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.     

The Utilization of Occupational Therapy Services for Persons with Charcot-Marie-Tooth Disease

ABSTRACT

The purpose of this study was to investigate the utilization of occupational therapy services in persons with Charcot-Marie-Tooth (CMT) disease, to better understand if services are being provided, the types of interventions being provided, and satisfaction of services. Using survey methods, an online questionnaire was made available to persons with CMT listed on association websites worldwide. One hundred and fifteen persons with CMT, residing in all geographical regions within the United States and seven other countries participated in the study. Around half of all participants had received occupational therapy services. Twelve interventions were identified as being provided for persons with CMT. Although the majority of individuals receiving occupational therapy services did not feel like it improved their quality of life, the majority of individuals would recommend occupational therapy services to others and would return to an occupational therapist. Of those participants not receiving occupational therapy, the majority felt they would benefit from occupational therapy services. The results suggest that occupational therapy services are not being well utilized for this population. A low response rate limits generalization, thus further research is necessary.     

Living with Chronic Pain: A Dynamic Learning Process

This study focuses on how patients describe and manage their pain in their everyday life. The data consist of interviews with 37 patients undergoing treatment for chronic pain. The study focuses on how experiences of pain are mediated and interpreted with the help of the individual's discursive resources. It is argued that this kind of resource is important in constituting a structure of relations between a suffering person, pain and context. In the analysis of the material a four-step procedure was used, including both formal and content-related aspects. It was found that the patients describe chronic pain as a dynamic phenomenon. Patients learn about their pain by actively constituting relations among themselves, the pain and their activities. For the patients, chronic pain is a structured phenomenon. Patients often describe how pain is initiated, worsens and is alleviated. Patients thereby learn to distinguish different figures in their pain, which they are able to relate to in their management of pain. This suggests that a life in pain could be seen as an apprenticeship process. The heart of the matter in this process is learning to become sensitive to and flexible towards variations in the pain and potential pain triggers in the environment. This knowledge is important, as mastering pain is a balancing act between inner resources and environmental circumstances.     

Mothers in Recovery: An Occupational Perspective

The purposes of this study were to discover the stories of mothers regarding their journeys to addiction and through recovery, to explore the impact of addiction on the occupational performance of mothers and to identify the factors perceived by these mothers as important in their treatment. A narrative inquiry with thematic analysis of data was utilized; semi‐structured interviews were conducted with 10 women in treatment for alcohol or other drug addiction who were all mothers of minor children. Alterations in occupational identity, occupational performance patterns and performance capacity were revealed. Environmental elements contributing to addiction and those important in recovery were identified and included structure (or the lack of it) and the persons populating the social environment. This qualitative study is not generalizable and should be viewed as relevant to these informants in this context; participants had histories of chronic substance addiction and are not representative of all addictions patients. Findings can be viewed within the context of other research to help enrich the reader's understanding of the complexity of issues. Further research is recommended to test the efficacy of occupational therapy interventions for substance addictions. Possible intervention studies might include those focused on environmental structure, exploration of interests in treatment and co‐occupations of mother and child. Copyright © 2011 John Wiley & Sons, Ltd.     

Negotiating Identities in Everyday Life: Adolescent fans of talent shows in Ireland and Austria

This article examines the ways in which TV talent shows engage with adolescent audiences. The discussion is set against the backdrop of textual analyses of reality TV, many of which claim that the structure of the shows promote a neo-liberal agenda, and it revolves around the extent to which the norms and values expressed in the shows are taken up by socially situated audiences. Based on a comparative study of teenage viewers in Ireland and Austria, we examine three levels of audience engagement with the shows; the social context of viewing, normative discourses and, identity-positioning. On each of these levels we found that viewers' meaning- making was strongly influenced by their everyday life experiences and that the negotiation process resulted not only in the reproduction of neo-liberal values, but also in tensions, contradictory positions, and challenges to the neo-liberal agenda.     

Prevalence of Chronic Diseases and Occupational Injuries and their Influence on the Health-Related Quality of Life Among Farmers Working in Small-Farm Enterprises

Objectives: This study aimed to determine the prevalence of chronic diseases and occupational accidents and injuries, and to examine their association with the quality of life among a sample of Iranian farmers.

Methods: A cross-sectional study was conducted among 736 male farmers. Data on the prevalence of chronic diseases and occupational accidents and injuries was collected using an author-developed questionnaire, and the SF-36 questionnaire was used to obtain information on quality of life.

Results: The prevalence of chronic diseases was 96.1%. Musculoskeletal diseases (MSDs), eye diseases and neurology diseases were the most prevalent diseases. Almost half of the farmers (42.7%) had experienced an occupational accident during the last 12 months and cuts and fractures accounted for the most frequent injuries. Sick leave was reported by 28.2% of the farmers and from those with history of accidents, 21.4% were hospitalized. A significant association was found between age and education level with quality of life. Most of the chronic diseases showed a significant and inverse association with quality of life, however, the strongest association was found for MSDs and mental disorders. Furthermore, the most important injury associated with quality of life was cuts and fractures.

