Constructing a Program Development Proposal for Community-Based Practice: A Valuable Learning Experience for Occupational Therapy Students

SUMMARY

Skills required to develop and fund programs can advance an occupational therapist professionally, and innovative occupation-based programs are necessary for the future of occupational therapy. This paper describes a community-based learning experience embedded within the occupational therapy curriculum of the Medical College of Ohio. While developing the Program Development Proposal, each student practices needs assessment; marketing; goals- and objectives-setting; occupation-based programming; budgeting; staffing; program evaluation; and grantsmanship. Outcome surveys of graduates indicate that the experience was positive and provided graduates with a solid foundation for program development. The experience also enhanced partnerships with community-based sites.     

Service Learning in an Occupation-Based Curriculum: Student Commentary

Recent trends toward occupation-based practice and the move toward masters-level occupational therapy (OT) education has forced OT educators to reevaluate their programs to meet the needs of the contemporary health care environment. Service learning is one way to bridge the gap between theory and practice. The Master of Occupational Therapy (MOT) Program at Cleveland State University (CSU), in keeping with its focus on occupation, incorporates three service-learning components into its curriculum. This paper, written by a second-year MOT student at CSU, discusses two of these experiences in depth. The first, which took place at a homeless shelter, included both a didactic and “clinical” component, with an emphasis on community-based mental health OT services. The second, which included a training component and a structured program, involved co-leading after-school social-emotional learning groups for low-income urban youth. Both experiences served to expand the clinical skills and reasoning of the MOT students while introducing both the students and agencies to the role of OT in non-traditional community settings. Based on these experiences, the author highly recommends that all masters-level OT programs should, if they have not done so already, institute service learning as a core component of their curricula, in order to prepare their students for contemporary OT practice.     

Occupational Therapy Intervention: Effects on Self-Care,Performance, Satisfaction,Self-Esteem/Self-Efficacy,and Role Functioning of Older Hispanic Females with Arthritis

ABSTRACT

The purpose of this pilot study was to compare the effectiveness of occupation-based and enabling/preparatory interventions on self-care, perceived performance, satisfaction, self-efficacy, and role function among older Hispanic females with arthritis. A pre- and post-outcome measures design with semi-structured interview and questionnaire/rating scales was used with matched participants assigned to one of two intervention groups or a control, non-intervention group. For measures of task-specific functioning and self-efficacy, there were no statistically significant differences in average gain scores between the two interventions. Average gain scores were higher for the enabling/preparatory intervention than for the control group. For the occupational intervention, the scores were higher than for the control group for self-care/activities of daily living (ADL) functioning and self-esteem/self-efficacy. The results suggest that client-centered occupational therapy intervention provided within the home environment is beneficial for occupational performance, participation, role competence, and quality of life.     

Culturally responsive care in occupational therapy: an entry-level educational model embedded in service-learning

Objective: This study focuses on the design of an entry-level educational model of culturally responsive care in occupational therapy embedded in service-learning (CRCOT-SL) that is perceived as clear, relevant, evidence-based, and useful by occupational therapy educators. The purpose of the model is to guide OT educators in teaching students to enable occupational participation and social inclusion in cross-cultural encounters. Method. The design consisted in defining the areas of the model and the components of each area, and articulating the learning process embedded in service-learning. A formative evaluation of CRCOT-SL was then performed using survey methods to collect feedback from 30 OT educators regarding the clarity, relevance, evidence-based constructs, and usefulness of CRCOT-SL. Results: CRCOT-SL was perceived to be clear, relevant, evidence-based, and useful to 81.5% of the OT educators who participated in the study. Minor modifications to the model were completed based on the educator’s feedback. Conclusions: CRCOT-SL is intended to respond not only to the dynamic, multicultural, and diverse environments in which practitioners currently practice but to the future needs of a global community facing social, political, economic, and environmental issues that will continue to affect dramatically people’s living conditions and occupational needs.     

Relationships between occupational therapy students’ understandings of disability and disability attitudes

Abstract

Background: Entering occupational therapy (OT) students have established beliefs, informed by sociocultural backgrounds. Understanding how students define and understand disability, and the relationships these understandings have to disability bias, can guide curriculum design decisions to integrate meso and macro level perspectives of disability into clinical reasoning.

Aim/Objective: This study’s aim was to explore incoming occupational therapy students’ (n?=?67) understandings of disability and their attitudes towards it.

