Embryos of occupational therapist paradigms: An exploratory study of Swedish occupational therapy students' perceptions of occupational therapy

The present study is an exploratory study of newly enrolled Swedish occupational therapy students' world view and field of action view of occupational therapy during their introductory week at the Occupational Therapist Educational Program at the University College of Health Sciences, Jönköping, Sweden, in the autumn of 1995. The study has its starting point in Törnebohm's theory of paradigms. The students answered essay questions on paradigmatic matters and the data were analysed qualitatively. Three themes were identified in the data: (i) notions of some concepts fundamental to occupational therapy; (ii) notions of the 'setting' of occupational therapy reality; and (iii) notions of the operational reality of occupational therapy. With their limited personal experience of occupational therapy, the students' perceptions reflected interested outsiders' views on the topic, influenced by information available in society and the questions given. They were shown to possess relevant and varied information about occupational therapy, but had difficulties in joining the information together in a coherent unity.     

Conducting case study research in occupational therapy

Background:  Case study research has been used increasingly in psychology and sociology in recent years. It provides researchers with an opportunity to explore a situation involving one individual or several individuals over time from multiple points of view.
Methods:  This literature review explains case study research as a method and summerises its scientific merit, also providing an example of its use.
Results:  Case study research offers occupational therapists a scientific methodology that can be used to understand and develop occupational therapy practice.
Conclusion:  This paper argues that case study research should be used more extensively by occupational therapists as the method respects the basic principles of occupational therapy.     

Occupational therapy students' paradigms: A passage from beholder to practitioner

The present study explores the development of occupational therapist paradigms among occupational therapy students at the Occupational Therapy Educational Program at the University College of Health Sciences, Jönköping, Sweden. The study is an explorative, comparative study of nearly qualified (last year) and newly enrolled (first week) occupational therapy students' world views and field of action views regarding occupational therapy. The students answered essay questions on paradigmatic matters, and their answers were analysed qualitatively. A study structure comprising three themes with appurtenant categories allowed comparisons between the two groups of students. A major finding was that the nearly qualified occupational therapy students' notions (in contrast to those of the newly enrolled students) gave expression to a more holistic health perspective in which there were numerous examples of interrelations between themes belonging to different paradigm components. According to Törnebohm interrelations between different paradigm components are characteristic of paradigms.     

A survey of recruitment and retention issues for occupational therapists working clinically in mental health

Background:  Mental health services Australia-wide have difficulty recruiting and retaining clinical occupational therapists.
Methods:  A survey of occupational therapists to identify factors that could influence their retention or loss from clinical mental health practice was undertaken.
Results:  Typically, respondents were female, aged 30 years or younger, working full-time at a grade 2 or 3 level, and had worked entirely in mental health. The main positive aspects that respondents identified about their positions were the 'social/emotional environment', 'aspects/nature of their roles', and 'using occupational therapy skills'. The main position constraints were 'insufficient time/workload' and 'insufficient use of occupational therapy skills/generic nature of work'.
Conclusions:  Recruitment and retention strategies are required to retain occupational therapists in clinical mental health positions.     

Investigation into the occupational lives of healthy older people through their use of time

Background/aim:  Older people are one of the largest groups using health-care services; therefore, it is important for occupational therapists to have an understanding of their occupational lives. Temporality is a key element of occupation, yet little research exists regarding older people and time use, despite the considerable temporal adjustments taking place at this lifestage. The aim of this study was to identify the occupational lives of healthy older people through the activities they undertake in a 24-hour period.
Method:  Data analysis of time-use diaries from 90 older UK residents (aged 60–85 years) who considered themselves to be healthy was undertaken, using 15 activity codes and three pre-coded terms: necessary, enjoyable and personal.
Results:  The participants spent most of their time sleeping and resting (34%), followed by performing domestic activities (13%), watching television, listening to the radio or music, or using computers (11%), eating and drinking (9%) and socialising (6%). Enjoyable activities occupied most of their time (42% of the day), followed by necessary (34%) and personal activities (16%).
Conclusion:  These data contribute to the growing evidence base regarding older people as occupational beings, indicating that they are a diverse group of individuals who are meeting their needs with dynamic, positive activities. This highlights the importance of a client-centred approach to occupational therapy, as it enables the clients to have choice, control and diversity in their activities when meeting their needs.     

The meaning of leisure for well-elderly Italians in an Australian community: implications for occupational therapy

Aim:  This paper documents a study that aimed to discover the meaning of leisure experiences for an ageing Italian community in a large regional centre in Victoria, Australia.
Methods:  This qualitative investigation used a phenomenological study design, and data were collected through semistructured interviews with 10 well-elderly Australian Italians.
Results:  Participants engaged in numerous leisure occupations that were meaningful to them and directly impacted on positive subjective experiences and health outcomes.
Conclusion:  This paper adds to an understanding of how leisure impacts on the health of well-elderly Australians and how occupational therapists can use leisure effectively in interventions for successful ageing.     

