Occupational therapists' perception of their practice: A phenomenological study

Background:  International literature seems consistent in reporting that occupational therapists value their methods. However, little empirical evidence has been generated supporting the basic system of belief for occupational therapy. Few studies have explored the nature of the occupational therapists' experiences and thoughts about their use of occupation as means and ends, and which strategies they use to implement their tools in their current practice. Accordingly, the aim of this study was to explore how occupational therapists understood and presented their practice and interventions.
Methods:  A sample of six occupational therapists graduated in different decades, from diverse client populations and health-care settings was selected to participate in a semistructured interview.
Results:  Three main themes were developed: 'To make the client's potentials visible', 'reaching a position one values' and 'looking with other eyes'. Whatever their specialities, the participants were unanimous in the way they described their role. Their common focus was 'activities of daily living'. However, they had problems describing their therapeutic tools, and were not able to clearly articulate the 'common sense aspects' of their own methods. The participants were engaged in constructing their professional identities, and stressed the need to construct professional boundaries relevant to their particular work.
Conclusion:  The occupational therapists perceived their practice and interventions as distinctly different from other team members, thus, they provided a 'counterpoint'. The participants used various ways of marketing their perspectives. While the novices tended to go along with the team, the experienced therapists tended to assert their own special contribution.     

Creating Occupational Therapy: The Challenges to Defining a Profession

The creation of a new profession in the early 20th century, such as occupational therapy, required a commitment to certain ideas and a willingness to accept certain challenges. This study examines the commitment to the idea of therapeutic and health supporting occupation by the early leaders and proponents of the profession and the challenges they faced in gaining acceptance of occupational therapy as a profession capable of delivering a valued health care service to society. Six challenges are reviewed as they occurred in the history of the profession and as they continue to challenge the profession into the present era.     

Occupational therapists' skills and attitudes regarding use of computers and assistive technology

The purpose of this study was to examine the skills and attitudes of a sample of practicing occupational therapists regarding the use of computers, and to explore their agreement with the Foundation Level Technology Competencies proposed for adoption in the United States of America (American Occupational Therapy Association, 1991; reported in Hammel and Smith, 1993). Out of a sample of 250 subjects, 89 occupational therapists in the USA completed a questionnaire regarding their experiences with, and attitudes towards computers, and their agreement with the proposed Competencies. The results indicated that while the majority of therapists had had some exposure to computers, they wanted to learn more—particularly how a computer could aid management tasks. While 50% or more of the therapists ‘Agreed’ or ‘Strongly Agreed’ with 19 of the 21 Competencies, the level of therapist ‘Indecision’ or ‘Disagreement’ with several of the Competencies suggests that either these Competencies require revision, or that if the Competencies are nationally adopted, many therapists may require intensive continuing education programmes to bring their skills to a competent standard. Adoption of these Competencies has many implications for international standards of occupational therapy practice and levels of computer education. Copyright © 1997 Whurr Publishers Ltd.     

The Nature of Emerging Practice in Occupational Therapy: A Pilot Study

The profession of occupational therapy is responding to changes in the health care system by expanding the contexts and models for service provision, typically referred to as emerging practice. As a pilot study, a survey was completed by 174 occupational therapists to gather information and opinions about emerging practice. Results indicated occupational therapists hold diverse perceptions about emerging practice settings and services as well as the role and significance of emerging practice within the profession. Occupational therapists engaged in emerging practice described numerous rewards and challenges inherent within the process of developing and delivering services. The findings indicate continued professional dialogue and research are needed to support the development and efficacy of occupational therapy services in emerging settings and roles.     

A Course in Autoethnography: Fostering Reflective Practitioners in Occupational Therapy

This paper describes an academic course designed to lay the foundation for reflective practice in occupational therapy. In this course, students conduct highly personalized research based on experiences in Level II fieldwork that leads to writing an autoethnography. The paper describes autoethnography, details its use in occupational therapy literature, and discusses the design and outcomes of the course. Students' experiences with this autobiographical genre of qualitative research are illustrated. In the writing process, students find clinical stories that must be told and learn to “move around” in their stories. The outcomes of the course include integration of personal and professional experiences, closure to academic preparation, and deep reflection about what it means to be an occupational therapist.     

Homelessness: Perspectives,Misconceptions, and Considerations for Occupational Therapy

SUMMARY

Like poverty, the problem of homelessness has been with us to varying degrees since the founding of our nation. Attempts to explain homelessness have an equally long history. Hence, the literature and popular media are home to divergent perspectives, explanations, and characterizations of homelessness. The objectives of this paper are to present a unifying taxonomy of prominent perspectives on homelessness, and to illustrate how various perspectives lead to particular characterizations of persons who become homeless. The taxonomy traces the connection between perspectives and interpretations of the problem and helps to illuminate implicit and often unexamined assumptions about who becomes homeless and why. Critical examination of these perspectives is vital because our individual and collective understanding of homelessness is a powerful determinant of how we approach occupational therapy practice with this population. Implications for community practice and program planning for individuals and families in homeless shelters are also discussed.     