Material and method: An online survey was used to collect data on students’ attitudes and definitions of disability. Mixed research methods were used to analyze students’ definitions of disability (content analysis) in relation to disability attitudes (Disability Attitudes Implicit Association Test).

Results/Finding: Findings reveal students enter curriculums with vast differences in understandings of people with disabilities and these may provide a basis for and contribute to differences in attitudes of disability.

Conclusions: OT students have established beliefs of disability as individualized or more socially constructed and these influence disability biases.

Significance: Students’ education has considerable influence in shaping attitudes and ways of interacting with people with disability. Understanding students’ assumptions as they enter a program is a first step to evaluate how curriculum design may influence development of student clinical reasoning strategies.     

The Use of Experiential Learning in an Occupational Therapy Program: Can it Foster Skills for Clinical Practice?

ABSTRACT

This paper examines the effectiveness of the integration of experiential learning opportunities near the end of the occupational therapy students’ didactic education. Using a pretest–post-test questionnaire, journaling, and feedback from a focus group, results suggested that there was a significant improvement in occupational therapy students’ self-perception of their ability to perform a multitude of occupational therapy-related skills. The development of professional skills was also seen in the provision of client-centered care during occupational therapy interventions. Although clinical reasoning skills were enhanced, results indicated that it had a large impact on the students’ professional growth and development.     

Mindfulness and human occupation: A scoping review

Background: Mindfulness is an emergent construct with implications for our understanding of approaches to engagement in human occupation. Little is known about how mindfulness is being applied and what its possibilities are in the occupation-based disciplines.

Objective: The purpose of this scoping review was to summarize, describe, and identify gaps in the existing literature on mindfulness in relation to human occupation.

Material and Method: A scoping review, guided by Arksey and O’Malley’s methodological framework was undertaken. The initial search yielded 929 articles; 20 articles met the criteria for inclusion. Articles included peer review and gray literature published in English between 2006-2016. Articles addressed mindfulness in OT or OS and included the terms ‘human occupation’, ‘occupational therapy’ and/or ‘occupational therapist’, and ‘mindfulness’ and/or ‘meditation’ or ‘yoga’.

Findings: The qualitative thematic analysis identified an overarching theme of mindful occupation, with 5 sub-themes including occupational presence; occupational awareness; occupational engagement; occupational well-being; and occupational fulfillment.

Conclusions and Significance: The findings have important implications for practice, education, theory and research. Future directions should focus on more depth and breadth of empirical research about mindful engagement in human occupation that can be used to implement and evaluate mindfulness in occupation-based theory and practice.     

Making use of research: Clinical views on an evaluation of everyday technology use

Objective: The study aim was to investigate how and when an evaluation of perceived difficulty in use of everyday technology (Everyday Technology Use Questionnaire, ETUQ) could be used in clinical occupational therapy. Method: Eight focus-group interviews were undertaken with a total of 42 participants (occupational therapists), and data were analysed with a constant comparative approach. Results: The findings are presented in four main categories, including (i) appropriate purposes and contexts for using ETUQ, (ii) standardization versus individual flexibility, (iii) approaching everyday technology use and occupation as one whole, and (iv) synthesizing and documentation. Conclusions: In conclusion, the participants considered ability to use technology to be an important topic for occupational therapy, particularly in investigations of clients with subtle disabilities and in connection with discharge from hospital – but not in inpatient care. They had different views on how to integrate ETUQ with evaluations of occupational performance, and new ideas on how information about clients’ ability to use technology could be utilized in interventions. They held standardized evaluations in high regard, but a paradox appeared in that many of them would use ETUQ in a non-standardized way, while simultaneously asking for a standardized output to be used in clients’ medical files and to guide interventions.     

Longitudinal Outcomes of an Alcohol Abuse Prevention Program for Urban Adolescents

PurposeThis randomized clinical trial examined longitudinal outcomes from an alcohol abuse prevention program aimed at urban youths.MethodsStudy participants were an ethnically and racially heterogeneous sample of early adolescents, recruited from community-based agencies in greater New York City and its environs. Once they assented to study participation and gained parental permission, youths were divided into three arms: youth intervention delivered by CD-ROM (CD), the same youth intervention plus parent intervention (CD_P), and control. Once all youths completed baseline measures, those in CD and CD_P arms received a computerized 10-session alcohol abuse prevention program. Parents of youths in the CD_P arm received supplemental materials to support and strengthen their children's learning. All youths completed postintervention and annual follow-up measures, and CD- and CD_P-arm participants received annual booster intervention sessions.ResultsSeven years following postintervention testing and relative to control-arm youths, youths in CD and CD_P arms reported less alcohol use, cigarette use, binge drinking, and peer pressure to drink; fewer drinking friends; greater refusal of alcohol use opportunities; and lower intentions to drink. No differences were observed between CD and CD_P arms.ConclusionsStudy findings lend support to the potential of computerized, skills-based prevention programs to help urban youth reduce their risks for underage drinking.     

