A strategy for supervising occupational therapy students at community sites

Within the field of occupational therapy various innovative strategies have been used to provide students with effective clinical education (fieldwork) opportunities. One of the more unusual strategies involves the student participating in a placement at a site where there is no occupational therapist and no well-defined role. The University of Alberta, Canada developed and piloted a new fieldwork supervisory position. Feedback was collected from both the sites and students to explore the impact of this position on the fieldwork experience for stakeholders. As well, sites and students were asked to give their opinions on more general aspects of these placements. Both sites and students positively endorsed the fieldwork educator for independent community placement's role. Most recommendations for improvement revolved around increasing the time dedicated to this position and making it permanent. Caution must be taken in generalizing the results of this study, as there may be various considerations that make this an appropriate supervision strategy in Alberta, Canada but not in other locations. Further research is required to determine whether this supervision strategy could be used with other students or professions in other locations.     

Chronic Fatigue Syndrome – an occupational therapy programme

The cause of Chronic Fatigue Syndrome (CFS) is as yet undetermined; therefore, precise definitions for diagnosis and research have been developed. The most accepted diagnostic criteria are detailed below. It has been suggested that there are 150 000 cases of CFS in the UK, with a 2:1 predominance of females to males, and that prognosis without treatment is poor. The patterns of illness seen in CFS are identified and the development of an occupational therapy programme for the management of CFS is described. Copyright © 1999 Whurr Publishers Ltd.     

Predischarge occupational therapy home assessment visits: towards an evidence base

Background/aim:  Predischarge home assessment visits are a commonly accepted, but little researched, aspect of occupational therapy practice. The aim of this research was to systematically investigate current predischarge occupational therapy home assessment visit practices in a rehabilitation ward of a regional Australian hospital.
Methods:  A retrospective chart audit was conducted over a 7-month time period and included 227 patients discharged from the inpatient rehabilitation ward at the study hospital.
Results:  Fifty-five per cent of patients in the study sample received home assessment visits. At least one recommendation for change was made as a result of the visit for 99% of those patients receiving visits. A total of 139 visits were completed and resulted in 1179 recommendations for change. The median number of recommendations made for the home assessment visits was 10 (range 0–33). The most common types of recommendations, timing of visits, persons present during the visit and documentation of visits were also investigated.
Conclusion:  Although occupational therapy home assessment visits are routinely completed, there is limited research available to provide evidence-based guidelines relating to predischarge occupational therapy home assessment visit practices. Recommendations for future practice and areas for further research into occupational therapy home assessment visits are discussed.     

Clients using community occupational therapy services: Sociodemographic factors and the occurrence of diseases and disabilities

Purpose: The aim of this study was to describe sociodemographic factors and the occurrence of diseases and disabilities among a representative sample of clients who were using community occupational therapy services in Norway. Method: A postal survey of occupational therapists about their last clients (n=168) was carried out in 2001. A survey questionnaire based on the International Classification of Functioning, Disability, and Health (ICF) was developed. Diagnoses were coded according to the International Classification of Primary Care (ICPC-2). Results: This study showed that more than half of the clients were adults, youths, or children. Only 17% of adults participated in “ordinary working life”, and of those approximately 10% were on sick leave and 62% were on disablement pension. A predominance of neurological diseases such as multiple sclerosis and Parkinson's disease was found (24%). Stroke was the most common principal diagnosis (19%). Musculoskeletal (16%) and mental diseases (13%) were also frequently reported. “Movement impairments” (96%) were most common in the body function component. Frequent problems in several domains of the activity and participation components were reported, in particular in “education, work and employment” (93–94%) and “recreation and leisure” (94%). Conclusion: Clients using community occupational therapy in Norway had numerous types of chronic and severe diseases, and a high occurrence of musculoskeletal impairment, activity limitations, and participation restrictions.     

Preparing students for practice in a changing community environment: an innovative course

This paper provides an overview of an innovative course in community occupational therapy. The course emphasises and prepares students for community practice in an environment profoundly affected by ongoing changes in Canada's health and social systems. Its rationale, objectives, structure, and content are outlined. In particular, the paper highlights the in vivo, problem-based component of the course, which centres around community-based fieldwork. A summary of the major results of the evaluation of the course is also presented. Although this course was designed for Canadian occupational therapy students, much of the material presented is potentially useful to educators of occupational therapy students in other countries. Copyright © 1996 Whurr Publishers Ltd.     

Conducting case study research in occupational therapy

Background:  Case study research has been used increasingly in psychology and sociology in recent years. It provides researchers with an opportunity to explore a situation involving one individual or several individuals over time from multiple points of view.
Methods:  This literature review explains case study research as a method and summerises its scientific merit, also providing an example of its use.
Results:  Case study research offers occupational therapists a scientific methodology that can be used to understand and develop occupational therapy practice.
Conclusion:  This paper argues that case study research should be used more extensively by occupational therapists as the method respects the basic principles of occupational therapy.     

Re-imagining occupational therapy clients as communities: Presenting the community-centred practice framework

Background: Occupational therapists’ are increasingly working with communities and providing services at the community level. There is, however, a lack of conceptual frameworks to guide this work.

Aim: The aim of this article is to present a new conceptual framework for community-centered practice in occupational therapy.

