Employment trends for occupational therapists: An analysis of employment advertisements in the Sydney Morning Herald 1984–90

Despite rapid growth in the number of occupational therapy graduates in Australia, almost no data are available concerning the demand and the expectations of employers. This study surveyed 6298 advertised positions available to occupational therapists, social workers, psychologists and counsellors in the state of New South Wales during the years 1984–90. Over this period the demand for occupational therapists grew by 53%, which exceeded the growth in demand for social workers and psychologists, but was less than that for community and mental health workers and counsellors. The employment base was found to be reasonably broad and 8% of jobs were in the private sector. The number of duties required of occupational therapists increased over time, and there was an increase in the demand for programme promotion, administration and supervision skills. The results are discussed in terms of the employment base and defining strengths of the profession, recommendations for strengthening the profession, and implications for the Australian Association of Occupational Therapists.     

Reliability of the Perceive, Recall, Plan and Perform System of Task Analysis: A criterion-referenced assessment

Objective:  To conduct preliminary examination of the rater and test-reliability of the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis, an ecological measure designed to assess task-embedded information processing capacity during occupational therapy assessment of confused and agitated adults following traumatic brain injury.
Methods:  Occupational therapists observed and scored client performance using the PRPP System of Task Analysis. Correlational analysis and measures of agreement were performed to determine interrater and intrarater reliability. Test procedures were examined for reliability and internal consistency.
Results:  Interrater and test reliability considered three factors: therapists, clients and tasks. A moderate level of interrater reliability was achieved between trained therapists (intraclass correlation coefficient (ICC) = 0.60). Test procedures were highly reliable (ICC = 0.88). Across two measurement occasions, therapists showed a tendency towards harder rating on the second test occasion (      –4.5%; 95% confidence interval for     : –10.67%→ 3.17%).
Conclusion:  The findings of this study support the use of criterion-referenced tests in the area of occupational performance measurement. Occupational therapists achieved moderate interrater reliability when measuring the performance of adults with brain injury on various activities of daily living. Test procedures were found to be highly reliable in measuring the occupational performance of adults demonstrating confusion and agitation typical to the stage of post-traumatic amnesia following head injury.     

Hospice and palliative care: A Delphi survey of occupational therapists' roles and training needs

This paper describes the use of the Delphi survey method to identify the roles and training needs of occupational therapists working in the field of hospice and palliative care in Australia. The study was conducted in 1993 using a purposive sample of 47 occupational therapists. The survey consisted of three consecutive questionnaires and five in-depth interviews. The results indicated that there is a role for occupational therapy in this new and expanding field, and that occupational therapists need to promote a higher profile for their profession and their skills through research, education and presentations to maximize this role. The study also highlighted the importance of continuing education for occupational therapists working in this field.     

Practical strategies for working with indigenous people living in Queensland,Australia

Internationally, occupational therapists have recognized the need to provide culturally appropriate services for indigenous people. This study explored experiences, perspectives and practical strategies of occupational therapists working with Aboriginal and Torres Strait Islander people living in rural and remote areas of Queensland, Australia. Semi-structured interviews were conducted with eight occupational therapists who had at least 12 months' experience providing services to Aboriginal and Torres Strait Islander people in health, rehabilitation or education services. Key themes identified in the data focused on strategies for facilitating effective communication with individuals and families, and collaborating with other service providers. The role of Aboriginal Liaison Officers or Indigenous Health Workers was emphasized by participating therapists. Participants identified resources that they perceived as useful in their practice, such as cross-cultural training and access to indigenous health workers. Other resources suggested for further development included information about learning styles of indigenous people and information about cultural variations between specific Aboriginal and Torres Strait Islander communities. The small number of participants limits generalizability of the findings. However, therapists can decide on the relevance of strategies to their own workplaces. Suggestions for further research focused on improving occupational therapy services for indigenous people in Australia. These include an investigation of therapy goals with indigenous people, and interviews with indigenous Australians and indigenous health workers about their experiences and perceptions of occupational therapy.     

1982 Sylvia Docker Lecture Occupational Therapists must be Facilitators not Inhibitors of Action

After briefly reviewing the lecturer's 30 years as an occupational therapist, the proposition is discussed that occupational therapists are lucky people because of the role they have played and must continue to play as active people in professional associations and in the community. The need to extend therapists influence more widely in the community both as members of their own profession and of multidisciplinary teams is discussed. Reference is made to new and different areas of concern in South Australia in which occupational therapists have been and are actively involved.     

