Hand Rehabilitation and Occupational Therapy

Occupational therapy for hands has been recognized as a speciality within the profession since the 1940s. The growing numbers of patients with acquired or congenital problems affecting their hands as well as the newer surgical procedures now available to restore lost function has challenged therapists. To manage the highly specialized needs of the complicated hand problems seen in the clinical setting, there is emphasis on perfecting technical skill. Equally required is the ability to remediate not only the physical dysfunction but also the patient's response to this dysfunction. For it is in this holistic approach to patient care that occupational therapy has its true strength in helping to successfully remediate the difficulties of the patient with a hand problem. Practical application of this principle is shown in a case study.     

Occupational Therapy Services to Enable Liver Patients to Thrive Following Transplantation

ABSTRACT

Transplantation is the only viable treatment for end-stage liver failure. With advances in biomedicine and surgical technique, survival rates have improved and current research is beginning to focus on patient-related outcomes such as of quality of life (QOL) and life satisfaction. However, attention to the rehabilitation needs of those patients whose lives are saved, is lagging. Pretransplantation, there are serious strains to role function and limitations to mental and physical capacity. Following transplantation, the ability to perform once easy familiar tasks is difficult for a prolonged recovery period. Within a year many people do well, others do not. Little has been done for this latter group. The purpose of this article is to systematically describe the contributions occupational therapy can make to the people struggling with the challenges faced during the transplantation process. The first part presents a framework for understanding the impact of end-stage liver disease, then the transplant, and the subsequent recovery through the combination of two frameworks: the International Classification of Functioning Disability and Health (ICF) and the Model of Human Occupation. The second part of this article will present the implications for occupational therapists throughout seven stages: (1) decline in health, (2) organ failure, (3) referral for transplantation, (4) the waiting period, (5) the transplant surgery, (6) recovery, and (7) return of health. Attention to the needs of transplant recipients who lack the adaptive skills to resume productive lifestyles has the capacity to improve participation outcomes for this population.     

建设项目职业病危害预评价和控制效果评价

目的通过对同一建设项目职业病危害预评价和控制效果评价的对比验证,以提高评价水平。方法某项目控制效果评价检测结果与类比调查相同作业点检测结果进行比较,并将预评价与控制效果评价两个主要评价环节进行比较。结果控制效果评价检测结果电焊烟尘监测点合格率80%,噪声监测点合格率71.2%,化学毒物中有一监测点锰及其无机化合物浓度超标;类比调查与控制效果评价相同作业点的检测结果有差异;预评价与控制效果评价结论基本相同。结论评价单位应做好预调查;在进行类比时应注意工艺、作业方式和布局设置的异同;企业提供真实的资料;监督部门应加强监管。     

Occupational Justice as a Quality Indicator for Occupational Therapy Services

ABSTRACT

Although a key concept in occupational therapy theoretical documents, the issue of occupational justice continues to be elusive to the everyday practitioner. The purpose of this article is to outline a quality improvement project focused on the incorporation of occupational justice concepts into daily treatment. For the purposes of this quality improvement project, occupational justice was explored through practitioners' perceptions of clients' preparation to face societal, physical, and political barriers based on the occupational therapy services they received. Project participants were able to identify current utilization of these concepts, barriers to utilizing concepts, and potential avenues for incorporation of occupational justice into daily practice. This project demonstrates that quality improvement activities, driven by practitioners providing direct care, can enrich occupational therapy programs and lead to the inclusion of social justice practices in occupational therapy services.     

The Horse as a Modality for Occupational Therapy

The purpose of this paper is to discuss the use of a horse as a therapeutic activity in the treatment of persons with physical disabilities. Occupational therapists have traditionally used goal-directed activities for treatment to achieve for patient gains in functional independence, both in specific dysfunctions and in the holistic manner of the patient interacting with the environment. The motivation of the patient to partake actively in the therapy is seen as a significant factor in the outcome of treatment. Hippotherapy involves the active participation of the patient in specifically prescribed activities with goal-directed results. The horse and the riding ring provide a non-traditional setting which can increase motivation of the patient and be ideal for the development of perceptual-motor coordination and sensory integration. The effective treatment of physical dysfunction using a horse to facilitate positive functional changes in patients will be discussed.     

