Dissertations / Theses on the topic 'History of occupational therapy'

The purpose of this study was to (a) gain an understanding of physical therapy (PT) and occupational therapy (OT) mentoring practices that occur in two large Canadian clinical teaching institutions, (b) understand how novice professionals are integrated into the workplace, and (c) examine the meaning that mentors and mentees attach to their mentoring experiences.The literature demonstrates that formal mentoring outcomes include building research competence (Byme & Keefe, 2002), strengthening personal and professional growth (Connor, Bynoe, Redfem, Pokora, & Clarke, 2000), contributing to an individual's academic career development (Pololi & Knight, 2005) and most importantly, promoting job satisfaction and retention (Smith, McAllister, & Snype-Crawford, 2001; Solomon, Salvatori, & Berry, 2001). The fact that no evidence with regard to physical and occupational therapy workplace mentoring exists inspired this study. This study examined the mentoring practices of five physical therapists and five occupational therapists working in two different university affiliated institutions. Using purposive sampling, six mentors with more than five years of experience, and four mentees with less or equal to one year of experience were recruited. Three in-depth interviews, and a concept mapping exercise followed by debriefing sessions in a focus group format, constituted the primary sources of data. Participants' and researcher's journals, and artifacts, such as memos, photographs, and interviews with four administrators/directors, completed the data collection. QSR Nvivo software was used to store and organize the data. The constant comparison method (Maykut & Morehouse, 1994) was utilized first to analyze the data. Thirty-two interview transcripts (526 pages) were coded to obtain conceptual themes. Categorization of data highlighted similarities and differences. Then, to triangulate the data, four participants' journals and interview and focus group transcripts were analyzed in depth using Lieblich's (1998) holistic-content approach. Using a narrative analysis approach allowed me to connect the data and constant comparison to explore the relationships and patterns across data (Maxwell & Miller, 2008). Narrative summaries were produced to represent a comprehensive view of four mentees and mentors' unique experiences; I used the ghostwriting approach to represent the narratives (Rhodes, 2000). The high expectations placed upon newly graduated professionals (McCloughen & O'Brien, 2005) coupled with the human resources shortage in the fields of PT and OT in Canada, render mentoring an essential element for hiring and retaining healthcare professionals. This study revealed that mentors facilitate the professional rite of practice of novice professionals by guiding them in choosing a profession, learning the ropes, and ultimately integrating them into the workplace. The findings demonstrated that previous clinical placements helped novices adapt to the workplace culture and assisted them with issues of place identity. In addition, this study highlighted the importance mentoring plays in constructing PT and OT professional identity. It showed that mentors and mentees working in complex healthcare settings all struggle, although in different ways, with the high demands of their jobs: However, with mentoring, they find ways to balance work and personal life. Finally, the results showed that the implementation of more formal mentoring programs might facilitate the integration of PT and OT professionals into the workplace, and suggested that institutions need to invest in these programs if they want to improve retention of their healthcare professionals, who are presently in higher demand than the existing supply.
Le but de cette étude était de parvenir à une compréhension des pratiques mentorales qui s'exercent en physiothérapie et en ergothérapie dans de grands établissements d'enseignement clinique universitaires canadiens, de comprendre la façon dont les professionnels débutants sont intégrés dans le milieu de travail, et d'examiner la signification que les mentors et mentorés accordent à leurs expériences mentorales. Dans cette étude, les pratiques mentorales de cinq physiothérapeutes et de cinq ergothérapeutes exerçant dans deux milieux universitaires canadiens distincts ont été examinées. Six mentors comptant plus de cinq années d'expérience et quatre mentorés avec un an ou moins d'expérience ont été recrutés en utilisant un échantillonnage de convenance. La réalisation de trois entrevues détaillées et l'élaboration d'une carte conceptuelle suivie de sessions de débreffage sous la forme d'un groupe de discussion ont constitué la principale source de collecte de données. Les journaux de bord des participants et des chercheurs, des artéfacts comme des mémos et des photographies ainsi que des entrevues avec deux administrateurs ont complété cette collecte de données. Le logiciel informatique QSR Nvivo a été utilisé pour enregistrer et organiser les données. La méthode de comparaison constante (Maykut & Morehouse, 1994) a été utilisée, dans un premier temps, pour analyser les données. Le processus de catégorisation des données a permis de mettre en évidence les similitudes et les différences. Par la suite, pour réaliser la triangulation des données, les transcriptions de quatre participants provenant des entrevues et des groupes de discussion concernant leurs cartes conceptuelles, ainsi que de leurs journaux de bord ont été analysés en profondeur à l'aide de l'analyse de contenu holistique de Lieblich (1998). L'utilisation d'une méthode mixte m'a permis dans un premier temps de relier les données et ensuite d'explorer les relations et les tendances qui s'en dégageaient (Maxwell & Miller, 2008). En conséquence, des résumés des narrations ont été produits pour représenter une vue d'ensemble des expériences uniques de quatre professionnels (deux mentors et deux mentorés) à l'aide de la méthode ghostwriting (Rhodes, 2000).Les attentes élevées à l'endroit des professionnels nouvellement diplômés (McCloughen & O'Brien, 2005), combinées à la pénurie de main d'œuvre en physiothérapie et en ergothérapie au Canada, contribuent à faire du processus de mentorat un élément essentiel à l'embauche et à la rétention des professionnels de la santé. Les conclusions de cette étude ont démontré que les mentors facilitent le rituel qui marque le passage des professionnels débutants à la pratique professionnelle en les aidant à choisir une profession, à apprendre les rouages du métier et, en fin de compte, à s'intégrer dans le milieu de travail. Cette étude a souligné l'importance que le mentorat joue dans la construction de l'identité professionnelle des ergothérapeutes et des physiothérapeutes ainsi que dans la facilitation de l'intégration des novices dans le milieu de travail. Enfin, les résultats de cette étude suggèrent que l'implantation de programmes de mentorat plus formels peut aider à consolider la construction de l'identité professionnelle des ergothérapeutes et des physiothérapeutes. Les institutions doivent investir dans des programmes formels de mentorat s'ils veulent améliorer la rétention de leurs professionnels de la santé, ces derniers étant en nombre inférieur à la demande.