Occupational therapy in palliative care: Is it under‐utilised in Western Australia?

Aim: To explore potential barriers to occupational therapy in palliative care in Western Australia, as perceived by occupational therapists and other health professionals. Method: A qualitative research methodology was used. Semi‐structured interviews were conducted with 10 occupational therapists and 10 health professionals (including a physiotherapist, a social worker, medical registrars and clinical nurses). Interviews were transcribed verbatim and analysed using content analysis. Results: The four main themes identified were: inconsistent understanding of the contribution that occupational therapists can make to palliative care, insufficient promotion of the potential contribution of occupational therapy, insufficient funding, and limited research on the role of occupational therapy in palliative care. Conclusion: This study provides an understanding of the barriers that have limited occupational therapists’ involvement in providing palliative care in Western Australia.     

Understanding where we come from: Occupational therapy with urban Indigenous Australians

Background:  This article outlines issues of service provision for Indigenous families in Brisbane, Australia. It presents guidelines for the development of a socially and culturally appropriate occupational therapy service for urban Indigenous children.
Methods:  A mixed methodology was used in two independent components of the research. Part 1 comprised a survey of paediatric occupational therapists in Brisbane. Part 2 consisted of focus groups and interviews with recipients of a newly established occupational therapy service for Indigenous children.
Results:  Survey findings indicated that very few Indigenous families access mainstream occupational therapy services. Issues and strategies for developing culturally appropriate practice emerged around five main themes. These were the need to develop effective relationships, develop particular personal qualities, understand the background of both the client and the therapist, both gain and give knowledge, and address logistical issues of service delivery.
Conclusions:  Service providers need to understand the social and cultural context of both their Indigenous clients and themselves. Recommendations for future education and practice are provided.     

Perceptions of occupational therapists practising in rural Australia: A graduate perspective

Background:  The difficulty in recruiting and retaining health professionals into rural and remote areas of Australia is well recognised. This study explored the perceptions of occupational therapists practising in rural locations regarding the essential skills necessary for rural practice and the ability of undergraduate education to prepare them for rural practice.
Methods:  A qualitative study using a phenomenological approach was conducted using semistructured in-depth interviews. Participants included occupational therapists who were graduates of James Cook University, who were practising in rural areas in Queensland and Victoria, and academic staff.
Results:  This study demonstrates that it is important for universities to develop both a mindset in their graduates for rural practice, as well as developing broader skills in addition to core discipline-specific skills. While subjects developing core occupational therapy skills are at the centre of undergraduate education, the importance of developing a broader understanding of rural health issues and skills in public health, primary health care and health promotion was emphasised.
Conclusion:  The development of specific skills to become competent rural practitioners and to cope with the challenges of rural practice can be strengthened through initiatives at the undergraduate level. Ongoing commitment from all universities across Australia to include rural curriculum content has the potential to improve recruitment and retention of occupational therapists and other health professionals into rural Australia.     

A comparison of Canadian and Australian paediatric occupational therapists

Paediatric occupational therapists were surveyed regarding their practices in Canada and Australia. Two hundred and eighty-nine Canadian occupational therapists and 330 Australian occupational therapists participated representing response rates of 28.9% and 55% respectively. The majority of respondents were female (98%), between 30 and 49 years of age (69%), had a bachelor's degree, worked on average 10.5 years in paediatrics and spent well over 50% of their work time in direct client care. The largest client diagnostic groups in both countries were those with developmental delays, learning disabilities and neurological disorders. Diagnostic groups were used as an organizing framework to portray theory, assessment and intervention use. Overall, the theoretical models cited most frequently in both countries were: Sensory Integration, Sensory Processing/Sensory Diet, Client-Centred Practice, and Occupational Performance Model. Australian therapists employed the Occupational Performance Model (Australia) for all groups, while it was rarely utilized in Canada. Common assessment tools in both Australia and Canada were the Peabody Developmental Motor Scales, Developmental Test of Visual Motor Integration, and the Bruininks-Oseretsky Test of Motor Proficiency. Intervention methods focused on: parental/care-giver education; activities of daily living/self-care skills training; client education; environmental modification; assistive devices; sensory integration techniques; sensory stimulation and sensory diet treatment methods; and neurodevelopmental techniques.     