Material and Method: The conceptual framework was developed from qualitative multi-case research on exemplars of community participation. The first was, a network of Canadian food security programs, and the second, a rural Australian community banking initiative. Key themes were identified from across the case studies, and cross-case findings interpreted using occupational therapy and occupational science knowledge, and relevant social theory. The outcome is a four-stage, occupation-focused, community-centered practice framework.

Findings: The Community-Centred Practice Framework can be used by occupational therapists to understand and apply a community-centered practice approach. The four stages are: (1) Community Identity, (2) Community Occupations, (3) Community Resources and Barriers, and (4) Participation Enablement.

Conclusions: Further research is needed to trial and critically evaluate the framework, to assess its usefulness as a robust, occupation-focused, frame of reference to guide community-centered practice in occupational therapy.

Significance: The proposed framework should assist occupational therapists to conceptualize community-centered practice, and to utilize and apply theory.     

An evaluation of a problem‐based learning experience in an occupational therapy curriculum in the UK

The objectives of the study was to evaluate an adapted approach to problem‐based learning (PBL) on a pre‐registration Masters course in Occupational Therapy at the University of East Anglia in the UK. The adaptation, named placement PBL, required students to write and select the material based on their placement experiences, for the cohort's learning. The evaluation purpose was to determine the students' views of the efficacy of placement PBL for facilitating their learning in the final 3 months of their pre‐registration education. Placement PBL was evaluated using both questionnaires and focus groups, with two cohorts of students for data collection. Placement PBL was seen to provide current, relevant and complex learning scenarios that help students to move from a theoretical understanding to application of theory in the complexity of actual service situations. The authors conclude that placement PBL has the potential to prepare students for the transition from student to qualified practitioner. Both researchers were also the PBL tutors which may have affected the students' honesty in their feedback. Further research is indicated for ongoing evaluations of the effectiveness of PBL in helping students to become confident occupational therapy clinicians, and comparative studies with other learning approaches. Copyright © 2010 John Wiley & Sons, Ltd.     

Philosophy,science and ideology: a proposed relationship for occupational science and occupational therapy

This paper explores the interaction between the philosophy of occupational therapy, the science of occupation and the regional ideology of a specific geographical area, and proposes two models to depict the relationship. One model focuses on the interaction between daily occupational therapy practice in a specific geographical region and the international influences on that practice. The international influences include the effect of occupational science. The second model focuses on the relationship between the philosophy of occupational therapy, occupational science and regional ideology. It concludes by showing the importance of developing a global identity through the importation of knowledge from evolving sciences in industrialized countries at the same time as basic and applied knowledge is developed in the scientific community of a geographic region. Copyright © 2000 Whurr Publishers Ltd.     

Therapeutic factors in occupational group therapy identified by patients discharged from a psychiatric day centre and their significant others

Therapeutic factors in occupational group therapy have only been subjected to minimal investigation [AUTHOR –I'VE REWRITTEN THE FIRST SENTENCE AS THE ORIGINAL SOUNDED ODD IN ENGLISH. IS THIS OK?]. Previous research (Howe & Schwartzberg, 1986) indicated that these factors accord with factors recognized in group psychotherapy, but additional specific occupational therapy factors were distinguished as well. The aim of the present study was to examine factors in treatment identified by patients and their significant others as therapeutic. Interviews with 20 mentally ill individuals and 12 significant others were conducted when the patients were discharged from a psychiatric day-care unit. Four therapeutic dimensions emerged from an inductive analysis of statements from the interviews: the group, the occupational, the treatment milieu, and the individual therapy. The majority of the statements were categorized in the group or occupational dimension. Important factors of the group dimension were group interaction, talking in a group, and the therapist's attitude and behaviour. The group factors were consistent with factors previously identified in group psychotherapy research studies. Being occupied, being engaged in certain activities, and developing new skills were significant within the occupational dimension. Since knowledge of which factors are perceived as helping the patients is important a) future replication studies are needed to determine how the occupational dimension should be specified into therapeutic factors, and b) research is required that makes clear how interventions can be improved by such factors. Copyright © 1997 Whurr Publishers Ltd.     

The values of occupational therapy: Perceptions of occupational therapists in Quebec

Objective: Recently, there has been increasing interest in the values of occupational therapy and the values held by occupational therapists. A wide range of values has been reported in the literature. Furthermore, despite the fact that values are an important part of professional identity, empirical studies have demonstrated that several occupational therapists possess an ambiguous professional identity. This study was undertaken to explore the values of Canadian occupational therapists, specifically French-speaking occupational therapists in Quebec. Methods: Semi-structured interviews were conducted with 26 occupational therapists. Their narratives were subject to hermeneutic analysis, a method of textual analysis common in philosophical research. Results: A total of 16 values were identified in the discourses of the occupational therapists interviewed: autonomy; human dignity; occupational participation; social justice and equity; professionalism; holism; partnership, environment, or ecological approach; quality of life; solicitude; honesty; integrity; health; creativity; professional autonomy; effectiveness; and spirituality. Conclusions: The results of this study are, in general, consistent with those reported in the few other empirical studies that have documented the values perceptions of occupational therapists. Finally, the explanation of the values of occupational therapists may reinforce their professional identity and favour best, or at least desirable, professional practices related to ethics and culture.