Conclusions: Based on the results, MSDs, mental disorders, and cut and fractures were the main determinants of the farmers’ quality of life. Hence, a better quality of life among farmers is especially dependent on eliminating ergonomics risk factors leading to developing musculoskeletal disorders, improving psychosocial work climate, and promoting occupational and personal safety culture.     

职业病患者生活状况及满意度的综合评估分析

目的　了解职业病患者生活状况及个人生活满意度 ,为今后做好职业病防治工作提供参考依据。方法　采用复合式调查法 ,对职业病患者的生活状况及个人生活满意度进行综合评估分析。结果　职业病患者心理异常表现主要有焦虑、抑郁等情绪障碍 ,患者对生活、医疗保障要求明显高于其它人群。结论　大力推行以养老、失业、工伤、医疗保险为主要内容的社会保障体系 ,是解决职业病患者后顾之忧的根本途径     

Determinants of Occupational Disease Incidence in Mexico Alvaro

Most occupational health researchers have studied individual determinants, tending to forget those causes that are universally present. To explore some determinants of occupational disease incidence in Mexico, the authors carried out an ecological study with data from 32 Mexican states. Using ordinary least squares regression, they explored associations between occupational disease incidence and the Gini coefficient, the percentage of small and median enterprises, and migration. Income inequality and the combined percentage of small and median enterprises were negatively associated with the incidence of occupational disease. In Mexico, the "population strategy" of the prevention of occupational disease suggests that big enterprises' contexts are related to a higher occurrence of occupational diseases. Further studies using multilevel approaches are needed to establish whether these occupational diseases are related to exposures present in big or in small and median enterprises.     

上海市原浦东新区2004—2010年慢性职业病发病情况分析

[目的]掌握上海市原浦东新区各类慢性职业病发病情况,分析发病规律,为制定职业病防治对策、措施和职业卫生监督管理提供依据。[方法]收集2004—2010年职业病报告卡,根据职业病目录进行分类后采用Excel表进行汇总分析。[结果]尘肺病特别是电焊工尘肺居原浦东新区慢性职业病病例之首,其次为铸工尘肺和苯中毒病例;船舶制造、机械加工和铸造企业为目前职业病病例高发单位;职业病病例数特别是电焊工苯中毒和噪声聋等病种有增长趋势;国有企业、私营企业和外资企业的慢性职业病发病人数占据前三位;实际接触工龄大部分为5年以上。[结论]2004—2010年各类慢性职业病病例主要为国有企业、私营企业、外资企业中的船舶制造、机械加工和铸造等用人单位的尘肺病、慢性职业中毒和职业病耳鼻喉口腔疾病,应进一步加强存在粉尘、有机溶剂、噪声等重点单位、重点岗位、重点人群的监督检查,同时加强宣传培训和教育指导,完善职业健康监护制度,切实保障广大劳动者的职业健康权益。     

2007-2009年内江市职业病防治工作现状分析

目的了解和掌握内江市2007-2009年职业病防治工作现状,为下一步开展职业病防治工作提供依据。方法对内江市2007-2009年健康危害因素信息系统报告资料进行统计分析。结果 2007-2009年内江市职业健康检查率为47.4%,疑似职业病患者检出率为1.47%;职业病危害因素监测率为81.2%,合格率为65.1%;职业病病例为392例,其中尘肺病例占95.2%（373/392）,煤炭行业的尘肺病病例占所有病例的87.1%（325/373）。结论内江市职业健康检查率、职业病危害因素监测合格率低于《国家职业病防治规划（2009-2015年）》60%和80%的要求,尘肺病是内江市的主要职业病。     

What is important to patients in palliative care? A scoping review of the patient’s perspective

Background: The research conducted in palliative care is often medically oriented. There are few studies clarifying the patient’s preferences, priorities and desires in palliative care. The occupational therapy research conducted mostly concerns occupational therapy interventions based on the profession’s experiences. Further knowledge is needed regarding what patients in palliative care want to prioritize.

Aim: The aim was to describe what patients in palliative care describe as important at the end of life.

Methods: A scoping review was conducted using the inclusion criteria: articles published in 2004-August 2015; written in English; participants?>18 years with life-threatening illness without possible cure; focusing on the patient’s experience.

Results: Seventeen articles were included in the review and they were based on interviews. The theme ‘Continuing occupational participation is important for people at the end of life’ was identified. This included five sub-themes: maintaining previous occupational patterns; feeling needed; being involved in the social environment; leaving a legacy; and living as long as you live.

Conclusions: The results show that continued occupational participation is important for people in palliative care. Occupational therapists can contribute to this by taking a highly person-centered approach and gaining information about what matters most for their clients.     