Made available in DSpace on 2018-06-18T13:12:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2015
Com o ensejo de cultivar a memória profissional e ampliar o debate historiográfico, a presente pesquisa visa compreender a fundação da Terapia Ocupacional na cidade de São Paulo e, em especial, identificar o ethos dos profissionais engajados neste processo. Para reduzir a escala de observação e aprofundar o estudo, foi necessária a delimitação espacial – o município de São Paulo – e temporal – de 1956, ano de criação do Instituto Nacional de Reabilitação (INAR) a 1969, ano de regulamentação da profissão com o Decreto-lei 938/69. Cabe salientar que trataremos das bases, da fundação, da profissão em uma determinada cidade e não pretendemos afirmar que ela foi o berço do estabelecimento da profissão no Brasil. Dada a escassez de pesquisas de cunho historiográfico sobre a Terapia Ocupacional no país, conhecer trajetórias de vida de terapeutas ocupacionais participantes da fundação da profissão nesta cidade nos pareceu o melhor caminho a ser trilhado e, para tanto, adotamos a história oral de vida como metodologia específica da História. Findo processo de Imersão/Cristalização três categorias de análise foram discutidas, a saber: Projeto político-pedagógico; Profissão humanista fundada por mulheres; Orfandade e legado profissional. Deflagramos a constituição da profissão como resultado de um imbricado jogo de forças, interesses e discursos entre as próprias terapeutas ocupacionais no contexto de enfraquecimento político do Serviço Social e ascensão da Psicologia no interior da instituição de ensino responsável pelo primeiro curso na cidade de São Paulo. No segundo volume, as narrativas transcriadas das cinco colaboradoras serão apresentadas, além de nossa proposta de intervenção na realidade como desdobramento da pesquisa de acordo com os pressupostos do programa de mestrado profissional em que nos inserimos.
With the opportunity to cultivate professional memory and expand the historiographical debate, this research aims to understand the foundation of Occupational Therapy in the city of São Paulo and, in particular, identify the ethos of professionals engaged in this process. To reduce the scale of observation and intensify the study, the espatial delimitation was necessary - the city of São Paulo – as well as temporal delimitation - 1956, year of creation of the INAR to 1969, year of regulation of the profession . It should be noted that the research deals with the foundation of the profession in a particular city and do not intend to assert that it was the birthplace of the establishment of the profession in Brazil. We adopted the oral history of life as a methodological approach because historiagraphical researche of Occupational Therapy is scarce in this country. Ended process of Immersion/ Crystallization, three categories of analysis were discussed: Political and pedagogical project; Humanistic profession founded by women; Orphanhood and professional legacy. We understand the establishment of the profession as a result of an interwoven set of interests and discourses in their own occupational therapists in the context of political weakening of Social Work and rise of Psychology in the educational institution that offering the course in São Paulo. Finally, we will present the full narratives of the five collaborators and, as research unfolding, a proposal for intervention in reality researched.

