Occupational Therapy Practitioners’ Knowledge and Perceptions of Childhood Asthma and Cystic Fibrosis

ABSTRACT

This study surveyed pediatric occupational therapy practitioners regarding their knowledge and perceptions about the chronic respiratory diseases (CRDs) asthma and cystic fibrosis which affect the functioning and quality of life for millions of children. Surveys were mailed to 250 members of the Ohio Occupational Therapy Association's pediatric member support group. Though 104 occupational therapy practitioners returned completed surveys, only the 82 who were currently practicing in pediatric settings were included in analysis. Respondents scored an average of 77% (SD = 10%) on a test of knowledge about asthma and cystic fibrosis. Respondents demonstrated several misperceptions about of the effects of these diseases on everyday life. A large majority (91%) endorsed one or more roles for occupational therapy with children with chronic respiratory diseases. Respondents indicated that confusion about the role of occupational therapy is a barrier to practice with children with CRDs. The results may prompt educational curricula to make adjustments, while continuing education courses may expand in addressing CRDs.     

Florida Farmworkers’ Perceptions and Lay Knowledge of Occupational Pesticides

Despite federal regulations, farmworkers often lack access to basic information about pesticides applied at their worksites. Focus groups revealed that farmworkers have developed an extensive body of lay knowledge, based on personal perceptions, about pesticides and pesticide exposure including means of pesticide exposure, means of pesticide entry into the body, and the potential health effects of pesticide exposure. We describe how this lay knowledge, when combined with technical information that is required to be provided to workers by law, provides valuable data to consider before developing and implementing health interventions designed to reduce the adverse health effects of pesticide exposure. Alfredo Bahena was formerly the Health and Safety Coordinator of the Farmworker Association of Florida in Pierson, Florida. Bahena assisted with the collection of much of the data presented in this article. Tragically, he was killed in a accident on April 18, 2004. This article is dedicated to his life and work. This study was supported by research grant R21-ES08766 from the National Institute of Environmental Health Sciences.     

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.     

Pharmacists’ Perceptions of Participation in a Community Pharmacy-Based Nicotine Replacement Therapy Distribution Program

The community pharmacy has been proposed as an ideal location for providing smoking cessation therapy to large numbers of patients. Studies of public health initiatives providing free nicotine replacement products through telephone quitlines have found increased call volumes and cessation rates. The purpose of this study was to evaluate a program where nicotine replacement therapy starter packs were provided to patients through community pharmacies at no cost. An online survey was developed to assess community pharmacists' participation in the program, perceptions of the initiative as a whole, and perceptions of smoking cessation counseling activities. Eighty-three pharmacists working at participating pharmacies completed the survey (65% response rate). Ninety-nine percent of pharmacists provided smoking cessation counseling during the study period; the median (IQR) number of patients counseled over the initial 3.5-months of the NRT distribution program was 50 (24-100), and the median number of minutes per counseling session was five (3-7). Most (89%) agreed smoking cessation counseling was accommodated into the pharmacy work-flow. A majority (85%) agreed the community pharmacy is an ideal location for distributing free NRT products and that the program should be replicated in other pharmacies (78%). Participating pharmacists viewed the program positively and perceived it to be effective in helping patients quit smoking. In conclusion, the community pharmacy is a viable location for implementation of community-based public health initiatives related to smoking cessation.     

Physicians’ Reactions to Patients Taking a Position: Sequence Analysis of Admission Interviews in Orthopedic Rehabilitation

Little is known about how patients influence health care providers’ communication behavior, although this knowledge may contribute to the understanding of the reciprocal influence of patient and provider communication and the pathways between communication and health care outcomes. Therefore, the aim of this study was to explore patients’ active communication behaviors and how this affects the immediate communication behavior of physicians. We coded 27 admission interviews from three German orthopedic rehabilitation centers with an adapted version of the Roter Interaction Analysis System. The data were analyzed using correlations and sequence analysis, specifically lag analysis. In this article, we report findings in relation to patients taking a position and physicians’ reactions. The analysis showed that while all patients took up a position during their consultation, they very rarely contradicted the physician. Moreover, many instances of patients’ expression of opinion were strongly determined by physicians’ behavior. When physicians asked patients for their opinions they often used alternative questions or closed questions that limited patients’ answering possibilities. While the lag analyses showed that patient communication behavior can influence physician communication, in the majority of instances patients’ expression of opinions did not lead to a discussion or shared decision making.     

