (for a total of 213 goals).
Results. There was a positive effect for overall intervention success. Although remedial and compensatory interventions were equally successful across student performance areas, therapist–teacher pairs demonstrated a preference for compensatory and academic goals.
Conclusion. The overall positive effect for intervention success suggests that when occupational therapists and teachers collaborate on behalf of students, they can facilitate student success in a variety of performance areas. Therapist–teacher preference for compensatory and academic goals indicates that therapist–teacher collaboration can be useful for occupational therapists to link interventions to academic goals in school contexts.
Occupational Therapy in Full-Inclusion Classrooms: A Case Study From the Moorpark Model
Authors: Kellegrew Diane Hammon , Allen Delores 
Published: April 2012

Abstract
This article provides a historic review of the movement toward integrated classroom placements as well as the characteristics of full-inclusion classrooms relevant to occupational therapy school-based practice. A full-inclusion model adopted by the Moorpark Unified School District is described. This model incorporates occupational therapy as a vital and integral component of the school’s inclusive education efforts.
Supervision and Consultation Services for Pediatric Occupational Therapists
Authors: Rainville Ellen Berger , Cermak Sharon A. , Murray Elizabeth A. 
Published: April 2012

Abstract
Objective. Occupational therapists with advanced experience or expertise provide supervision and consultation services in a variety of settings. This pilot study examined the use of such supervision and consultation services by pediatric occupational therapists.
Method. Special education administrators and pediatric occupational therapists from Massachusetts, a state often regarded as a leader in special education, responded to surveys designed especially for this study. These surveys asked about current supervision and consultation use, satisfaction with present services, and the need for additional resources in this area. Opinions regarding practice areas that would best be addressed by supervision and consultation were also obtained.
Results. Both administrator and therapist respondents agreed that expert occupational therapy supervision and consultation are needed. Identified areas of interest were classroom supervision and consultation strategies, service delivery decisions, and evaluation methods.
Conclusion. Pediatric occupational therapists need expert supervision and consultation from occupational therapists with advanced experience or expertise in addition to traditional management, education, and training methods.
Meaningful Work in Supportive Environments: Experiences With the Recovery Process
Authors: Strong Susan 
Published: April 2012

Abstract
Objective. This ethnographic study examined what makes work meaningful for persons with persistent mental illness and how this meaningfulness relates to their recovery.
Method. Twelve persons between 32 and 58 years of age who had been involved an average of 19 years with a formal mental health system participated in in-depth interviews and a focus group. Thematic analysis and case studies were understood in the context of the investigator’s 15 months of participant observation of 35 persons with psychiatric disabilities working at an affirmative business.
Results. The meaning of work varied with participants ’perception of their illness and their self-concept. Changes in their self-efficacy and self-concept were driven by their participation in work activities to operate the affirmative business.
Conclusion. Findings suggest that therapists could potentially facilitate these changes in clients’ sense of self-efficacy and self-concept by helping them make connections with meaningful occupations and contributions to organizations in the community and to experience challenges and successes in the context of meaningful work.
Funding Community Practice: Stage 1
Authors: Brownson Carol A. 
Published: April 2012

Abstract
A broad definition of community practice has implications for how occupational therapy services are defined, delivered, and funded. The historical foundations of occupational therapy support an expansion into health promotion and prevention programming that is based in the community. Moving into these roles opens up an array of funding possibilities. It may also require developing new partnerships, new skills, and work under different job titles. This article describes two approaches to broadening occupational therapy’s role into the community and gives examples of programs and funding sources for each.
Occupation and Survival: A 25-Year Follow-Up Study of an Aging Population
Authors: Iwarsson Susanne , Isacsson Ǻke , Persson Dennis , Scherstén Bengt 
Published: April 2012

Abstract
Objective. In this retrospective study of an elderly population cohort living in a defined Swedish rural area, the relationship between occupation and survival as a measure of objective health was investigated. The cohort has been followed for 25 years.
Method. On the basis of the baseline socioeconomic interview from assessments performed when the participants were 67 years of age, an index of active participation in daily occupation was devised. The index was used to investigate the covariation between generic everyday occupation and long-time survival.
Results. For the female participants, Kaplan-Meier curves demonstrated differences in survival between the “less active” and “more active, ” and Cox regression survival analyses resulted in a significant covariance between occupation and survival. For the male participants, no such differences were found.
Conclusion. The significant results for the women implied support for the core assumption of occupational therapy that a relationship exists between occupation and health. The lack of differences in survival among more active and less active men demonstrates the complexity of studying occupation.