Orientador: Lucia Helena Reily
Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Artes
Made available in DSpace on 2018-08-07T11:30:29Z (GMT). No. of bitstreams: 1 Silva_JoseOtavioMottaPompeue_M.pdf: 3495232 bytes, checksum: 8c2abb18d675dd1d926f211cb92d216e (MD5) Previous issue date: 2006
Resumo: O objetivo desta pesquisa foi investigar os primeiros anos (de 1946 a 1957) do ateliê de pintura - localizado no hospital psiquiátrico do Engenho de Dentro, no Rio de Janeiro, Brasil - do ponto de vista dos artistas plásticos envolvidos, bem como a sua repercussão no campo da arte. Os dados foram coletados por meio de entrevistas com pessoas que participaram do início deste ateliê, análise de gravações em vídeo do acervo do Museu de Imagens do Inconsciente, revisão bibliográfica, incluindo consulta a jornais e revistas da época para reconstruir um panorama histórico sobre o ateliê de pintura. A literatura já mostrou como a psiquiatra Nise da Silveira, uma das mais importantes personalidades femininas do século passado no Brasil, associou-se ao jovem artista Almir Mavignier para criar um ateliê que usava a arte como recurso terapêutica no tratamento de um grupo de internos do hospital psiquiátrico. O presente estudo buscou reconstituir partes ignoradas desta história: como os internos foram convidados a freqüentar o ateliê, a atuação de Mavignier no desenvolvimento das atividades de arte, como se deu a confluência de outros artistas ao Engenho de Dentro, instigados pela produção plástica dos pacientes psiquiátricos e a organização de exposições em espaços culturais bem como em eventos de saúde mental. A produção plástica realizada neste ateliê, que deu origem ao Museu de Imagens do Inconsciente, ganhou notoriedade entre os críticos de arte da época, sendo exposta em importantes museus, como o Museu de Arte Moderna de São Paulo. Este estudo buscou mostrar os processos por meio dos quais os críticos tiveram contato com o trabalho. As obras do Museu de Imagens do Inconsciente foram reconhecidas internacionalmente por personalidades como C. G. Jung e Albert Camus. A produção plástica realizada neste ateliê também teve ressonância em artistas contemporâneos como Francisco Brennand, Ivan Serpa e Abraham Palatnik, que visitaram este ateliê. O estudo sugere que o fato de um artista plástico desenvolver os trabalhos no ateliê no contexto psiquiátrico representa um diferencial nos resultados. Concluímos que este ateliê de pintura faz parte do mosaico da história da arte no Brasil e que seu estudo mais sistemático nas diversas fases pode trazer contribuições para reflexões interdisciplinares nos campos da arte, saúde mental, e educação
Abstract: This study aimed to investigate the early years (from 1946 to 1957) of the art studio of the Engenho de Dentro Psychiatric Hospital in Rio de Janeiro, Brazil, from the point of view of the artists involved in the project, as well as its repercussions in the art world in Rio and São Paulo. Data was collected through interviews with participants who worked during the first years of the studio, analysis of video recordings from files owned by the Museu de Imagens do Inconsciente, and review of the literature, including research into articles published in newspapers and magazines of the period, all of which helped to reconstruct a historical ambience for this painting studio. Publications have shown how Nise da Silveira, psychiatrist, one of the most important Brazilian female figures of the last century, became associated with Almir Mavignier, visual artist, who together created the studio where art was to be used as a therapeutic resource for treating a group of patients at the psychiatric facility. The present study attempted to reconstruct unknown parts of this story: how eleven patients were chosen and invited to go to the studio, Mavignier's way of proposing and organizing art activities, how other visual artists began to flock to the Engenho de Dentro instigated by the artistic production of the psychiatric patients, and the organization of exhibits in culture centers, as well as mental health conferences. The visual arts products that came out of this studio, which gave way to the renowned Museu de Imagens do Inconsciente, began to intrigue art critics, and were exhibited in major museums, such as the Museum of Modem Art in São Paulo. This study aimed to show the processes whereby the critics came into contact with the work of psychiatric patients and their role in divulging these images." The production of the Museu de Imagens do Inconsciente was recognized internationally by people such as C. G. Jung and Albert Camus. There was also significant response from contemporary Brazilian artists such as Francisco Brennand, Ivan Serpa and Abraham Palatnik, all of whom visited the studio. This study suggests that the fact that a visual artist headed the work done at the studio in the psychiatric environment affected the results in important ways. We conclude that this painting studio is part of the mosaic of Brazilian art history and that a thorough study of the various phases in the history of the studio will bring important contributions to interdisciplinary thinking in the fields of art, mental health and education
Mestrado
Mestre em Artes