Diversity in occupational therapy: Experiences of consumers who identify themselves as minority group members

Background/Aim:  The occupational therapy profession is in need of self-examination in view of the extent to which culturally constructed meanings of occupation guide its work within an increasingly diverse practice environment.
Methods:  Semistructured interviews were completed with 14 individuals who defined themselves as minority group members in order to gain an understanding of their experience of the occupational therapy process.
Results:  Five themes emerged: the importance of social location, the need for safety and acceptance, avoiding omissions, understanding differences in occupation, and the face of discrimination.
Conclusions:  Cultural and sexual identities influence occupational choices and interface with the social location of the therapist to influence the therapeutic process. Despite holistic and client-centred values, the comprehensive nature of occupational therapy is not experienced by clients of minority groups. Practice models are needed that provide directives for the establishment of alliances with minority clients and that highlight the significance of exploring occupational choices, experiences of oppression and the impact of the therapists' culture on the therapeutic process.     

How and why do occupational therapists use the OTseeker evidence database?

Background:  OTseeker is a free online bibliographic database containing systematic reviews and methodological ratings of randomised controlled trials relevant to occupational therapy. The database aims to help therapists efficiently identify high quality pre-appraised research.
Aim:  This study explored the search practices of therapists who regularly used OTseeker, what they did with the information retrieved and their perceptions of the database.
Sample:  A purposive sample of 11 occupational therapists was recruited in 2004. All had visited OTseeker at least five times in the previous 12 months.
Study design:  Qualitative.
Methods:  A semistructured interview was conducted with each participant. Grounded theory methods were used for analysis.
Findings:  Five distinct categories were identified: reasons for visiting OTseeker, learning about OTseeker, search times and locations, using information from OTseeker, and improving OTseeker. Therapists used the database to teach or model evidence-based practice, answer clinical questions and keep up-to-date. Suggestions for improvement focussed on search functionality, access to abstracts and the location of the PEDro rating scale. Only two participants synthesised information from OTseeker into a summary, and/or used it to inform client reports.
Conclusion:  This study suggests that OTseeker is helping to increase research utilisation by occupational therapists. Further research is needed to help therapists apply research evidence to change practice and policy.     

Attitudes of entry level occupational therapy doctoral students towards inclusion for students with disabilities

Background/Aims:  The increasing popularity of inclusive education for students with disabilities and the attitudes towards it inevitably affect school-based occupational therapy practice. This survey study investigated the attitudes of entry-level occupational therapy doctoral (EOTD) students towards inclusive education and the effect of professional education on their perception.
Methods:  A total of 62 EOTD students responded to a self-developed questionnaire, Attitudes and Inclusive Education Survey , yielding a response rate of 91.2%.
Results:  Results of the study revealed that entry level occupational therapy doctoral students have positive attitudes towards inclusive education and believe that the inclusion movement has an inevitable impact on school-based occupational therapy practice. Professional education in occupational therapy might positively affect students' attitudes.
Conclusion:  Given the close association between one's attitude and behaviour, the findings of the study are particularly encouraging. Future research needs to further examine school-based occupational therapy practice in inclusive environments.     

Shaping knowledge regarding occupation: examining the cultural underpinnings of the evolving concept of occupational identity

Background/aim:   Within occupational therapy and occupational science, knowledge regarding occupation-based concepts is in the process of being developed, disseminated and acted upon internationally. It is critical to reflect on the forces shaping the ways in which this knowledge is being constructed.
Method:   In this paper, the ways in which cultural assumptions and values have influenced the evolving concept of occupational identity are examined through applying Kluckhohn and Strodtbeck's framework of cultural variations in values to two contemporary conceptualisations of occupational identity.
Results:   The analysis demonstrates the ways in which values most consistent with Western culture are embedded within and dominate these contemporary conceptualisations of occupational identity, emphasising a future orientation, achievement-based doing, individual choice, and mastery of individuals over nature.
Conclusions:   This paper points to conceptual boundaries within which occupational identity is currently being shaped and points to alternative possibilities in the hope of prompting dialogue and research that looks at this concept in more diverse ways. Heightened sensitivity to the influence of culture on the shaping of occupation-focussed knowledge will serve to strengthen and enrich the growth of the evolving body of knowledge pertaining to occupation, and foster culturally sensitive research and practice.     

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.     