Issues affecting Australia's rural occupational therapy workforce

ABSTRACT: The unequal distribution of health workers across Australia in favour of urban areas affects the provision of effective health services to rural and remote communities. Additional pressures on the current and future supply of occupational therapists may arise from a restructuring of the health labour force and demographic changes in the age structure of the population. Projections made on the basis of these data indicate that employment growth for occupational therapists will create a demand for 9600 therapists in 2005, or 79.9% more than the number of occupational therapists employed in 1994. Factors such as reductions in the level of immigration and the number of people of working age, and a diminishing population of school leavers to fill student places in universities will make it difficult to meet the projected demand for occupational therapists. Occupational therapy labour force planning suffers from a lack of detailed data on under-serviced areas. Such data are critical for clarifying the magnitude of the projected discrepancy between future demand and supply needs for occupational therapists in rural and urban areas in Australia.     

Housing adaptations from the perspectives of Swedish occupational therapists

Abstract

Aim: The aim of this study was to investigate how occupational therapists in Sweden administer housing adaptation cases, how they perceive the housing adaptation process, and which improvements they consider necessary. Methods: A total of 1 679 occupational therapists employed by the county councils or the local authorities (and involved in housing adaptations) participated in a web-based survey. The survey targeted issues related to referral and needs identification, assessment, certification, case progress feedback, and evaluation. Results: Less than half of the occupational therapists systematized the assessment prior to intervention and very few conducted any evaluation afterwards. Feedback from workmen or grant managers to the occupational therapists on each case's adaptation progress was often asked for but rarely given. The majority of the participants were satisfied with the housing adaptation process in general, while at the same time they indicated a need for further improvements in the process. Differences between occupational therapists related to employer and year of graduation were found on the majority of the targeted issues. Conclusions: To conclude, to a very large extent housing adaptations seem to be based on non-standardized procedures for assessment, and only a few of them are evaluated systematically.     

Fine motor difficulties: The need for advocating for the role of occupational therapy in schools

Background:  Fine motor difficulties can impact on the academic, social and emotional development of a student.
Aim:  The aims of this paper are to: (i) investigate the need for support to students experiencing fine motor difficulties from the perspective of their classroom teachers, and (ii) report on the level of knowledge teachers have in regard to the role of occupational therapists in supporting students with fine motor difficulties.
Methods:  Fifteen teachers from a stratified random sample of public schools within two regions of Victoria, Australia, were interviewed in this qualitative, grounded theory investigation.
Results:  Results showed that the current level of support for students with fine motor difficulties is inadequate.
Conclusion:  Occupational therapists in Victoria need to advocate their role in developing the fine motor skills of students at both an organisational and an individual level in order to increase the access of students with fine motor difficulties to occupational therapy services.     

The Domain of Concern of Swedish Occupational Therapists Working in Psychiatric Care

As a consequence of the development of psychiatric care in Sweden, occupational therapists have adapted their roles to changing practice settings. The aim of this study was to investigate the domain of concern of occupational therapists in psychiatric care, operationalized as perceived responsibilities. Furthermore, the relationships of the domain of concern to underlying theories and models, clinical supervision, intervention strategies, and organization of the care were investigated. Data were collected by a mail questionnaire to occupational therapists working in psychiatric care with a response rate of 67%, in all 334 occupational therapists. A factor analysis revealed six domain-of-concern areas. The three most prominent factors were ADL, housing and leisure, Psychosocial dysfunction, and Work and studies, which confirmed that occupational therapists' focus is on the patient's occupational performance skills as well as the environment that supports or hinders the patient's performance. The occupational therapists were using a broad range of underlying theories and models as well as intervention strategies and several relationships to domain-of-concern factors were found. This study gave an overall view of the occupational therapists' domain of concern, but there is also need for a more detailed and thorough understanding of how occupational therapists define their domain of concern, which calls for more qualitatively oriented in-depth studies.     

Professional accreditation of occupational therapy educational programs: A bright or embattled future?

As Australia introduces a new system of individual accreditation through the program for individual accreditation of occupational therapists, there is a need to also consider the place and scope of specialised educational program accreditation in the maintenance of professional standards. The present article reviews issues relating to educational program accreditation including: the need for accreditation and its tradition in occupational therapy; types of accreditation and stakeholders involved; accreditation processes; and evidence of effectiveness. It suggests that professional association demands of programs and the accreditation processes used for audit and inspection must be relevant and reasonable in order to be considered credible and necessary by all stakeholders. Standards and professional accreditation processes that do not demonstrate that they are relevant and reasonable will face an embattled future. Those that do provide mechanisms for true quality improvement through relevant, well-conceived processes should have a bright future in a world seeking benchmarks for quality in professional preparation programs.     

