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.     

Australia's occupational therapy workforce: Jobs for the future

The forces that affect the economic, technological and industrial structure of Australia in the future will also affect its occupational and educational structures. The number of people participating in the education system is expected to grow, but at a slower rate than over the past decade, and the proportion of the workforce with a qualification is expected to reach a historically high level by the year 2005. Workforce modelling projections indicate that more highly skilled occupations will have strong employment growth over the next decade. It is estimated that, in 2005, the demand for occupational therapists will represent an increase of 79.9% of the number working in 1993–94. However, the accuracy of this projection is based on a macro-analysis of data from various sources and does not account for any analysis of factors internal to the profession that may affect its occupational structure or employment growth. The paucity of occupational therapy microworkforce data has been noted by national workforce planning agencies and regular national workforce collections will start in 1998. Inclusion of macro- and microfactors into a comprehensive occupational therapy workforce planning framework is essential to the development of appropriate response strategies that address demand and supply issues for occupational therapy jobs in the future.     

An organizational case study of the case manager's role in a client's return-to-work programme in Australia

The purpose of this study was to examine the case manager's role in a return-to-work programme in Sydney, Australia. The investigators examined the case manager's role assumed by occupational therapists, physiotherapists, psychologists and rehabilitation counsellors when providing occupational rehabilitation services. Files of closed cases (n=172) were examined to investigate the relationship between the case manager's profession and return-to-work outcomes. It was found that the provider of occupational rehabilitation examined in this study achieved above-average return-to-work rates (83%), with no significant difference between case managers. There was, however, a significant relationship between the client's type of injury and the case manager (p<0.001), and case length was significantly different between case managers (p=0.004). The occupational therapist had the largest case management load (43%), followed by the rehabilitation counsellor (23%). There were trends (0.05相似文献   

Measuring rural allied health workforce turnover and retention: What are the patterns,determinants and costs?

Objectives: To measure variations in patterns of turnover and retention, determinants of turnover, and costs of recruitment of allied health professionals in rural areas. Design: Data were collected on health service characteristics, recruitment costs and de‐identified individual‐level employment entry and exit data for dietitians, occupational therapists, physiotherapists, podiatrists, psychologists, social workers and speech pathologists employed between 1 January 2004 and 31 December 2009. Setting: Health services providing allied health services within Western Victoria were stratified by geographical location and town size. Eighteen health services were sampled, 11 participated. Main outcome measures: Annual turnover rates, stability rates, median length of stay in current position, survival probabilities, turnover hazards and median costs of recruitment were calculated. Results: Analysis of commencement and exit data from 901 allied health professionals indicated that differences in crude workforce patterns according to geographical location emerge 12 to 24 months after commencement of employment, although the results were not statistically significant. Proportional hazards modelling indicated profession and employee age and grade upon commencement were significant determinants of turnover risk. Costs of replacing allied health workers are high. Conclusions: An opportunity for implementing comprehensive retention strategies exists in the first year of employment in rural and remote settings. Benchmarks to guide workforce retention strategies should take account of differences in patterns of allied health turnover and retention according to geographical location. Monitoring allied health workforce turnover and retention through analysis of routinely collected data to calculate selected indicators provides a stronger evidence base to underpin workforce planning by health services and regional authorities.     

Sources of stress experienced by occupational therapists and social workers in mental health settings

This study examined the sources of stress experienced by occupational therapists and social workers employed in Australian public mental health services and identified the demographic and work-related factors related to stress using a cross-sectional survey design. Participants provided demographic and work-related information and completed the Mental Health Professionals Stress Scale. The overall response rate to the survey was 76.6%, consisting of 196 occupational therapists and 108 social workers. Results indicated that lack of resources, relationships and conflicts with other professionals, workload, and professional self-doubt were correlated with increased stress. Working in case management was associated with stress caused by client-related difficulties, lack of resources, and professional self-doubt. The results of this study suggest that Australian occupational therapists and social workers experience stress, with social workers reporting slightly more overall stress than occupational therapists.     