Activities of Daily Living: An Area of Occupational Therapy Expertise

If occupational therapists are to provide services in the area of activities of daily living in such a way as to demonstrate their uniqueness and expertise, they must be clear in their own minds as to their uniqueness and the value of their contributions. They must also be able to communicate these effectively to others. This paper approaches the problem from two perspectives. Firstly, stimulated by the results of a survey of Royal Perth Hospital occupational therapists and a review of the literature, the authors describe a definition and classification of activities of daily living developed in order to standardise terminology and organise the content of treatment reports. Secondly, a professional model is presented to explain the uniqueness of occupational therapy in terms of activities of daily living. The use of these approaches in justifying occupational therapy intervention and communicating it to others is discussed.     

某铝厂建设项目职业病危害预评价

目的 识别、评价、控制建设项目可能产生的职业病危害因素，防治职业病，保护劳动健康，为卫生行政部门审批建设项目提供科学依据。方法 选择与建设项目类似的工程进行类比调查，采用检查表法、类比法与定量分级法相结合的原则进行评价。结果 该建设项目的选址与总体布局、生产设备布局、职业病防护设施设计、卫生辅助用室设置等符合国家有关规定；生产过程中可能产生粉尘、毒物、噪声、高温、热辐射、放射性物质等主要职业病危害因素；属于严重职业病危害的建设项目。结论 该项目生产过程中可能产生的职业病危害是可以预防的，从职业卫生角度分析该项目是可行的。     

慢性病健康教育研究进展

采取多种形式的健康教育方式是控制慢性病的必要手段。文章从慢性病健康教育的内容、形式和方法等方面进行分析,研究它的发展方向,同时就目前研究中存在的影响因素进行探讨。     

Occupational therapists' perception of their practice: A phenomenological study

Background:  International literature seems consistent in reporting that occupational therapists value their methods. However, little empirical evidence has been generated supporting the basic system of belief for occupational therapy. Few studies have explored the nature of the occupational therapists' experiences and thoughts about their use of occupation as means and ends, and which strategies they use to implement their tools in their current practice. Accordingly, the aim of this study was to explore how occupational therapists understood and presented their practice and interventions.
Methods:  A sample of six occupational therapists graduated in different decades, from diverse client populations and health-care settings was selected to participate in a semistructured interview.
Results:  Three main themes were developed: 'To make the client's potentials visible', 'reaching a position one values' and 'looking with other eyes'. Whatever their specialities, the participants were unanimous in the way they described their role. Their common focus was 'activities of daily living'. However, they had problems describing their therapeutic tools, and were not able to clearly articulate the 'common sense aspects' of their own methods. The participants were engaged in constructing their professional identities, and stressed the need to construct professional boundaries relevant to their particular work.
Conclusion:  The occupational therapists perceived their practice and interventions as distinctly different from other team members, thus, they provided a 'counterpoint'. The participants used various ways of marketing their perspectives. While the novices tended to go along with the team, the experienced therapists tended to assert their own special contribution.     

An examination of the psychometric properties of the occupational identity questionnaire for community-living elderly who require care

IntroductionAuthors created an Occupational Identity Questionnaire Provisional version (OIQ-P) to assess occupational identity for elderly individuals. The purpose of this study was to examine the psychometric properties of the OIQ-P.MethodsParticipants included 135 (42 males) elderly who lived locally and required care or support. OIQ-P was evaluated in terms of structural validity, criterion validity and internal consistency.ResultsBased on the results of an exploratory factor analysis and confirmatory factor analysis, an OIQ with a factor structure of 3 factors and 14 items was created. Rasch rating scale model revealed that 14 participants and 1 item did not fit the goodness of fit, nevertheless, the overall result was good. Spearman''s rank correlation coefficient indicates that there was a law correlation between OIQ and the occupational identity scale of the Occupational Performance History Interview Version 2. In terms of internal consistency, the person separation index and person separation reliability coefficient were 2.30 and 0.84, respectively.ConclusionThis study confirmed the structural validity, criterion validity and internal consistency for the OIQ. To enhance the clinical utility of the OIQ, it is necessary to examine the interpretability and conduct an intervention study using the OIQ.     

Client Perspectives on Occupational Therapy in Rehabilitation Services

The purpose of this qualitative study was to explore clients’ perspectives on the outcome of occupational therapy practice in rehabilitation and, furthermore, to look at certain components of practice and explore whether and how they may influence clients’ practice experience. Data were gathered through open, unstructured interviews with 20 adult clients after discharge from rehabilitation institutions in Iceland. Analysis of data was performed using both the constant comparative method and the coding procedures of the grounded theory approach. Results emerged around three interwoven categories: balance and enjoyment, enabling everyday life, and building a new future. Although mainly positive, people did also offer some negative points of view. Positive outcomes of occupational therapy are experienced at different levels and enhanced by organization of the therapy process, purpose and meaning of occupations, and the relationship between client and therapist. It is concluded that occupational therapists working in rehabilitation may have to pay more attention to their clients’ occupational issues and needs and involve them more in a goal-directed therapy process. Occupations used in therapy should be more balanced to meet the different needs of men and women and reflect the whole occupational spectrum of each individual.