The Occupation-Based Intervention of Bathing: Cases in Home Health Care

Abstract

Although bathing skills can be an indicator of long term placement, documentation of occupational therapists doing bathing as an occupation-based intervention is limited. Five clients were referred to a hospital-based home health agency with various diagnoses and at different levels of functioning. Each client was assessed at admission and discharge using the Outcomes and Assessment Information Set and the occupational therapists used the Activities of daily living (ADL) of bathing as the intervention based on client centered expressed needs. Findings reveal a statistically significant change in individuals pre- and post-assessment of bathing (Z?=?–2.032, p?=?.042) supporting occupation-based interventions, specifically bathing, should be further researched as a means of significantly improving the functional status of clients.     

Occupation-based intervention in hand injury rehabilitation: Experiences of occupational therapists in Malaysia

Introduction: In a previous study consensus was sought from Malaysian occupational therapists of occupation-based intervention (OBI) that was perceived as a means and an end. Occupation as a means refers to occupational and purposeful tasks as a therapeutic agent while occupation as an end refers to occupation as an outcome of intervention. The purpose of this follow-up study was to describe the occupational therapists’ experiences of providing OBI in hand injury rehabilitation in Malaysia. Methods: Sixteen occupational therapists with more than five years of experience in hand rehabilitation were individually interviewed on their experiences of using OBI in practice. Data were thematically analysed using interpretative phenomenological analysis. Results: Definition of “Occupation as a means”, and “Occupation as an end” was broadened after data analysis of interviews to include two new themes: “Rewarding yet challenging” and “Making OBI a reality”. Occupational therapists had positive experiences with OBI and perceived that occupation as a means and an end can be merged into a single therapy session when the occupational therapists use an occupation that is therapeutic. Conclusion: Although occupation as a means and as an end have different purposes, when the ultimate goal is to enhance the clients’ maximum level of functioning both can be used for successful rehabilitation of hand injuries.     

Service Learning: The Process of Doing and Becoming an Occupational Therapist

ABSTRACT

The purpose of this phenomenological study was to explore the perceptions and experiences of entry-level occupational therapy students participating in a service-learning experience designed to provide preventive occupation-based social skills groups to low-income urban youth attending after-school care. Reflective journals and focus groups were used to study how the students made sense of their experience. Qualitative data analysis resulted in six major themes revealing the process of professional growth over the eight-weeks. Professional reasoning progressed from mechanical procedural reasoning to flexible forms of conditioning reasoning. Findings emphasize the critical role of active participation in real-life contexts on learning how to become an occupational therapist. Study findings provide a discussion about the possibilities of preparing future occupational therapy practitioners to address society's occupational needs in emerging practice areas.     

Group leader and participant perceptions of Balancing Everyday Life,a group-based lifestyle intervention for mental health service users

Abstract

Background: There exist few recovery and occupation-based interventions for mental health service users. Balancing Everyday Life (BEL) is a new occupation-based lifestyle intervention that was created to fill this need.

Aim: To gain group leaders’ and participants’ perspectives of the BEL intervention content and format, including factors that helped, hindered, and could be improved.

Methods: A constructivist grounded theory method guided data collection and analysis. Interviews took place with 12 BEL group leaders and 19 BEL participants from out-patient psychiatry settings and community-based day centers in Sweden.

Results: BEL’s structure and content were appreciated, yet flexibility was desired to adapt to participant needs. BEL could act as a bridge, helping participants connect with others, and to a more engaged and balanced everyday life. Facilitating factors included a person-focused (versus illness-focused) approach, physical and emotional environments, and connection. Barriers included room resources. More sessions were desired for the intervention.

Conclusion: Group leaders and participants experienced BEL as a useful tool to instigate meaningful change and connection in the participants’ lives. The combination of a positive person-focused approach and group support was appreciated. These results could inform future research, evaluation, and development of occupation-focused lifestyle interventions for mental health service users.