Parents' evaluations of pre-school services for children with Down syndrome in two Scottish regions

Summary Parental evaluations of current pre-school provision for children with Down's syndrome were surveyed in two Scottish regions. Two methods were used: postal questionnaires and telephone interviews. Services covered were those provided by general practitioners, hospital specialists, health visitors, speech therapists, occupational therapists, physiotherapists, educational psychologists, home teachers, social workers and voluntary organizations. Regional differences were found in provision and in parental satisfaction with currently available services, with some of these differences being dependent on child age. Overall, parents felt they were being given insufficient professional support, with contradictory advice not uncommon. Findings indicate that if limited resources are to be used to the maximum benefit of family and child, both subjective and objective measures of the relative values of different kinds of support at different ages are urgently needed.     

The development of the Mental Health Advice Centre in Lewisham Health District

The Mental Health Advice Centre in Lewisham, South East London, represents an innovation in psychiatric service aiming to integrate primary health care with mental health professionals and to provide easy access for patients to psychiatric and psychological help. The Centre has been operating for 3 years and is staffed by a multi-professional team comprising psychiatrists, clinical psychologists, psychotherapists, social workers, community psychiatric nurses, occupational therapists, research workers, and volunteers. This report outlines the development of the Centre and presents the results of two years' evaluative work. Social, demographic, and psychiatric characteristics of the clients who attended the Centre during these two years are described.     

La profession de sexologue en Europe : diversité et perspectives communes

The Euro-Sexo study was conducted in seven European countries (Denmark, Finland, France, Italy, Norway, United Kingdom and Sweden) using a protocol first developed in France in 1999. The objective of this survey was to define sexologists as a professional group, and in terms of their social and demographic characteristics, their level of training in sexology, the conditions under which they practice and their professional identity. The results of the survey showed that the number of sexologists per million inhabitants varies enormously from one country to another (fewer in the South of Europe and significantly more in Finland). Most sexologists are health practitioners (but not physicians), and mainly women, except in France, which is the exception. Nurses, midwives, marital counsellors and to a lesser extent psychologists are the most commonly represented professions, but the extent varies according to the country. Most sexologists working in Europe are not physicians. More than two-thirds of sexologists (particularly the non-physicians) have been trained in sexology and/or human sexuality. For a majority of respondents to the questionnaire, sexology represents less than 25% of their professional activities and (with the exception of France and Denmark) most of them do not call themselves either sexologists or sex therapists. The diversity of the professional profiles observed in the different countries raises questions concerning the status of this profession: is it a fully-fledged profession in itself, or rather a specialization within the framework of mainstream health professions?     

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.     

Professional and organizational commitment in paediatric occupational therapists: the influence of practice setting

The professional and organizational commitment of paediatric occupational therapists working in two distinct practice settings, schools and medically based settings, was investigated. A web‐based survey program was used to administer a questionnaire to occupational therapists employed in New York, New Jersey and Connecticut. The study employed social identity theory as a guiding perspective in understanding therapists' professional and organizational commitment. One hundred and fifty‐seven paediatric therapists responded to the Professional Commitment Questionnaire and the Organizational Commitment Questionnaire to gauge their commitment to both the profession and their employing organizations. Results indicated that paediatric therapists, regardless of employment setting, have high professional commitment. Paediatric occupational therapists employed in medically based settings indicated statistically significant higher organizational commitment than their school‐based counterparts. For therapists that work in school settings, the presence of a professional cohort did not influence professional commitment scores. As the study employed a web‐based survey methodology, only individuals who were members of associations and had access to a computer and the Internet were able to participate. Further study might include widening the participant pool as well as adding additional instruments to explore both professional and organizational commitment on a more national scale. Copyright © 2010 John Wiley & Sons, Ltd.     

