Translating knowledge to practice: an occupational therapy perspective

Background/Aim:  Translating knowledge to practice, also called ‘knowledge translation’, is increasingly recognised as a driving force to strengthen and improve the healthcare system. How knowledge translation fits with occupational therapy practice deserves examination. Methods:  This paper will explore how an action process model, the Knowledge‐To‐Action Process, may advance knowledge translation in occupational therapy. Occupational therapists typically view knowledge in a broad sense, encompassing research, tacit knowledge, expert opinion and client evidence. The Knowledge‐To‐Action Process facilitates application of client, therapist and research knowledge to occupational therapy practice. Results:  Examination of knowledge translation through the lens of the Knowledge‐To‐Action Process creates awareness of the value of client, therapist and research knowledge. It also highlights opportunities as practitioners to implement knowledge translation. Conclusions:  Models able to flexibly reflect an occupational therapy perspective of knowledge have a potentially vital role in successful knowledge translation. Furthermore, these models allow therapists and other stakeholders to analyse complex situations and identify targeted knowledge translation strategies.     

“瘾疹”病因病机与治法的隐喻分析

从隐喻的视角观察"瘾疹"的临床表现,审视其病因病机、治则治法,以探寻瘾疹病因病机的隐喻特征,发掘产生各种治法的可能的认知根源。从"瘾疹"病名与临床表现入手,将自然界不同季节的风及由风引发的现象作为始源域,将瘾疹的临床表现作为目标域,通过始源域的自然之风来体认人体感受的"风邪"。源于自然界之风具有明显的季节性,而不同季节的风可以使人们明显地感知其差异,自然界提供的有关风及与风相伴自然现象,很可能是中医学"风寒、风湿、风热、风燥"的认知根源。对风及相伴现象造成危害的防护,很可能是瘾疹治法提出的起始点。     

Understanding personal narratives: an approach to practice

AIM: This paper explores the need for and nature of personal narratives and their relevance to nursing practice. It proposes that the co-creative aesthetic process can be used to understand and co-create personal narratives through an emphasis on self-defining memories and metaphor. BACKGROUND: Many authors in nursing and other human sciences have recognized the need for and importance of personal narrative, its relationship to aesthetic knowing and its value in qualitative research and in practice. The role of memory and metaphor in the creation of meaning in personal narratives, however, has not been sufficiently explored in nursing literature. DISCUSSION: The nature of personal narrative is explored, focusing on the way meaning is created from self-defining memories using metaphor. Then, the importance of personal narratives in nursing practice is considered, followed by discussion about how meaning in personal narratives may be co-created between clients and nurses using an aesthetic process developed by the author. CONCLUSION: The co-creative aesthetic process is an example of nursing as art and can be used to co-create personal narratives in practice. The experience of co-creating a self story with a nurse can be healing, as the self story is heard by a caring person, memories are understood in new ways, and the self story is both confirmed and recreated.     

Cross-Cultural Perspectives on the Concept of Retirement: An Analytic Redefinition

A cross-cultural valid analytic definition of retirement remains elusive in gerontology despite a long tradition of research on the topic. Inadequate attention has been paid to consistently defining the key concepts used to examine retirement and to specifying its occurrence in non-Western, non-industrial societies. This paper critically reviews basic cultural tenets in the notion of retirement, and proposes a more comparatively valid definition. It then proposes a three part comparative categorization by exploring retirement in contemporary Western nations and comparing it with retirement-like practices from a range of non-Western cultures including Thai, Chinese, Ladak, Fulani, Lusi and Aymara.     

Role of the frontal lobes in implicit and explicit retrieval tasks

While the role of the frontal lobes in explicit retrieval tasks is well supported, the findings for implicit tasks are less conclusive. We investigated the role of the frontal lobes in perceptual and conceptual implicit priming. Three memory paradigms were given under both implicit and explicit retrieval instructions, using word fragment completion, picture fragment completion and category exemplar generation. Three groups of individuals with frontal lesions were compared to normal controls: Left dorsolateral lesions (n = 5), right dorsolateral lesions (n = 4), and medial lesions (n = 9). Word fragment completion priming was impaired by left dorsolateral lesions, with other priming tests unaffected by any lesion. Explicit performance showed a different pattern, with category exemplar cued recall impaired by left dorsolateral and medial lesions. These findings support the role of the frontal lobes in both implicit and explicit retrieval mechanisms under certain conditions requiring strategy application or lexical retrieval.     

