Occupational Therapy in Health Care

Social critics have been writing with increasing frequency about the dramatic changes that we are beginning to experience in our society. Economic, political, scientific/technical and social forces are all combining to reshape and restructure our world. Many traditional institutions will change in response to these transformations in society. In particular, the health care system as we know it today is expected to be radically different by the end of this decade. This paper presents a view of the future of health care as specialists move from a mechanistic, cause-effect orientation to a systems view of human problems. Occupational therapy's readiness and willingness to assume new roles in patient care is evaluated. Finally, strategies for dealing with new clinical puzzles are discussed.     

Occupational Therapy Care of Rheumatic Disease Patients

The purpose of this evaluation was to determine if the level of independence achieved in self-care, home, and community skills at time of discharge from an inpatient occupational therapy program was maintained up to one year post-discharge. With the use of a structured interview form, a trained volunteer telephoned patients at three, six, and twelve months post-discharge. Of the 363 patients followed, 86% and 97% reported that they maintained or increased their levels of independence. This suggests that there was effective carryover of functional skills into the home and community.     

The Role of Occupational Therapy in Palliative Care

The purpose of this paper is to define the role of occupational therapy in palliative care, to describe the services currently available in the metropolitan area of Perth, Western Australia, and to make recommendations for the extension of occupational therapy services in the area of palliative care. The literature regarding occupational therapy in palliative care is reviewed; The results of interviews with occupational therapists and patients currently involved in palliative care are analysed; and the recommendations for future services are offered.     

Deinstitutionalisation of Occupational Therapy and Health Care Administrators Knowledge

Administrators of 100 Brisbane health care agencies were surveyed about their level of knowledge of traditional and nontraditional roles of occupational therapy and other allied health professions. Administrators were found to have reasonable levels of knowledge of the allied health professions, poor knowledge of occupational therapy, and very low levels of knowledge of the nontraditional roles of occupational therapy. Lack of health care administrator awareness of occupational therapy is a barrier to the transition of the profession from institutionally based models of practice to working in community health settings.     

Ethical Dilemmas Encountered by Community-based Occupational Therapists in Home Care Settings

This study of occupational therapists practising in the field of gerontology was conducted to determine the subjects' conception of Instrumental Activities of Daily Living (IADL). and current practice in relation to assessment and treatment of their clients. A survey method was used to obtain data from 135 practising occupational therapists. The results showed that many of the subjects were unfamiliar with the term “instrumental activities of daily living.” In addition, the study showed that occupational therapists actually did spend a considerable portion of their practice time in the area of IADL, reporting that the most common tasks for intervention were meal preparation, light housework, transportation, shopping and use of the telephone. When reporting on methods and accuracy of assessment procedures, subjects agreed that “observation of performance” and standardized assessment tools were the most accurate forms of assessment. With the rapidly ageing population, and government policy for keeping people in their own homes for as long as possible. IADL is set to become a significant part of occupational therapy (OT) evaluation and intervention.     

Occupational Therapy in the Intensive Care Unit: A Systematic Review

This paper is a synthesis of the available literature on occupational therapy interventions performed in the adult intensive care unit (ICU). The databases of Ovid MEDLINE, Embase, the Cochrane Library, ClinicalTrials.gov and CINAHL databases were systematically searched from inception through August 2016 for studies of adults who received occupational therapy interventions in the ICU. Of 1,938 citations reviewed, 10 studies met inclusion criteria. Only one study explicitly discussed occupational therapy interventions performed and only one study specifically tested the efficacy of occupational therapy. Future research is needed to clarify the specific interventions and role of occupational therapy in the ICU and the efficacy of these interventions.     

Occupational Therapy

Occupational therapists prevent dysfunction and maintain and restore function for people with HIV/AIDS in the areas of work, selfcare and play/leisure. These occupational areas are assessed and treated from psychosocial, physical and environmental perspectives. This article examines occupational therapy assessment and treatment for people with HIV/AIDS with the primary focus on adaptive equipment, energy conservation, habits and time management, and work.     

居家护理

美国人常用Home Care，而英国人常称Domiciliary Care，是指向住在家里的病人提供的医护（Healthcare）或辅助性护理（支持性护理。Supportive Care）。（Domiciliary的词汇意义就是“在住所提供的，在家里进行的”。）网络上，“Home Care”有“家庭护理”，“居家照护”。“家庭看护”等不同译文，但从这种护理的特征来看，译为“居家护理”可能更合适。     

Occupational Risk Factors for Blood and Body Fluid Exposure Among Home Care Aides

This cross-sectional study of home care aides examines self-reported occupational exposure to blood and body fluids to determine if factors that place these workers at risk can be identified. Home care aides working for two agencies in the Chicagoland area were surveyed. A total of 62 (6.3%) of the home care aides reported instances of blood and body fluid exposure either via sharps or mucous membrane contact. Although few aides reported performing health care-related tasks such as colostomy care, caring for a urinary catheter, or bowel stimulation (which were outside their scope of duties), those who did were significantly more likely to experience blood and body fluid exposure (p ≤ .01). Level of assistance needed by clients in tasks such as feeding, laundry, and transportation was also found to be significantly associated with blood and body fluid exposure (p ≤ .01). These data highlight the importance of, and need for, home care aid training in the use of universal precautions.     

Stress Management as a Component of Occupational Therapy in Acute Care Settings

The recent explosion of stress literature in the medical community has created a new awareness of "stress" as a potentially destructive force in itself. Contributing the physical and psychological dysfunction, stress has now been linked with a wide range of diagnoses including cancer, cardiac disease and arthritis. The importance of incorporating stress management activities into daily life is increasingly apparent. Occupational therapists concerned with patients' ability to achieve health enhancing independent living skills are in a key position to help patients master stress management skills and incorporate them into activities of daily living. This article will explore the incorporation of stress management into occupational therapy programming for a variety of acute care patients. It will review the components of stress, the stress cycle, the relaxation response, the occupational therapy role based on a model of human occupation, and will review current programs through case study of four patients: one diagnosed with cancer (leukemia), one with anorexia nervosa, one with chronic pain and the fourth, a patient in medical intensive care.     

Effectiveness of an Occupational Therapy Home Programme in Spain for People Affected by Stroke

The main aim of this paper is to assess the effects of an occupational therapy home programme in Spain on 23 people who had had stroke (mean age 61.17 years). The programme was made up of a set of activities and techniques of physical, cognitive, social and functional nature aimed at preventing, maintaining and/or rehabilitating the abilities affected of people who had had stroke. A multiple‐baseline intrasubject design and replication with a treatment withdrawal period to check whether the effects of the programme remained was applied. The results show a significant statistical improvement, concerning not only the participants' cognitive skills through Loewenstein Occupational Therapy Cognitive Assessment Battery – Second Edition but also their functional independence as assessed by the Barthel Index. Despite the low number of participants, being one of the limitations of our study, the results support the need to carry out research about the effectiveness of rehabilitation treatments in the home with the goal to plan how public healthcare systems should tackle them and how to improve those already being used. Copyright © 2014 John Wiley & Sons, Ltd.     

Home Intravenous Therapy

No abstract available for this article.     

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]