Interprofessional vs. interdisciplinary services in school-based occupational therapy practice

Interdisciplinary or transdisciplinary service is strongly advocated in school-based occupational therapy practice. The terms, interdisciplinary and transdisciplinary, however, are not accurate in their use. This paper examines the difference between the terms of discipline and profession and recommends the more precise and appropriate use of interprofession and transprofession related to school-based occupational therapy practice. Occupational therapy is a profession, not a discipline. Using the terms of interprofession and transprofession can benefit the occupational therapy profession by increasing language use precision, facilitating professionalism, and improving interprofessional interactions and collaborations based upon accuracy.     

Occupational therapy in hospital based care in the Netherlands: a comparison of occupational therapy in general care (nursing homes,rehabilitation centres and general hospitals) and psychiatric care

Objective: to investigate (1) whether differences in occupational therapy practice exist between general and psychiatric care and (2) whether differences in occupational therapy practice exist between general care settings. The four most common settings where occupational therapists work in the Netherlands (nursing homes, rehabilitation centres, general hospitals and psychiatric hospitals) were studied. Method: a total of 143 therapists, working in 49 occupational therapy departments, participated in this study. They collected data on 1051 patients. For each patient a standard registration form, based on the International Classification of Impairments Disabilities and Handicaps (ICIDH) was filled out. This form contained information about (i) patient characteristics (ii) occupational therapy diagnosis and treatment goals in terms of ICIDH and (iii) treatment characteristics. Results and conclusions: occupational therapy treatment goals and interventions showed clear differences between psychiatric and general care settings. The differences in occupational therapy practice across general care settings were small. Copyright © 1996 Whurr Publishers Ltd.     

2002 — 2020年上海市浦东新区居民主要慢性病早死概率研究

  目的  分析中国长三角区域重点慢性病服务提供能力现状及其发展的均衡程度,为促进长三角区域重点慢性病预防控制能力建设高质量均衡发展提供参考依据。  方法  收集2009年1月1日 — 2019年12月31日长三角区域有关重点慢性病的公开文件资料,借鉴适宜公共健康体系中“服务功能”要素,构建服务提供种类覆盖率（SCR）和定量可考核服务种类覆盖率（ASCR）2个指标定量分析长三角区域重点慢性病服务提供能力,并基于耦合协调度模型分析长三角区域重点慢性病服务提供能力发展的均衡程度。  结果  中国长三角区域重点慢性病服务提供水平方面,SCR和ASCR平均值分别从2009年的21.2 %和10.0 %提升到2019年的82.8 %和51.5 %;从各级预防角度看,SCR和ASCR均以三级预防表现最好;从三级预防整体看,2019年上海市SCR覆盖率最高（96.0 %）,安徽省SCR覆盖率最低（71.0 %）,江苏省ASCR覆盖率最高（63.9 %）,浙江省ASCR覆盖率最低（33.0 %）;在长三角区域重点慢性病服务提供发展均衡水平方面,SCR和ASCR的耦合协调度值分别从2009年的38.97和11.58上升到2019年的90.73和70.72;2019年长三角区域SCR一级预防、二级预防和三级预防均衡等级分别为9级、9级和10级,ASCR分别为7级、7级和8级。  结论  中国长三角区域重点慢性病服务提供能力及均衡水平逐年上升,三级预防优于一级和二级预防,SCR各级预防均衡发展水平优于ASCR。     

Use of creative activities in occupational therapy practice in sweden

The aim of this study was to describe the prevalence of creative activities in occupational therapy in Sweden and how often Swedish occupational therapists use creative activities as a means of intervention. A web‐mail survey was sent to 2975 Swedish occupational therapists working in health care at regional, county council or primary health care level, and those working in vocational rehabilitation. A total of 1867 (63%) answered the questionnaire and showed that 44% did use creative activities as a means of intervention and most often by practitioners working in psychiatric health care. The most commonly used form of creative activity was arts and crafts followed by gardening. This web‐mail survey was based on a limited amount of items regarding creative activities. Further research should focus on in‐depth inquiries about how occupational therapists and their patients perceive the use of creative activities as a means of treatment in occupational therapy. Copyright © 2012 John Wiley & Sons, Ltd.     

Diversity in intermediate care

This paper discusses the evolution of intermediate care (IC) and presents interim observations from a survey of providers in England being conducted as part of a national evaluation. Telephone interviews covering various issues concerning the level of provision and style of delivery have been conducted with 70 services to date. Data from these are used to discuss the progress, range and nature of IC in relation to clinician viewpoints and academic and official literature on the subject. IC ‘on the ground’ is a multiplicitous entity, with provision apparently evolving in accordance with the particularities of local need. While protocols for medical involvement in IC generally appear to be well established, there are some tensions concerning integration of services in a locality, care management processes and questions of flexibility and inclusiveness in relation to eligibility criteria.     

Focus on family care givers for individuals with dementia: implications for occupational therapy practice

Although family carers assume a pivotal role in caring for relatives with dementia, few occupational therapy studies are directed towards them (Gitlin, Corcoran & Leinmiller-Eckhardt, 1995). In this qualitative study, the researcher explored the feelings and experiences of family carers when caring for relatives with dementia. Fifteen family carers were invited to participate in two focus group interviews. Four themes emerged from the findings. First, caring duties included hands-on assistance in daily living tasks and supervision of clients' behaviours. Second, carers devised caring strategies to facilitate the caring process. Third, feelings of caregiving were fluid and complex. Finally, negative caring experiences outweighed positive ones. By understanding the unique needs of family carers, occupational therapists should include therapy to family carers as part of treating individuals with dementia. Suggested interventions include collaborative work with family carers; support groups for family carers; and education on handling techniques of cognitive impairments and behavioural changes. Copyright © 1997 Whurr Publishers Ltd.     

