Occupational therapy with people with depression: Using nominal group technique to collate clinician opinion

Aims. This aim of this study was to obtain a consensus from clinicians regarding occupational therapy for people with depression, for the assessments and practices they use that are not currently supported by research evidence directly related to functional performance. The study also aimed to discover how many of these assessments and practices were currently supported by research evidence. Methods. Following a previously reported systematic review of assessments and practices used in occupational therapy for people with depression, a modified nominal group technique was used to discover which assessments and practices occupational therapists currently utilize. Three online surveys gathered initial data on therapeutic options (survey 1), which were then ranked (survey 2) and re-ranked (survey 3) to gain the final consensus. Twelve therapists completed the first survey, whilst 10 clinicians completed both the second and third surveys. Major findings. Only 30% of the assessments and practices identified by the clinicians were supported by research evidence. A consensus was obtained on a total of 35 other assessments and interventions. These included both occupational-therapy-specific and generic assessments and interventions. Principle conclusion. Very few of the assessments and interventions identified were supported by research evidence directly related to functional performance. While a large number of options were generated, the majority of these were not occupational therapy specific.     

Occupational therapists as object users: A critique of Australian practice 1954–1995

This research sought to identify the conventions and expectations that guide Australian occupational therapists' use of objects, and to critique these against professional beliefs and values. A history of ideas methodology was used to analyse the content of a sample of issues of the Australian Occupational Therapy Journal, spanning 42 years. This revealed that therapists have been strongly influenced by mechanistic thinking, with a resultant focus on biomechanical, neurological and functional aspects of object use, which has excluded consideration of the client's subjective experience of using objects and the symbolic meaning of the objects used. The centrality of assistive devices, splints and formal assessments to occupational therapists' identity and professional development is also identified. Current practices are critiqued as inconsistent with respecting clients' dignity and worth.     

搏动性心室辅助装置Excor治疗儿童终末期心衰

目的:评价应用气动外置式搏动性心室辅助装置(VAD)Excor(Berlin Heart AG)治疗儿童终末期心功能衰竭(ESHF)的可行性。方法:1990年至2003年 12月共55例儿童ESHF患者接受Excor心室辅助治疗。结果:6例(10．91％)心功能恢复后撤离辅助装置, 23例(41．82％)过渡到心脏移植,26例(47．27％)死亡。平均辅助时间(28．0±8．1)天,最长辅助天数421天。结论:Excor作为中、长期搏动式VAD,可辅助ESHF儿童患者向心脏移植或心功能恢复过渡。     

作业疗法对复发性抑郁症疗效的观察

目的探讨作业疗法对复发性抑郁症患者的治疗效果。方法将82例复发性抑郁症患者随机分为治疗组(42例)和对照组(40例)。治疗组在日常药物治疗的基础上使用作业疗法进行合理情绪治疗,对照组仅进行相应的药物治疗及一般的康复治疗。于治疗前后分别用汉密尔顿抑郁量表(HAMD)、临床疗效总评量表(CGI-GI)评定疗效,1年后随访。结果治疗42天后,两组的HAMD量表评分自治疗1周后均有有显著性差异,至6周差异最为显著,P0.05,CGI-GI评分比较自第4周后出现显著性差异,P0.05;治疗结束后,研究组及对照组总有效率分别为95.23%和90.0%,两组比较差异无显著性,P0.05;显效率为78.6%和52.5%,两组比较有显著性差异,P0.05。一年后复发率治疗组为7.14%,对照组为22.5%(χ2=3.87,P0.05)有显著性差异。结论作业疗法对复发性抑郁症患者是一种有效的康复治疗方法,能降低复发率。     

Creating Occupational Therapy: The Challenges to Defining a Profession

The creation of a new profession in the early 20th century, such as occupational therapy, required a commitment to certain ideas and a willingness to accept certain challenges. This study examines the commitment to the idea of therapeutic and health supporting occupation by the early leaders and proponents of the profession and the challenges they faced in gaining acceptance of occupational therapy as a profession capable of delivering a valued health care service to society. Six challenges are reviewed as they occurred in the history of the profession and as they continue to challenge the profession into the present era.     

基于发明专利的全球心室辅助装置技术创新态势研究

目的:研究全球心室辅助装置(VAD)领域的发明专利,分析揭示技术创新态势,为VAD领域的研发提供信息支撑.方法:采用专利分析方法,从技术创新时间趋势、技术创新热点、技术创新国家和地区以及主要竞争对手等角度,对智慧芽专利数据库收录的VAD发明专利进行分析,揭示VAD领域的发展态势.结果:VAD领域目前共有发明专利申请11...     