Latina Mothers’ Perceptions of Healthcare Professional Weight Assessments of Preschool-Aged Children

To understand Latina mothers’ definitions of health and obesity in their children and perceptions of physician weight assessments. 24 low-income Spanish speaking Mexican mothers of children ages 2–5 years were recruited to participate in 4 focus groups. Half of the mothers had overweight or obese children and half had healthy weight children. Focus group comments were transcribed and analyzed using grounded theory. Themes and supporting comments were identified independently by 3 reviewers for triangulation. A fourth reader independently confirmed common themes. Mothers define health as a function of their child’s ability to play and engage in all aspects of life. Obesity was defined with declining physical abilities. Mothers state health care provider assessments help determine a child’s overweight status. Causative factors of obesity included family role-modeling and psycho-social stress, physical inactivity, and high-fat foods consumed outside the home. Controlling food intake was the primary approach to preventing and managing obesity but mothers described family conflict related to children’s eating habits. These findings held constant with mothers regardless of whether their children were overweight, obese, or at a healthy weight. Mothers utilize physical limitations and health care professional’s assessment of their child’s weight as indicators of an overweight status. These results highlight the importance of calculating and communicating body mass indices (BMI) for Latino children. Eliminating non-nutritive foods from the home, increasing physical activity, and involving family members in the discussion of health and weight maintenance are important strategies for the prevention and management of childhood obesity.     

Hearing Loss and Older Adults’ Perceptions of Access to Care

We investigated whether hard-of-hearing older adults were more likely to report difficulties and delays in accessing care and decreased satisfaction with healthcare access than those without hearing loss. The Wisconsin Longitudinal Study (2003–2006 wave, N = 6,524) surveyed respondents regarding hearing, difficulties/delays in accessing care, satisfaction with healthcare access, socio-demographics, chronic conditions, self-rated health, depression, and length of relationship with provider/site. We used multivariate regression to compare access difficulties/delays and satisfaction by respondents’ hearing status (hard-of-hearing or not). Hard-of-hearing individuals comprised 18% of the sample. Compared to those not hard-of-hearing, hard-of-hearing individuals were significantly more likely to be older, male and separated/divorced. They had a higher mean number of chronic conditions, including atherosclerotic vascular disease, diabetes and depression. After adjustment for potential confounders, hard-of-hearing individuals were more likely to report difficulties in accessing healthcare (Odds Ratio 1.85; 95% Confidence Interval 1.19–2.88). Satisfaction with healthcare access was similar in both groups. Our findings suggest healthcare access difficulties will be heightened for more of the population because of the increasing prevalence of hearing loss. The prevalence of hearing loss in this data is low and our findings from a telephone survey likely underestimate the magnitude of access difficulties experienced by hard-of-hearing older adults. Further research which incorporates accessible surveys is needed. In the meantime, clinicians should pay particular attention to assessing barriers in healthcare access for hard-of-hearing individuals. Resources should be made available to proactively address these issues for those who are hard-of-hearing and to educate providers about the specific needs of this population.     

Emotional Intelligence,Self-Efficacy,and Occupational Therapy Students’ Fieldwork Performance

ABSTRACT

This study explored the relationship of emotional intelligence level and self-efficacy to fieldwork performance for occupational therapy students. Occupational therapy students (n = 199) from 36 occupational therapy programs in the United States completed the two surveys, the Mayer-Salovey-Caruso Emotional Intelligence Test and the Student Confidence Questionnaire, during their professional Level 2 fieldwork placements. The surveys were compared to the Fieldwork Performance Evaluation for the Occupational Therapy Student completed by the fieldwork educators. Results showed that degree of emotional intelligence, having a choice in the fieldwork setting, and having professional experience in a related setting were positively correlated to Fieldwork Performance scores. Students’ self-efficacy was not related to Fieldwork Performance scores. This suggests fostering students’ emotional intelligence and capacity for accurate skill appraisal supports fieldwork success.     