Learning from the past,looking to the future: Exploring our place with Indigenous Australians

This paper aims to explore ways in which we as occupational therapists in Australia can participate in enabling a different and better future for all Australians. In doing so, it is necessary to explore our history and our cultures, both individually and collectively as a profession, and to understand the ways in which these shape who we are and what we do. As occupational therapists, we have valuable knowledge and skills that have the potential to contribute in a positive way to the health and educational outcomes of Indigenous Australians. As a profession operating in Australia, we also have a responsibility to reach this potential. This paper aims to present some of these contributions and to provide examples of practical and culturally safe ways in which we can take action.     

Four years after graduation: Occupational therapists' work destinations and perceptions of preparedness for practice

Objective:  The present study sought to identify the work destinations of graduates and ascertain their perceived preparedness for practice from a regional occupational therapy program, which had been specifically developed to support the health requirements of northern Australians by having an emphasis on rural practice.
Design:  Self-report questionnaires and semistructured in-depth telephone interviews.
Participants:  Graduates ( n =  15) from the first cohort of occupational therapists from James Cook University, Queensland.
Main outcome measure:  The study enabled comparisons to be made between rural and urban based occupational therapists, while the semistructured interviews provided a deeper understanding of participants' experiences regarding their preparation for practice.
Results:  Demographic differences were noted between occupational therapists working in rural and urban settings. Rural therapists were predominantly younger and had worked in slightly more positions than their urban counterparts. The study also offered some insights into the value that therapists placed on the subjects taught during their undergraduate occupational therapy training, and had highlighted the differences in perceptions between therapists with rural experience and those with urban experience regarding the subjects that best prepared them for practice. Generally, rural therapists reported that all subjects included in the curriculum had equipped them well for practice.
Conclusions:  Findings suggest the need to undertake further research to determine the actual nature of rural practice, the personal characteristics of rural graduates and the experiences of students while on rural clinical placements.     

Factors influencing job satisfaction among Jordanian occupational therapists: a qualitative study

Purpose: The main purpose of this study was to explore factors influencing job satisfaction and dissatisfaction among Jordanian occupational therapists. Methods: Ours was an explorative qualitative study involving the use of structured open‐ended written questions. Participants were asked to answer in narrative their perception about the factors behind their job satisfaction and dissatisfaction. In addition, they were asked to express their suggestions, ideas, or solutions for increasing job satisfaction. Results: Ninety‐three occupational therapists responded to the survey. For job satisfaction questions, four themes emerged: a humanistic profession; professional issues; work benefits; and work environment. Participant’s comments at the end of the survey revealed one general theme for improving job satisfaction, ‘a call for improvement’. Discussion: This qualitative study revealed that the humanistic nature of occupational therapist was counterbalanced by several dissatisfying factors for occupational therapy practitioners in Jordan. The need for better supported working conditions in terms of financial rewards, recognition, awareness and resources as well as public and professional recognition of occupational therapists are needed to enhance the occupational therapy profile in Jordan. A comprehensive collaboration is highly needed between the individual practitioners, representatives of the profession, government and hospital administrators.     

Icelandic occupational therapists' attitudes towards educational issues

The purpose of this study was to assess the readiness of occupational therapists in Iceland to accept a professional as opposed to a technical view of the profession. Most Icelandic occupational therapists were educated in other countries, with little emphasis on liberal arts, sciences and research. The first Icelandic occupational therapy programme, a university-level programme, was founded in 1997. All Icelandic occupational therapists were surveyed. Eighty-seven questionnaires were sent out and 80 (92%) were returned and used for statistical analysis. The results of the study showed that Icelandic occupational therapists valued academic skills over technical skills, emphasizing occupational therapy theory unique to the profession and research to validate practice. More recognition among other health professionals was considered the most needed change in the profession. The results of the study showed that the clinicians' attitudes confirmed in general what is emphasized in the curriculum and in students' fieldwork. Further research is needed to explore whether the Icelandic occupational therapy profession succeeds in promoting research and recognition by other health professions.