Occupational therapy adaptation of the home environment in Sweden for people with asthma

The purpose of this study was to evaluate changes of lung function, respiratory symptoms and indoor air quality after reducing allergens and indoor pollutants in the home environment of people with asthma (n = 21). A quasi-experimental pre-/post-test design with one group of participants was implemented. The interventions included removal of wall-to-wall carpets (n = 14) or improvement of indoor air exchange (n = 7). Participants' lung function, symptoms, medication and type-1 allergy were recorded before and after the intervention. The indoor environment was monitored at house calls by an occupational therapist using conventional physical, biological and chemical methods. There was an improvement of lung function evidenced by an increased mean Forced Expiratory Volume (FEV(1) %) and a reduction of airway obstruction (reversibility, % of baseline value), which indicate an improved asthmatic condition. Lung function assessed by vital capacity, bronchial hyper-responsiveness, mean of Peak Expiratory Flow, symptom score and medicine consumption did not change significantly. There was a tendency that the amount of airborne dust (p=0.06) was reduced in the indoor environment. Relative humidity, carbon dioxide, formaldehyde and house dust mite levels had decreased after the intervention, but not significantly. Asthma symptoms related to the home environment are probably caused by several factors. When people with asthma suffer from increased symptoms in the home, house calls should be performed routinely. Dust samples from beds and carpets for analysis of allergens give information about exposure, and environmental assessments should be performed before interventions. Occupational therapists can make a valuable contribution in evaluating the home environment and suggesting ergonomic adaptations for individuals with asthma.     

Occupational therapy and early intervention: a family-centred approach

The purpose of this study was to identify factors that encourage or inhibit family-centred practice in the occupational therapy intervention process. A qualitative paradigm using grounded theory methodology was utilized to gather and analyse data. Participants included six families and four occupational therapists. Data analysis from the family interviews identified six categories: education, communication, relationship, parental roles, follow through, and scheduling. With further analysis two central themes of time and support were extracted from these categories. Analysis of the occupational therapists' interviews revealed six categories: education, communication, relationship, sibling/family participation, follow through, and empowerment. The central themes emerging from these categories are time and natural routine. The themes obtained from the families and occupational therapists were then compared and family individuality was identified as the core concept. Viewing families as a unique entity is necessary to assist occupational therapists in providing the most effective family-centred occupational therapy.     

心力衰竭患者左心室辅助装置传动系统感染的研究进展

左心室辅助现已成为终末期心力衰竭患者的主要外科治疗策略,在提高心力衰竭患者存活率的同时,常导致一些严重的并发症。心室辅助装置特异性感染,特别是传动系统感染,是心室辅助患者术后常见并发症。生物膜的形成和迁移促进感染向泵腔和血流等更深层次组织的扩散,为后续治疗增加难度,甚至会危及患者生命安全。本文从心室辅助装置传动系统感染的流行病学特征、致病机制、诊断,以及预防和治疗方面的现状进行综述。     

Homelessness: Perspectives,Misconceptions, and Considerations for Occupational Therapy

SUMMARY

Like poverty, the problem of homelessness has been with us to varying degrees since the founding of our nation. Attempts to explain homelessness have an equally long history. Hence, the literature and popular media are home to divergent perspectives, explanations, and characterizations of homelessness. The objectives of this paper are to present a unifying taxonomy of prominent perspectives on homelessness, and to illustrate how various perspectives lead to particular characterizations of persons who become homeless. The taxonomy traces the connection between perspectives and interpretations of the problem and helps to illuminate implicit and often unexamined assumptions about who becomes homeless and why. Critical examination of these perspectives is vital because our individual and collective understanding of homelessness is a powerful determinant of how we approach occupational therapy practice with this population. Implications for community practice and program planning for individuals and families in homeless shelters are also discussed.     

Negotiating Occupational Identities while Living with Chronic Rheumatic Disease

The purpose of this study was to explore everyday occupation for five persons living with chronic rheumatic disease. Data were collected through qualitative interviews, followed by participant observations in the subjects’ homes. The data were analysed using a qualitative comparative approach, followed by an interpretation of the results based on narrative theory. Four themes were identified from the analyses: (a) the continuing challenges of everyday occupational life, (b) activities anchored to personal occupational history, (c) everyday occupations mediating personal meaning, and (d) activities involving suspense or unpredictability. The results showed that everyday occupation was a challenge for the participants, as their illness caused considerable variation in pain and functional abilities. This influenced the subjects’ ability to perform occupations of everyday life. Their individual occupational history was closely interwoven with their everyday life and served as the foundation for their way of managing the situation. The everyday occupations of the subjects also served as mediators of their personal values and interests, and they made changes following these issues, not as anticipated due to their changing functional condition. The narrative structure of occupation was found to provide the subjects with opportunities to manage issues concerning their identity and created high-level negotiating skills. Processes of negotiating occupational identities in the subjects’ everyday life are presented and discussed, and may add new knowledge to occupational therapy and occupational science, as well as generating further research questions.