Parents’ Perceptions of Causes of and Solutions for School Violence: Implications for Policy

This study explores perceptions of causes of and solutions for school violence in a sample of 202 parents interviewed in the wake of nationally publicized school shootings. We also investigate the effects the school shootings had on children, parents’ perceptions regarding firearms, and changes in parenting behavior. Parents exhibited strong support for almost all proposed causes and solutions, and we address their desire for immediate and often invasive interventions to prevent future violence. We contrast parents’ perceptions with their own parenting behaviors and with literature on effective interventions. Results are discussed within the context of policy implications. Editors’ Strategic Implications: Parents’ perceptions and behaviors are frequently influenced by history effects. The national attention received by school shootings provided an opportunity for exploration of those perceptions and self-reported behaviors. The authors provide evidence from timely surveys that parents struggle with identifying causal factors that may contribute to school violence and consequently support a myriad of strategies for intervention including very invasive environmental preventive strategies. The findings suggest that social scientists should play a proactive role in translating research-supported preventive strategies to effective replications in the community and make research available in formats that are available and comprehensible by the lay public.     

Women Professional Progress to Chef’s Position: Results of an International Survey

Many researchers argue that gender is a cultural construction rather a natural one. Haute Cuisine and the culinary field is a good illustration to how gender influenced the evaluation and the recognition of the cooking task in two different spaces, the professional and domestic. To analyze the reasons behind the low number of women chefs, we run a survey that targeted professionals in the cooking field. It included both gender and participants from Europe and USA. The survey results confirm the main argument that women are under-represented due to the masculine culture of kitchen work and culinary industry. Women therefore need to deal with it and to keep developing themselves professionally in order to achieve their place. A change in the industry dynamics will assess the barriers encountered in general by all professionals. The same change should impact household arrangements to facilitate women’s evolution in the professional sphere.     

Evaluating Two Health Care Facilities’ Ability to Meet Health Literacy Needs: A Role for Occupational Therapy

ABSTRACT

Many clients have difficulty understanding health information, which may lead to less use of preventive services, greater use of hospital emergency services, poor physical and mental health, and an increased risk of death. Therefore, the objective of this article is to present a review of the accessibility of a rehabilitation center and an independent living facility with regard to navigation of the facility, understandability of written and oral communication, use of technology, and implementation of policies and procedures within these facilities. Findings from the reviews identified areas for improvement for both facilities in navigation as well as written and oral communication. Recommendations to the facilities are discussed for revision of signage and written and oral communication. Implications for occupational therapy practitioners, including establishment of best practices for health literacy and providing consultation for other health care professions, are highlighted. Possible future research is explored regarding evaluation of the effectiveness of the intervention.     

Ministers’ Perceptions of Church-Based Programs to Provide Depression Care for African Americans

African Americans, compared with white Americans, underutilize mental health services for major depressive disorder. Church-based programs are effective in reducing racial disparities in health; however, the literature on church-based programs for depression is limited. The purpose of this study was to explore ministers’ perceptions about depression and the feasibility of utilizing the church to implement evidence-based assessments and psychotherapy for depression. From August 2011 to March 2012, data were collected from three focus groups conducted with adult ministers (n = 21) from a black mega-church in New York City. Using consensual qualitative research to analyze data, eight main domains emerged: definition of depression, identification of depression, causal factors, perceived responsibilities, limitations, assessment, group interpersonal psychotherapy, and stigma. A major finding was that ministers described depression within a context of vast suffering due to socioeconomic inequalities (e.g., financial strain and unstable housing) in many African American communities. Implementing evidence-based assessments and psychotherapy in a church was deemed feasible if principles of community-based participatory research were utilized and safeguards to protect participants’ confidentiality were employed. In conclusion, ministers were enthusiastic about the possibility of implementing church-based programs for depression care and emphasized partnering with academic researchers throughout the implementation process. More research is needed to identify effective, multidisciplinary interventions that address social inequalities which contribute to racial disparities in depression treatment.     

Health Care Students’ Attitudes Towards Working with Sexual Health in Their Professional Roles: Survey of Students at Nursing,Physiotherapy and Occupational Therapy Programmes

The aim of this study was to explore differences and similarities in health care students’ attitudes towards working with and communicating with patients about sexual health issues in their future professions. The aim was also to explore whether the students’ gender, age and future professions were influencing factors and whether there was a change in attitude depending on educational levels, gender, age and future professions. The study also aimed to explore the potential development of those differences and similarities in attitudes between health care students having achieved different levels of education and training in their future professions. A cross-sectional quantitative study was performed with an online survey distributed to nursing, occupational therapy and physiotherapy students. The students believed that they needed increased sexual health education and increased communication skills about sexual health. Gender and future profession are factors that significantly affect the attitudes of the students towards working with sexual health. Nursing and occupational therapy students have a more positive attitude towards addressing sexual health in their future professions than do physiotherapy students. Further research is needed in this field to improve competence in sexual health for all student groups, particularly physiotherapy students. Further research is also needed to explore the significance of gender regarding education in sexual health and attitudes towards working with sexual health.     