Spirituality and health: towards a framework for exploring the relationship between spirituality and health

BACKGROUND: A growing body of evidence has found that spirituality enhances health. However, spirituality is an elusive concept that defies clear definition. This inevitably presents difficulties when comparing the findings of studies. Therefore conceptual clarification is essential if practitioners are to better understand the relationship between spirituality and health. AIMS: The aim of this paper is to develop a conceptual framework, which can be used to explore the relationship between spirituality and health. METHODS: The concept-indicator model was used to analyse spirituality in the literature. The literature was searched for empirical indicators or what are taken as essential attributes of spirituality. Similarities and differences between approaches were identified and these formed the basis of a framework. FINDINGS: The analysis identified three approaches (a trichotomy) to spirituality in the literature. These were termed the transcendent, the value guidance and the structuralist-behaviourist approaches. The paper shows how by clarifying the different conceptualizations of spirituality and the interrelationship between them researchers can also clarify their respective contributions to health. Thus a contribution is made towards making more explicit the ways in which key aspects of spirituality such as transcendence, meaning and purpose, connectedness, hope, and faith, work to produce health benefits in terms of prevention, recovery from illness, or coping with illness. CONCLUSIONS: The framework (or trichotomy) will enable practitioners to understand better the connection between spirituality and health. In particular, it will show that to appreciate the benefits that patients might experience from their value or belief systems, practitioners must actively explore the content of those systems in a respectful way.     

Can the Neuman Systems Model be adapted to the Malaysian nursing context?

Nursing in Malaysia is still developing as a profession. Issues such as using nursing conceptual models or frameworks in the delivery of nursing care have not been addressed by the majority of nurses. One reason for this has been the level of education and preparation of nurses, while another reason lies with the origins of existing nursing conceptual models. Most nursing conceptual models have their origins in North America. Their utility by nurses of different cultures and academic preparations might not be appropriate. Nursing is a social activity, an interaction between the nurse and the patient. It is carried out in a social environment within a particular culture. Conceptual models developed in one culture might not be readily implanted into another culture. This paper discusses how a conceptual model developed in North America; that is, the Neuman Systems Model, can be adapted into the Malaysian nursing context.     

Caregivers of persons with a brain tumor: a conceptual model

Researchers have documented negative physical and emotional consequences for both family caregivers of persons with cancer as well as caregivers of persons with a neurologic disorder. However, there is a unique subset of caregivers who must provide care for someone who may suffer from both a short, terminal trajectory of disease, as well as neurological and neuropsychiatric sequelae - the caregiver of a person with a primary malignant brain tumor. The purpose of this article was to describe a conceptual framework for providing care for a person with a primary malignant brain tumor. The demands of this particular care situation are described, as well as potential resources available to the caregiver to meet those demands. Finally, the stress response that results from the balance between care demands and caregiver resources is illustrated. Development of a conceptual framework for this caregiving population is the first step in assisting nurses to identify factors that place caregivers of persons with a primary malignant brain tumor at risk for negative consequences, and to design interventions to improve caregiver health.     

Quality Health Outcomes Model

Purpose: Donabedian's 1966 framework of structure, process, and outcome has guided three decades of study in the United States of the elements needed to evaluate and compare medical care quality. Donabedian's perspective was essentially linear, assuming that structures affect processes, which in turn affect outcomes. Patient characteristics are sometimes considered as mediating outcomes and clinical interventions are considered to be processes. A model is presented in the following article that relates multiple factors affecting quality of care to desired outcomes. It extends previous models by positing dynamic relationships with indicators that not only act upon, but reciprocally affect the various components.
Scope and Sources: The proposed model was derived from a synthesis of the authors' experience in quality of care practice and research, as well as selected previous theories.
Conclusions: The quality health outcomes model is sufficiently broad (a) to guide development of databases for quality improvement and outcomes management, (b) to suggest key variables in clinical intervention research, and (c) to provide a framework for outcomes research and outcomes management that compares not only treatment options, but organizational or system level interventions. The model also has several policy implications.