Employer-sponsored occupational therapy professional development in a multicampus facility: A quality project

Aim:  To critically assess and develop recommendations for professional development (PD) for occupational therapists in a multisite specialist cerebral palsy occupational therapy service.
Method:  Quality improvement project based on principles of participatory action research: audit of PD resources/activity; stakeholder consultations and literature review.
Results:  The PD program goal, resources, strategies, activities and evaluations conducted at the centre were identified and described. Areas for improvement were identified by critically considering the PD program in the context of reviewed literature. There was an assumption that personal change through PD would help attain the organisational goal of clinically competent practitioners who use evidence-based practice in a family-centred context.
Recommendations:  Future PD plans and evaluations need to explicitly address this assumption. The use of structured reflection and the 'clinical reasoning' conceptual framework was recommended as one way to help personal change from PD to have workplace impact. This project provides a precedent and guide to occupational therapy PD planners regarding a whole-of-organisation approach to developing and maintaining competence through PD.     

Cultural awareness among Queensland undergraduate occupational therapy students

Aim:  Australia's cultural diversity generates substantial challenges and implications for students and health-care professionals. This study investigated the cultural perceptions and self-rated level of cultural competence of undergraduate occupational therapy students in Queensland, Australia.
Results:  Two hundred and ninety-three students completed the Cultural Awareness Questionnaire. The findings indicated that the majority of students have a positive attitude towards cultural differences and influences on occupational therapy services. Students also recognised the importance of cultural awareness and highlighted the need for increased incorporation of cultural information and experience throughout the undergraduate course.
Conclusion:  The implications of this study are discussed with reference to the future academic planning of culturally sensitive occupational therapy course and fieldwork experiences.     

Job satisfaction in occupational therapy: a qualitative investigation in urban Australia

Background:  Job satisfaction has been shown to affect levels of staff retention and work productivity, but few studies have been conducted with occupational therapists in an Australian setting.
Methods:  Using a hermeneutical phenomenological approach, the findings from a study examining the factors that contribute to job satisfaction in occupational therapists working in Australia, are reported.
Results:  Job satisfaction in occupational therapy was derived from the sense of achievement felt when providing effective clinical care. Job dissatisfaction stemmed from the poor profile and status of the profession.
Conclusions:  Based on the study findings, there is an imperative that the profession of occupational therapy continue to use research findings to support clinicians in providing effective health care, and improve the community understanding of occupational therapy.     

Language, identity and representation: occupation and occupational therapy in acute settings

Aim:   This article presents findings from a participatory action research study into the experience and use of occupation, theory and evidence in the everyday practice of a group of occupational therapists working in a large metropolitan hospital delivering a range of acute services, in Melbourne, Australia.
Methods and findings:   Narrative data gathered from 11 individual interviews and 10 group discussions were analysed through numerous iterative cycles to explore research issues and evaluate research actions. This article discusses why the participating occupational therapists chose to change the language they used to describe their practice from a focus on 'function' to a focus on 'occupation'. This change improved the therapists' levels of confidence, strengthened their professional identities and provided for a sense of renewed empowerment within the organisation.
Conclusions:   The findings suggest that occupational therapists in acute settings can utilise language more effectively to augment their ability to promote the vital and unique contribution that occupational therapy has to make. Such small, yet powerful changes can empower occupational therapists to address long-standing dilemmas of representation and enable transformative practices.     

Learning style preferences of Australian occupational therapy students

Background/aim:  The learning styles and teaching implications for nursing and health science students have been well researched in other countries. Less research has considered the learning styles and implications for occupational therapy students. The current study examines the learning styles of occupational therapy students at one Australian university.
Methods:  The learning style preferences of first year undergraduate occupational therapy students ( n  = 120) were investigated. The students completed the Kolb Learning Style Inventory (LSI) and Fleming's VARK (Visual, Aural, Read/Write, and Kinaesthetic) Questionnaire in the first weeks of their course.
Results:  The response rate was 97% ( n  = 116). Learning style preferences as determined by the Kolb LSI were spread over all four Kolb LSI learning styles with 'diverging' (30.2%) and 'converging' (28.4%) being the most preferred. Instructional preference as measured by the VARK Questionnaire was kinaesthetic learning (33%), followed by the multimodal preference VARK (18.1%). Visual and aural categories were these students' least preferred methods of learning.
Conclusions:  The results of the current study support previous research indicating a range of teaching methods should be utilised to accommodate for the variability of students' learning styles within educational programs. To accommodate the range of learning experiences encountered in fieldwork and later in professional practice, students need to strengthen their capacities to use a variety of learning styles. This paper proposes that student learning for evidenced-based practice be facilitated by a range of learning opportunities including practical experiences.