Overseas Occupational Therapists in Australia: the Issue of Recognition

The Australian government established the Council on Overseas Professional Qualifications (COPQ) in 1969. In response to approaches by the occupational therapy profession, an Expert Panel in Occupational Therapy was established in 1979 in order to develop a screening examination to be used in assessing the competency of overseas trained occupational therapists. This paper describes the development of the COPQ examination for all overseas qualified occupational therapists wishing to work in Australia; the experience of candidates since its inception in 1983; and the problems associated with achieving recognition of the COPQ examination throughout Australia given the lack of uniform recognition procedures in the various States and Territories. The need for a consistent national approach to the policy of recognition and employment of overseas trained occupational therapists is addressed, with stress placed on the need for all employer groups, in both the public and the private sectors, to cooperate with COPQ's assessment procedures.     

Icelandic Occupational Therapists' Attitudes Toward Professionalism

The goal of this study was to capture the main demographics of Icelandic occupational therapists and their attitudes concerning professionalism. The entire population of Icelandic occupational therapists was surveyed. Eighty-seven questionnaires were sent out and 80 (92%) were returned and used for analysis. Results of the study indicated that Icelandic occupational therapists are active in their association, willing to take on duties for the advancement of the profession, and interested in conducting research. The attitudes of Icelandic occupational therapists were generally quite uniform. However t-tests and one-way ANOVAs (analyses of the variance) (p&lt;0.05) revealed significant differences in some attitudes and professional activities according to level of education, length of professional experience and country of education. The findings from this study are valuable for the profession at present, and can also be used to monitor future changes.     

Professional and clinical differences amongst clinicians dealing with sexual problems in the United Kingdom

The varied practices of physicians, psychologists, nurses and therapists were recorded as part of a collaboration between seven European countries. This paper describes sexual and relationship problems presented by patients to UK clinicians working in the field of human sexuality. Differences in the professional groups and approaches towards treating these problems by physicians and non-physicians are reported and discussed. The majority of clinicians working in human sexuality within the United Kingdom are female non-physicians. Nurses and marital counsellors were the largest professional group within the multidisciplinary profession of sexology working in the United Kingdom. Fewer UK clinicians have undergone training in sexology that their European counterparts and only 46% of clinicians working in the field describe themselves as a sexologist or sex therapist. The vast majority of clinicians did not devote more than a quarter of their work time to sexual problems and sexual dysfunction.     

Enabling international communication among Brazilian occupational therapists: seeking consensus on occupational terminology

The purpose of this study was to examine how key occupational therapy terminologies are used by Brazilian occupational therapists. A nominal group approach combined with a Delphi technique involving 31 Brazilian occupational therapists was applied. A sociolinguistic approach was adopted since it broadens our understanding of the social and cultural determinants of terminology consolidation. Brazilian occupational therapists were found to adopt the term activity more often than human action or doing. Even less often were praxis and occupation applied. No consensus was reached regarding which of the terms is most preferred. While Brazilian occupational therapists have been developing their profession from international standards, it is still embedded in local demands and policies. Additionally, the political context must be considered when building an international dialogue between members of a professional body. Such a dialogue could engage professionals from different countries in meaningful exchanges about their practices. These exchanges may lead to the development of solid professional communities that can contribute meaningfully to social change. Copyright © 2010 John Wiley & Sons, Ltd.     

2008—2012年河池市有色金属企业工人上岗前职业健康检查结果分析

目的通过对上岗前职业健康检查资料的分析,了解河池市有色金属企业劳动者就业前的身体健康状况,为制定职业病防治策略及岗前择业提供参考依据。方法对该市近5年来6家有色金属企业10 972人上岗前的职业健康检查资料进行统计分析,并对各年度的检查情况、职业禁忌证、疑似职业病和其他疾病或异常结果的检出情况进行比较。结果上岗前职业健康检查人数呈逐年上升的趋势,5年职业禁忌证检出986人,检出率为8.98%;铅作业职业禁忌证检出率较高,为3.65%;疑似职业病共检出18人,检出率0.16%;其他疾病和单项（多项）指标异常检出3 083人,检出率28.10%;所检项目未见异常人数6 885人,占总检人数的62.75%。结论该市有色金属企业工人就业前的身体健康状况不容乐观,相关部门应加强对厂矿企业的监督管理和职业卫生知识及相关法律、法规的培训宣传工作,督促用人单位主动安排即将从事接触职业病危害因素作业的劳动者进行上岗前的健康检查。     