The Impact of Managed Care on the Practice of Occupational Therapy by Hand Therapists

Current Occupational Therapy (OT) literature on managed care is limited to opinion or anecdotal experience. Questionnaires were mailed to 214 OTs practicing as hand therapists nationwide to test the null hypothesis that there was no difference in reimbursement or barriers to practice for OT services between patients enrolled in managed care organizations and those enrolled in fee-for-service insurance plans. Statistically significant results were obtained indicating greater barriers to reimbursement for OT under managed care. The primary effect has been the increased administrative demands it places on both therapists and patients. [Article copies available for a fee from The Haworth Document Delivery Service: 1–800–342–9678. E-mail address: getinfo@haworth.com]     

某公司钽扩建项目职业病危害因素预评价

目的识别某公司钽扩建项目可能产生的职业病危害因素，并对控制效果进行评价。方法按照《建设项目职业病危害评价规范》要求，采用类比法和检查表法进行评价。结果该建设项目在生产过程中可能产生毒物、噪声和高温等职业病危害因素；类比检测结果显示：钽粉车间破碎室和混料室钽的短时间接触容许浓度分别为26．10、26．44mg／m^3，超过国家标准。还原、降氧和烧结车间的WBGT指数（湿球黑球温度）分别为26．1、25．9、25．4℃，为高温作业岗位；还原车间及操作室、降温车间、烧结车间、循环水站操作室等工作场所的噪声分别为84、72、81、82、66dB（A），符合国家标准。结论该项目属于职业病危害严重的建设项目。生产过程中可能产生的职业病危害因素是可以预防的，从职业卫生角度分析该项目是可行的。     

Student Recruitment and Selection for Occupational Therapy

The School of Occupational Therapy at the Cumberland College of Health Sciences has attempted to integrate the student recruitment and selection process with the curriculum objectives of a training programme for occupational therapists. This approach is based on the view that student selection is one component of a total interacting system of manpower development. The primary role of the occupational therapist and the skills required to fit that role were defined and used to rationalise a selection process aimed at producing an effective practitioner. There is a focus on increasing self selection by applicants. It is suggested that compulsory attendance at information sessions, personal/social factors assessed at interview and past academic record are effective measures for identifying students who would succeed in the occupational therapy curriculum. There is a need for further research in this area and the development of this selection process generates questions which may determine the direction of that research.     

职业性手外伤分布特征及预防

手外伤是常见的创伤之一.在我国,手外伤病例占全部创伤病例的比例较高.上海华山医院所在行政区手外伤的发生率约为4.5‰ [1];某医院在全年急诊病例中手外伤占全部创伤病例的34.42%[2].     

Examining Intraprofessional Competencies for Occupational Therapist and Occupational Therapy Assistant Collaboration

Abstract

This study examined competencies perceived by occupational therapists and occupational therapy assistants as important for intraprofessional collaboration. While interprofessional practice is well defined, less is known about collaboration within professions with varied levels of practice credentials. Occupational therapy practitioners (N?=?351) rated 20 competencies in four domains (Intraprofessional Teamwork, Roles/Responsibilities, Communication, and Values/Ethics) through an online survey. A high percentage of respondents perceived all competencies as important or very important. There were significant differences between occupational therapists and occupational therapy assistants in ratings of five competencies, including: seeking information/support from the team partner, flexibility for effective partnership, engagement in professional development for collaboration, communicating ideas, and providing feedback about performance. Outcomes contribute to understanding intraprofessional collaboration for occupational therapy practice. Competencies can serve as guidelines for education and professional development.     

Using Chaos Theory to Understand a Community-Built Occupational Therapy Practice

SUMMARY

Community-built occupational therapy programs interact with a wide range of systems. This interaction does not occur in an orderly manner, but in an unpredictable fashion. The use of chaos theory may help program developers understand actual and potential interactions that may occur. To illustrate the use of chaos theory, a case study is presented.     

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.