Submitted by Alison Vanceto (alison-vanceto@hotmail.com) on 2017-02-01T11:51:28Z No. of bitstreams: 1 DissIC.pdf: 2002678 bytes, checksum: b06535b93a7d1f19d4743c1080c4a2fc (MD5)
Approved for entry into archive by Camila Passos (camilapassos@ufscar.br) on 2017-02-08T12:03:20Z (GMT) No. of bitstreams: 1 DissIC.pdf: 2002678 bytes, checksum: b06535b93a7d1f19d4743c1080c4a2fc (MD5)
Approved for entry into archive by Camila Passos (camilapassos@ufscar.br) on 2017-02-08T12:06:26Z (GMT) No. of bitstreams: 1 DissIC.pdf: 2002678 bytes, checksum: b06535b93a7d1f19d4743c1080c4a2fc (MD5)
Made available in DSpace on 2017-02-08T12:06:35Z (GMT). No. of bitstreams: 1 DissIC.pdf: 2002678 bytes, checksum: b06535b93a7d1f19d4743c1080c4a2fc (MD5) Previous issue date: 2016-12-01
Não recebi financiamento
This work aims at the production of knowledge about Occupational Therapy in Brazil. This subject is explored by means of the current view of the scientific profile and the historical course of the profession from written and oral sources, reflecting on knowledge, conceptions and perspectives produced by occupational therapists up to the present time, including external and internal forces that make up the production of knowledge and action fields. The objective of this research is to understand the processes of production of knowledge about Brazilian Occupational Therapy by means of professional trajectories, theoretical and methodological production, conceptions and perspectives. It is about an exploratory research of a subject that is supposed to be revised nowadays with a qualitative and participant approach bringing the participants to the dialogue and composition of the text. Plural methodological procedures, articulated and compound, have been included at the presentation of results. Researchers who invest on general subjects of the Brazilian Occupational Therapy have been identified through a mapping process. Two identified researchers and three occupational therapists indicated by them are the interlocutors of this work, because of their production of dialogues about Brazilian Occupational Therapy in a comprehensive way. These interlocutors have been interviewed to get to know their trajectories, conceptions, perspectives and production about Occupational Therapy. Historical routes, challenges about the profession in Brazil, their construction of knowledge and debate on identity have been presented. It reflects about fundamentals, epistemology and theoretical and methodological perspectives, objects of study, concepts, conceptions and knowledge of Occupational Therapy in Brazil along history and at the present time. The aim is to value the diversity of expressions, stories and the interlocutors' individual production as well as to relate to their trajectories and experiences in knowledge production, which currently contribute for the composition of the net of knowledge about the profession. By means of their individual trajectory and its context, it is possible to find connections and instigating components for knowledge production about the profession. By gathering action fields, knowledge areas, references, support nets and other interlocutors, it has been possible to map part of the composition of the net of knowledge production of the profession at the present time. Some changes and transformation have been observed in the way of conceiving a profession, of acting and producing knowledge which influences on the national identity of Occupational Therapy and its epistemologic construction. It has been possible to explore the field, make up stories, memories, trajectories and reflect on produced knowledge about the profession in Brazil, thus, conceiving history and memory as collective and social constructions, identifying this way, producers and interlocutors of this knowledge and outstanding connection points in their trajectory, valuing knowledge production about Brazilian Occupational Therapy, and contributing for a discussion around general knowledge about the profession, its fundamentals, epistemology, identity, concepts, conceptions and perspectives, theoretical and methodological, in the Brazilian and contemporary context.
O presente trabalho dedica-se à produção de conhecimentos sobre a terapia ocupacional no Brasil. O tema é explorado por meio de um panorama atual do perfil científico, de um percurso histórico da profissão, com fontes escritas e orais, refletindo sobre os conhecimentos, concepções e perspectivas produzidos por terapeutas ocupacionais até a atualidade, compreendendo as forças internas e externas que compõem a produção de um campo de saberes e fazeres. O objetivo desta pesquisa é compreender processos da produção de conhecimentos sobre a terapia ocupacional brasileira por meio de trajetórias profissionais, produções, concepções e perspectivas teórico-metodológicas. Trata-se de uma pesquisa exploratória de um tema a ser revisto na atualidade, de abordagem qualitativa e participante ao trazer os interlocutores para o diálogo e composição do texto. Incluiu-se procedimentos metodológicos plurais articulados e compostos na apresentação dos resultados. Foi realizado um mapeamento que identificou pesquisadores que investem em temas gerais da terapia ocupacional brasileira. Duas pesquisadoras identificadas e mais três terapeutas ocupacionais indicadas por elas são interlocutoras do trabalho, por produzirem diálogos sobre a terapia ocupacional brasileira, de forma ampliada. As interlocutoras foram entrevistadas para conhecer suas trajetórias, concepções, perspectivas e produções sobre a terapia ocupacional. Apresenta-se percursos históricos, desafios da profissão no Brasil, sua construção de conhecimentos e o debate sobre identidade. Reflete-se sobre temas dos fundamentos, epistemologia e perspectivas teórico-metodológicas, objetos de estudo, conceitos, concepções e conhecimentos da terapia ocupacional no Brasil, na história e atualidade. Buscou-se valorizar a diversidade das expressões, relatos e produções individuais das interlocutoras e, também, relacionar suas trajetórias e experiências na produção de conhecimentos, que contribuem para a composição da rede de conhecimentos da profissão na atualidade. Ao conhecer os caminhos individuais e seus contextos, é possível encontrar conexões e componentes instigadores para a produção de conhecimentos sobre a profissão. Reunindo campos de atuação, áreas do conhecimento, referenciais, redes de apoio e outros interlocutores, mapeou-se parte da composição da rede de produção de conhecimentos da profissão na atualidade. Observa-se mudanças e transformações na forma de conceber a profissão, atuar e produzir conhecimentos, que influenciam na identidade nacional da terapia ocupacional e na sua construção epistemológica. Foi possível explorar um campo, compor histórias, memórias e trajetórias, e refletir sobre conhecimentos produzidos sobre a profissão no Brasil, concebendo história e memória como construções coletivas e sociais, identificando produtores e interlocutores desses conhecimentos, pontos de conexão e de destaque em suas trajetórias, valorizando a produção de conhecimentos sobre a terapia ocupacional brasileira e contribuindo para uma discussão em torno de conhecimentos gerais sobre a profissão, seus fundamentos, epistemologia, identidade, conceitos, concepções e perspectivas teórico-metodológicas, no contexto brasileiro e contemporâneo.