Occupational therapy students' perceptions of their cultural awareness and competency

Occupational therapy students' perceptions of cultural awareness and their self-rated level of cultural competence were investigated. Seventy-two participants at four stages of education (on entry, on completion of university-based studies, on completion of fieldwork and one year following graduation) completed the Cultural Awareness and Sensitivity Questionnaire. The findings indicate that occupational therapy students graduated with an understanding of cultural diversity and the realization that cultural awareness and sensitivity are essential to culturally competent practice. The findings suggest that there is not enough exposure to cultural issues in both university-based education and in fieldwork. This study was limited to one state university and to most students aged < or =24 years and predominantly female. It did not explore the factors that influence the development of cultural competence and the methods to develop it. Future studies should monitor actual culture-related exposures to determine how learning experiences are organized and the ways culture influences the learning process and clinical competence.     

Interprofessional practice: Social work students’ perspectives on collaboration

ABSTRACT

As the value of interprofessional practice becomes increasingly recognized, it is critical to educate social work students so that they understand the importance of interprofessional practice, and the role that social workers play. The objective of this research was to understand social work students’ experiences, attitudes, and perspectives toward interprofessional practice. A cross-sectional, non-probability convenience sample was used (N = 125), with data collected from students in a large school of social work in New York State in order to understand their experiences in the field and classroom. Results of a linear regression showed that overall, students had positive perspectives on interprofessional collaboration, with one of the strongest predictors being students' positive attitudes toward interprofessional practice. The results also point to students having limited experience in working in interprofessional teams and exposure to training, either on the job or in the classroom. To help students gain more experience and training, fieldwork opportunities in interprofessional practice can be expanded, and more courses can be offered, particularly collaborating with other academic disciplines.     

Occupational therapists as object users: A critique of Australian practice 1954–1995

This research sought to identify the conventions and expectations that guide Australian occupational therapists' use of objects, and to critique these against professional beliefs and values. A history of ideas methodology was used to analyse the content of a sample of issues of the Australian Occupational Therapy Journal, spanning 42 years. This revealed that therapists have been strongly influenced by mechanistic thinking, with a resultant focus on biomechanical, neurological and functional aspects of object use, which has excluded consideration of the client's subjective experience of using objects and the symbolic meaning of the objects used. The centrality of assistive devices, splints and formal assessments to occupational therapists' identity and professional development is also identified. Current practices are critiqued as inconsistent with respecting clients' dignity and worth.     

Research utilization models: frameworks for implementing evidence-based occupational therapy practice

Evidence-based practice is an important step in the professional evolution of occupational therapy and also provides the means for state-of-the-art innovative clinical service for clients. An essential step in incorporating innovations and developments into clinical practice is through research utilization. Nine models of research utilization developed in the literature are reviewed and critiqued. These are: (1) the Conduct and Utilization of Research in Nursing (CURN) Project; (2) the Stetler-Marram Model; (3) the University of North Carolina Approach; (4) the Innovation Diffusion Process Model; (5) Killeen's Matrix of Research Activity; (6) the Iowa Model of Research In Practice; (7) the Western Interstate Commission for Higher Education In Nursing Project; (8) the Nursing Child Assessment Satellite Training Project; and (9) the Linkage Model. Research utilization models provide a framework for collaboration and the necessary conditions for research utilization activities to be successful. Copyright © 1999 Whurr Publishers Ltd.     

Occupational therapy and early intervention: a family-centred approach

The purpose of this study was to identify factors that encourage or inhibit family-centred practice in the occupational therapy intervention process. A qualitative paradigm using grounded theory methodology was utilized to gather and analyse data. Participants included six families and four occupational therapists. Data analysis from the family interviews identified six categories: education, communication, relationship, parental roles, follow through, and scheduling. With further analysis two central themes of time and support were extracted from these categories. Analysis of the occupational therapists' interviews revealed six categories: education, communication, relationship, sibling/family participation, follow through, and empowerment. The central themes emerging from these categories are time and natural routine. The themes obtained from the families and occupational therapists were then compared and family individuality was identified as the core concept. Viewing families as a unique entity is necessary to assist occupational therapists in providing the most effective family-centred occupational therapy.     

Perceptions of occupational therapists practising in rural Australia: A graduate perspective

Background:  The difficulty in recruiting and retaining health professionals into rural and remote areas of Australia is well recognised. This study explored the perceptions of occupational therapists practising in rural locations regarding the essential skills necessary for rural practice and the ability of undergraduate education to prepare them for rural practice.
Methods:  A qualitative study using a phenomenological approach was conducted using semistructured in-depth interviews. Participants included occupational therapists who were graduates of James Cook University, who were practising in rural areas in Queensland and Victoria, and academic staff.
Results:  This study demonstrates that it is important for universities to develop both a mindset in their graduates for rural practice, as well as developing broader skills in addition to core discipline-specific skills. While subjects developing core occupational therapy skills are at the centre of undergraduate education, the importance of developing a broader understanding of rural health issues and skills in public health, primary health care and health promotion was emphasised.
Conclusion:  The development of specific skills to become competent rural practitioners and to cope with the challenges of rural practice can be strengthened through initiatives at the undergraduate level. Ongoing commitment from all universities across Australia to include rural curriculum content has the potential to improve recruitment and retention of occupational therapists and other health professionals into rural Australia.