Parents’ Perceptions of Water Safety and Quality

Every day parents make choices about the source of water their families consume. There are many contributing factors which could affect decisions about water consumption including taste, smell, color, safety, cost, and convenience. However, few studies have investigated what parents with young children think about water quality and safety in the US and how this affects the choices they are making. This study aimed to describe the perceptions of parents with regard to water quality and safety and to compare bottled water and tap water use, as well as to examine motivation for water choices. We conducted an online questionnaire to survey parents living in Pennsylvania about water quality and safety, and preference for bottled versus tap water. Parents were recruited through child care centers, and 143 surveys were returned. The survey results showed high overall scores for perception of tap water quality and safety, and a preference for tap water over bottled water. We found that parents were concerned for the environmental impact that buying bottled water may have but were also concerned about potential contamination of tap water by natural gas drilling processes and nuclear power plants. These findings regarding parental concerns are critical to inform pediatric health care providers, water sellers, and suppliers in order that they may provide parents with the necessary information to make educated choices for their families.     

The Effectiveness of Two Implementation Strategies for Improving Teachers’ Delivery of an Evidenced-based HIV Prevention Program

Prevention Science - Effective implementation strategies are needed to enhance the success of evidence-based prevention programs. The current study evaluates the effects of two implementation...     

Professional experience and ergonomic aspects of midwives’ work

Objectives

The most frequent manner of attending childbirth imposes on midwives assuming poor body position affecting the musculoskeletal system. Long professional experience does not mitigate the negative effects. The adopted movement habit, as well as the type, number and frequency of actions influence the body posture. The aim of the study was to identify ergonomic threats of basic occupational midwives activities and how particular spinal segments arrangements while attending childbirth using the same technique in senior midwives differ from those of junior ones. It was also checked whether pain influences the working position assumed by midwives.

Materials and Methods

Examinations were conducted in 95 midwives aged 21?C50 (X = 29.25±9.34): 51 graduates of BSc midwifery who worked 680 h in delivery rooms during obligatory practical classes and apprenticeship and 44 senior midwives with professional experience of 7?C27 years (X = 14.84±5.98). The study was threefold. The spinal alignment while performing work activities associated with attending childbirth was assessed using the OWAS system and the SonoSens Monitor, the center of gravity projection on basal plane ?? using the AccuGait AMTI stabilometric platform. The measurements were taken during a simulation of attending childbirth (on examination model). A survey was conducted aimed at identifying spinal pain.

Results

Midwives?? working postures require unnatural body alignments. Postural instability in the working position and no maximal usage of basal plane were observed. The work overload may afflict the musculoskeletal system, which was confirmed by different pain discomforts in 67.3% of the examinees.

Conclusions

Spinal alignment while attending childbirth is individually differentiated and in every case non-ergonomic. Identifying explicitly spinal overloads is difficult, but the most prevalent ones affect lumbar and cervical regions altogether. Spinal pain is frequently noted, both in junior and senior midwives, and is characteristic for midwives working in maximal movement ranges.     

Stability of children’s insurance coverage and implications for access to care: evidence from the Survey of Income and Program Participation

Even as the number of children with health insurance has increased, coverage transitions—movement into and out of coverage and between public and private insurance—have become more common. Using data from 1996 to 2005, we examine whether insurance instability has implications for access to primary care. Because unobserved factors related to parental behavior and child health may affect both the stability of coverage and utilization, we estimate the relationship between insurance and the probability that a child has at least one physician visit per year using a model that includes child fixed effects to account for unobserved heterogeneity. Although we find that unobserved heterogeneity is an important factor influencing cross-sectional correlations, conditioning on child fixed effects we find a statistically and economically significant relationship between insurance coverage stability and access to care. Children who have part-year public or private insurance are more likely to have at least one doctor’s visit than children who are uninsured for a full year, but less likely than children with full-year coverage. We find comparable effects for public and private insurance. Although cross-sectional analyses suggest that transitions directly between public and private insurance are associated with lower rates of utilization, the evidence of such an effect is much weaker when we condition on child fixed effects.