Rehabilitation hospitals serve to foster a client’s independence in preparation to return home after an injury or insult. Having space in rehabilitation environments that is home-like and supportive for each client can facilitate participation in occupations and assist in learning and practicing the skills needed to transition to home. Yet, typically occupational therapists provide interventions to clients in therapy gyms with exercise and impairment based equipment. Currently the stroke population is changing and identifying the optimal rehabilitation environment is imperative to guide occupational therapy practice. This dissertation contains three studies relating to the rehabilitation environment and occupational therapy interventions. The first study focused on the perceptions of occupational therapists regarding their optimal rehabilitation environment, identifying that they would prefer to offer their clients a variety of rehabilitation environments and that there is a relationship between the environment and the type of intervention provided. A second study examined the effects of occupation-based interventions provided in a home-like environment to an individual recovering from chronic stroke with the results indicating enhanced occupational performance, resumed competence in desired roles, improvement in affected upper extremity function, and notable neuroplastic change. The final study investigated how the rehabilitation environment influenced the interventions used by the occupational therapists. The findings supported the relationship between the therapy environment and a specific intervention; working in the therapy gym with preparatory methods and being in a home-like space using occupation-based interventions. The environment influenced occupational therapy interventions and it is recommended that the occupational therapist match the client’s goals to the ideal environment for optimal intervention.