Occupational therapy assessments used in acute physical care settings

Abstract

Objective: The aim of this study was to identify the assessments used by occupational therapists in acute care practice, their purpose, and the role of home visits and standardized tests. Methods: A cross-sectional survey containing closed and open questions was sent to therapists working in physical acute care settings using convenience sampling. This article reports on the responses of 70 New Zealand occupational therapists (response rate = 74%). Results: The study found that informal assessments (i.e. interviews and observations) were commonly used to evaluate daily living skills and to provide information about the home environment, cognition, transferring, leisure, and upper limb function. When situations were particularly complex, cognitive assessments and home visits were used judiciously to further investigate assumptions related to safety in discharge procedures. Standardized assessments were not widely used but were typically considered when cognitive ability needed to be confirmed. Conclusions: Occupational therapists' expertise lies in interviewing clients and in skilled observations of function. Standardized ADL assessments could complement occupational therapy practice but further research is needed to determine their value. In the final analysis, assessments should ensure that that both safety and client/carer concerns are at the centre of decision-making.     

Utilisation of strategic analysis and planning by occupational therapy services

Many occupational therapists in practice can testify to the continually changing environments that impact on the delivery of effective services in the modern human service delivery system. It is within this context that occupational therapists are urged to regularly undertake strategic planning to keep track of and deal with these ongoing changes. In the present article, strategic analysis and planning will be discussed as a tool for occupational therapists in practice. The first step in strategic planning is an analysis of the external and internal environments of a particular service. The current article will provide an example of an environmental analysis as first step. This is followed by a discussion of the second step: the consideration of appropriate strategies and models of service delivery. The aim of the present article is to emphasise the importance of critical reflection by practitioners in order to adapt to the environmental changes influencing occupational therapy service delivery .     

A survey of end-of-life care in care homes: issues of definition and practice

Care homes throughout the UK provide long-term care for frail older people. Whilst care homes are a home for life, many of the older people living in this setting also die there. There is increased interest in improving the care that older people receive in care homes towards the end of life. One way to achieve this has been through links with specialist palliative care services. The knowledge held in care homes by staff, residents and their family carers has yet to be fully integrated into this work. Consequently, a postal survey of care home managers in one English county was undertaken to examine the characteristics of end-of-life care for older people in these care homes. We sought to establish the managers' understanding of end-of-life care; the extent to which dying and death is present in this setting; the attributes of the resident population living in these care homes; and the availability of resources to support the provision of end-of-life care in this setting. The survey identified that managers held diverse understandings regarding the meaning of end-of-life care. The features of the residents' conditions and the dying that they experience requires a different way to conceptualise end-of-life care. A longer-term perspective is offered here that encompasses the whole period of a person's residence in a care home.     

Language, identity and representation: occupation and occupational therapy in acute settings

Aim:   This article presents findings from a participatory action research study into the experience and use of occupation, theory and evidence in the everyday practice of a group of occupational therapists working in a large metropolitan hospital delivering a range of acute services, in Melbourne, Australia.
Methods and findings:   Narrative data gathered from 11 individual interviews and 10 group discussions were analysed through numerous iterative cycles to explore research issues and evaluate research actions. This article discusses why the participating occupational therapists chose to change the language they used to describe their practice from a focus on 'function' to a focus on 'occupation'. This change improved the therapists' levels of confidence, strengthened their professional identities and provided for a sense of renewed empowerment within the organisation.
Conclusions:   The findings suggest that occupational therapists in acute settings can utilise language more effectively to augment their ability to promote the vital and unique contribution that occupational therapy has to make. Such small, yet powerful changes can empower occupational therapists to address long-standing dilemmas of representation and enable transformative practices.     

Engagement and social interaction in dementia care settings. A call for occupational and social justice

As full citizens, people with dementia are entitled to engage in social and occupational activities in residential care settings. Limitation or deprivation of choice and experience of valued occupations has been described elsewhere as occupational injustice. This research frames the unmet needs of people with dementia for occupation and social interaction, as issues of human rights and citizenship. It identifies a gap in current measurement tools of engagement in residential settings and in response, presents the Assessment Tool for Occupational and Social Engagement (ATOSE) as an objective measure of engagement. It examines results from a study of five residential care settings in Ireland using the ATOSE which included 73 residents with dementia and/or enduring mental health diagnoses. Residents spent on average, 38% of their time engaged and 62% of their time not engaged while in their communal sitting rooms. The ATOSE observations supported the rights of residents as citizens to have low levels of engagement addressed. A critical gerontology lens is employed to discuss concepts of citizenship, occupational justice, and social justice in the context of this research project.     

Cost drivers of public hospital occupational therapy outpatient care

This study examined the associations between various patient-related, demographic and episode-based factors, and the length of time associated with completed episodes of outpatient (ambulatory) occupational therapy care. Data were provided over a 10-month period by eight public hospitals in three Australian states. An episode described occupational therapy outpatient management for one patient with one condition, and consisted of start and finish dates, and all the occasions of service in between. The median value of the total patient-attributable time of an occupational therapy episode of care was 70 min. Factors that were strongly associated with long occupational therapy episodes were age, communication issues and hospital location (metropolitan or country). This study provides the basis for future investigations into the costs of providing 'best practice' occupational therapy outpatient services.