Occupational Therapists: Their Career Views Eighteen Months After Graduation

A survey of 74% of the 1979 graduating class in occupational therapy at Cumberland College of Health Sciences indicated that 88.8% were employed in their profession. Some (29.6%) had experienced brief involuntary unemployment. Job satisfaction and career choice satisfaction were high, although 83.7% anticipated change from current employment within the next five years. Many (56.6%) expressed intentions to specialise in their profession and 39% planned to enrol in study programmes. Aspects of work considered most important were opportunities to develop skills, chances to do something worthwhile and the friendliness of co-workers. The graduates experienced deprivation regarding the first two aspects and satisfaction regarding the third. Work aspects considered of least importance were pay, physical surroundings, and promotion opportunities. The most stressful aspect of work was dealing with other health professionals, who were perceived as confused about the role of occupational therapists.     

The health and wellbeing of mental health professionals

We examine dimensions of job satisfaction, occupational burnout and general health of a sample of 123 mental health care professionals (psychiatric nurses and nursing assistants, and smaller professional groups such as social workers, occupational and recreational therapists and psychologists) employed at a large Canadian psychiatric hospital. Psychiatric nursing assistants exhibit more of the consequences of job-related stress (less job satisfaction, greater occupational burnout, greater incidence of negative physical and psychological symptoms of stress) relative to the other professional groups in the sample. This may be linked with their position within the hospital organization (having less authority and professional autonomy relative to the other groups), affecting their ability to cope with job-related problems and stresses experienced by all direct care workers. We examine attitudes of mental health professionals towards organized support groups at the hospital, which could provide one forum for the open discussion (and potential resolution) of job-related stresses and problems experienced in hospital settings.     

Sexological Competence of Different Rehabilitation Disciplines and Effects of a Discipline-specific Sexological Training

Dealing with sexual problems due to disease or disability is part of medical rehabilitation, but both patients and professionals experience barriers to discuss sexual issues. A brief discipline-specific sexological training for rehabilitation professionals was therefore developed and evaluated in two rehabilitation centers in The Netherlands. Among the 283 participants were physicians (42), physical therapists (38), occupational therapists (40), psychologists and social workers (26), nurses (101), and other disciplines (36). Measurements before training, after training, and at 3–4 months follow-up showed increase of self-rated sexological competence and of scores on the Knowledge, Comfort, Approach, and Attitudes towards Sexuality Scale (KCAASS) during the training that were maintained at follow-up. Disciplines differed in sexual competence before training and in increase of sexual competence after training. Implementation of the training in other rehabilitation centers is recommended.     

大庆市2004--2008年职业卫生现状

目的了解大庆市职业卫生现状,为石油城市今后的职业病防治工作重点提供方向。方法现场调查并填写调查表。结果正式职工接触粉尘人数占总接触人数的15．9％,明显少于非正式用工接触粉尘人数占总接触人的比率（36．5％）;正式用工职业健康检查人数占总接触人数的95．0％,而非正式用工职业健康检查人数占总接触人数的45．2％,正式用工的职业健康监护率明显高于非正式用工的职业健康监护率;2004--2008年5年间,在正式用工中共发现32例职业病病人,其中尘肺14例,尘肺的发病率为10．2／万;急性中毒14例、慢性中毒4例,与接触人数比职业中毒的发病率为4．4／万;非正式用工中共发现29例职业病人,均是尘肺,占接触人数的62．5／万,非正式用工的职业病发病率明显高于正式用工。结论以石油化工业为主的城市,职业卫生工作的重点和难点仍在粉尘行业中小企业的尘肺病防治上,应加强临时用工的职业健康监护。