The incidence of diabetes in the United Kingdom is increasing and its impact on health and social care costs is significant, with considerable personal consequence for the individual with diabetes. Current approaches to managing or preventing diabetes include education, self management and lifestyle change but the evidence suggests that some people are unwilling or unable to make lifestyle changes recommended for better health and wellbeing. This qualitative study examined the potential role of occupational therapy, with its focus on individual and daily occupations, to enable people with diabetes to manage this condition in the context of their own lives. Using a process of intuitive inquiry, it comprised three separate studies all using semi-structured interviews. The first, designed to explore the lived experience of diabetes, involved seven people with a diagnosis of type 1, type 2 or pre-diabetes. Findings were shared with participants using a felted metaphor of charting a course of health and well-being through a choppy sea. The second study involved ten occupational therapists with type 1, type 2, gestational or pre-diabetes and examined the use of metaphor as a means of understanding the lived experience. In addition the potential role of occupational therapy was explored with participants. Using knowledge gained from studies 1 and 2, the third study involved five people with type 2 diabetes and used metaphor as a means of exploring difficulties and successes in diabetes self management. All three studies were then drawn together to consider the use of metaphor and the potential role of occupational therapy in diabetes self management. From the findings a model of the occupation of diabetes self-management is proposed along with a framework for occupational therapy intervention in diabetes self-management that focuses on the professional belief of the impact of occupation on health and wellbeing and considers the individual in their particular life context.

Magister Scientiae (Occupational Therapy) - MSc(OT)
Occupational justice empowers individuals, especially the previously disadvantaged, to have their basic needs met, as well as turn their potential into reality, through human rights and labour legislation, which provides access to equal opportunities. However, with the amount of different choices, in terms of occupational roles, facing the individual to fill their time with, effective management thereof to preserve one’s health and well-being on a daily basis, is not necessarily guaranteed. Occupational science, and more specifically, occupational therapy education imparts the importance of occupational balance, a concept which denotes a balance between the person, their environment and their occupations, some of which are strenuous and others relaxing. Occupational balance can be achieved by adapting the physical, mental, social and rests occupations.

Thesis (MOccTher (Interdisciplinary Health Sciences. Occupational Therapy))--University of Stellenbosch, 2007.
Objectives: The study aimed to identify the functions that occupational therapy leaders perform in clinical settings in the Metropole District of the Provincial Administration of the Western Cape (PAWC) and determine the influence of these functions on clinical practice. Methodology: The researcher used a descriptive design and a non-standardised questionnaire which was compiled to collect the data for the study. The questionnaire was piloted with a group of occupational therapy leaders from the Boland Overberg Region. Feedback was used to refine the final study questionnaire. Thirty-five study questionnaires were mailed or handed to the participants in the study and the researcher received 25 completed questionnaires; therefore, the response rate was 71.4%. The data were analysed using the Statistical Package for the Social Sciences (SPSS 10.0) for all the questions. Descriptive statistics were used to report the data. Inter-observer reliability was checked by using the split-half method. The results revealed that the study questionnaire was reliable as Cronbach's Alfa was calculated at 0.90, correlation coefficient Pearson’s r was calculated at 0.51, and Spearman-Brown was calculated at 0.67. Results: The results were presented in relation to the respondents’ number (N = 25). The participants identified 57 leadership functions, grouped as managerial, ethics-related, education, research, and consultation functions. The participants reported to have high performance in both direct and indirect occupational therapy services. Performance in the direct occupational therapy services functions was higher than the performance in the indirect occupational therapy services. Minimal performance in occupational therapy leadership functions was reported for consultation, ethics related, and research functions which need to be addressed by in-service training. The indirect occupational therapy services enabled the participants in the study to perform on a more optimum level regarding the direct occupational therapy services. The occupational therapy leaders had many empowering factors in their work place such as subordinates, supervisors, and top management. Conclusion: The 57 leadership functions identified in the study culminated in an occupational therapy leadership functions framework (OTLFF) which represents the managerial activities of the occupational therapy leaders in the PAWC. These study findings are useful guidelines for occupational therapy professionals and students as guidelines for leadership training, participant facilities to compile job descriptions, and educational facilities to set educational curricula. Recommendations: The study had many shortcomings; therefore, generalisation of results can't be done. The researcher recommends replication of the study using a larger and more representative sample.

One of the most important challenges of health and medical care is to strength the role of the patient in the treatment. In psychiatric care the patient must be seen as a resource and should be given the opportunity to participate in his treatment. The overall aim of the thesis was to investigate and describe how patients in psychiatric care perceive participation, and how existing assessments support participation.

Study I describes how patients in psychiatric institutional care perceived their opportunities to be active and to participate in their own treatment. The ICF (International Classification of Functioning Disability and Health) inspired the study. By means of a questionnaire, 61 patients reported their opinions of the value of received care, highlighting concepts such as activity and participation. Ten of those patients were then selected for a semi-structured interview. The study showed that patients who were treated according to compulsory care (LPT) were generally more dissatisfied with their opportunities to be active and participate in their own care than patients treated according to the law of health and medical care (HSL). Younger patients in particular were more dissatisfied. Some important factors in the environment were continuity and reception from the staff. Facilitating factors for activity and participation were agreement between patient and staff about the treatment plan, discussions about expectations, and creating conditions for engagement in activities and or responsibility.

Study II investigates if there is harmony between the CPRS-S-A (Comprehensive Psychopathological Rating Scale-Self-Assessment), the OCAIRS–S (Occupational Circumstances Interview and Rating Scale) and the OSA (Occupational Self Assessment), and if they can replace each other when the occupational therapist collects information about the patient. Another aim was to investigate how occupational therapist uses the collected information in the treatment plan process. Fourteen patients with depression disorders took part in the study. The study showed that even if the symptoms of the disease were improved at the end of the treatment period the patients still had problems with occupational performance, reduced self-confidence and the structure of their day. Consequently the assessments cannot replace each other. The study emphasized the importance of using both interview and self-assessments when collecting information about the patient, since these methods complement each other in identifying the needs and goals of the treatment. Many problems were related to the patient’s social environment but this was not reflected in the treatment plan; few goals were identified in this area.

In conclusion, occupational therapists should use self-assessments and interviews in order to support the patient’s participation in psychiatric care. Furthermore, it is important to use assessments for both occupational performance and medical symptoms when identifying the patient’s needs and goals of treatment since there is a discrepancy between the two areas; symptoms are reduced earlier than perceived problems in occupational performance. Regardless of what kind of law the patient is treated under, all patients have the right to participate in their own treatment. This thesis also shows that the social environment is important in enabling the participation of patients in their psychiatric care.

En av de viktigaste utmaningarna inom hälso- och sjukvården är att stärka patientens ställning i behandlingen. Inom psykiatrisk vård så måste patienten ses som en resurs och ges möjlighet att vara delaktig i sin behandling. Det övergripande syftet med denna avhandling var att undersöka och beskriva hur patienter inom psykiatrisk vård uppfattar delaktighet och hur existerande instrument stödjer delaktighet.

Studie I beskriver hur patienter inom psykiatrisk slutenvård uppfattar sina möjligheter till aktivitet och delaktighet under vårdtiden. ICF (Klassifikation av funktionstillstånd, funktionshinder och hälsa ) inspirerade studien. Genom en enkät svarade 61 patienter på värdet av den vård som de erhöll, där begrepp som aktivitet och delaktighet belystes. Tio patienter valdes sedan ut för en semistrukturerad intervju. Studien visar på att patienter som vårdats utifrån Lagen om Psykiatrisk Tvångsvård (LPT) var generellt mer missnöjda än de patienter som vårdats utifrån Hälso- och Sjukvårdslagen (HSL). Även yngre patienter var mer missnöjda. Några viktiga faktorer i miljön som påverkar möjlighet till delaktighet var kontinuitet och bemötande från personalen. Underlättande faktorer för aktivitet och delaktighet var att det fanns en samstämmighet mellan patient och personal i vårdplaneringen, att förväntningar diskuterades, att förutsättningar till engagemang i aktiviteter gavs och att patienten fick möjlighet att ta eget ansvar.

Studie II undersöker om det finns harmoni mellan CPRS-S-A (Comprehensive Psychopathological Rating Scale-Self-Asessment), OCAIRS-S (Occupational Circumstances Interview and Rating Scale) och OSA (Occupational Self Assessment) och om de kan ersätta varandra när arbetsterapeuten samlar information kring patienten. Ett annat syfte var att undersöka hur arbetsterapeuten använder den insamlade informationen i behandlingsplanen. Fjorton patienter med depressionssjukdom deltog i studien. Studien visar att även om de medicinska symptomen förbättras i slutet av behandlingen så har patienten fortfarande problem i aktivitetsutförande, nedsatt självkänsla och struktur på dagarna. Bedömningsinstrumenten kan inte ersätta varandra. Studien betonar vikten av att använda både intervju och självskattning vid datainsamling kring patienten, då de kompletterar varandra vid identifiering av behov och mål i behandlingen. Många problem var relaterade till patientens sociala miljö, dock saknades detta i behandlingsplanerna; få mål och åtgärder identifierades inom detta område.

Sammanfattningsvis, arbetsterapeuten bör använda självskattningar och intervjuer i syfte att stödja delaktighet inom psykiatrisk vård. Dessutom är det betydelsefullt att använda bedömningsinstrument både för aktivitetsutförande och medicinska symptom för att identifiera patientens behov och mål i behandlingen då det är en diskrepans mellan dessa två områden; medicinska symptomen reduceras tidigare än upplevda problem i aktivitetsutförandet. Oavsett vilken lag som styr vårdformen så har alla patienter rätt till delaktighet i sin egen behandling. Denna avhandling visar också på att den sociala miljön är viktigt för delaktighet för patienter inom psykiatrisk vård.

Increasingly health workers are expected to self-evaluate within the work-place thus raising the question as to how they develop such skills. To date there has been very little research on self-assessment in higher education courses which prepare health professionals for their future careers. The project aimed to investigate occupational therapy students' self-evaluation skills during their professional education and within their first work-place. This practice based investigation was conducted by a member of academic staff in one of the two centres in Scotland offering a BSc in Occupational Therapy course. Data was collected from two different universities offering the course, the study period was the academic years from 1992 to 1996. Four different research tools were used, a content analysis of relevant course documents was carried out; 113 students and 15 academic staff were surveyed using questionnaires, with regard to their understanding and use of self-assessment within the course; self-grading of academic work by three cohorts of students (n=113) was conducted and fifteen graduates and workplace supervisors health care and social work were interviewed through the use of repertory grid interviews. Self-evaluation was emphasised and strongly, linked to professional development, within the course documents of both universities. Students and academic stab identified clinical placements as the area within which, most commonly selfassessment occurred and developed. Students were generally positive with regard to self-assessment being used within the academic components of the course, however, staff were more hesitant. The students consistently under-rated their academic assessments although the majority were within a five-percent range of the experts' marks. One cohort of students did demonstrate an improvement in self-assessment over the three years but similar trends were not detected with the other two cohorts. The repertory grid interviews produced a large number of constructs (507 constructs). It would appear that graduates are able to self-assess accurately within the work place, as there was high agreement between graduates and supervisors regarding the graduates' skills and abilities. In conclusion this investigation indicates that there are discrepancies between course aims and objectives and the reality of self-assessment in the educational context. Although students have the opportunity to practice self-assessment within the academic situation they are limited in their ability to self-assess accurately. They are, however, very confident at self-assessing within the workplace. This confidence may be linked to the fact that as students self-assessments was practised during the clinical component of the course. There is a need for further research with more cohorts being followed throughout the length of their course and also cohorts within other courses.

Occupational therapy is broadly about the experience of ‘doing’ as the basis of human participation. This requires access to the means of participation: space, facilities and resources for different forms of human action. People who have experienced disability are frequently prevented from engaging in activities which other people can access, and can benefit from. Their rights to social participation at all levels are restricted, and this is a political aspect of their impairment - something that is recognized in feminist discourse in the recognition of the relationship between the personal and the political. Consequently rehabilitation has a dimension which is not just about restoring or adapting function, but also about addressing the social and political circumstances which produce barriers to occupation. The submitted works discuss a rights based approach to human occupation, which in turn derives from a narrative understanding of ‘doing’ as an individual and collective expression of actions. My most significant and original contributions to occupational therapy and occupational science concern the development of an argument for the understanding of a political dimension to human occupation. These works are accompanied by research papers which evidence some aspects of my theories. In its concentration on clinical and medically led objectives the profession has infrequently recognized the relationship between health conditions and the wider issues of social and economic disparities. Part of my work has called attention to the systematic nature of exclusions which prevent access to meaningful and purposeful occupation, and calls for therapists to work with their clients not only in terms of traditional intervention, but to address them through political alliance.

Thesis (MOccTher)--Stellenbosch University, 2000.
ENGLISH ABSTRACT: The rights of people with disabilities to equal opportunities for employment is acknowledged on a national and international level. A key area whereby this can be addressed is through effective vocational rehabilitation programmes in occupational therapy. The delivery of high quality health care services is an important issue for the consumer and government within the health arena. This implies that standards have to be developed for the various services. The standards will serve the purpose of activating quality assurance and quality improvement processes in all health care services. Vocational rehabilitation of people with disabilities and the emphasis that is placed on good quality care, resulted in the question: "How can occupational therapists ensure that they will deliver a good quality service in a vocational assessment area?". The question is posed specifically in terms of the assessment of a person's work abilities, as this step is viewed as most important in the vocational rehabilitation process. The step(s) that follow will be determined by the results obtained from the assessment. The purpose of the study is to identify a standard statement and generic measurement criteria that will be used to set the standards for Structure, Process and Outcome for vocational assessment areas. The establishment of measurement criteria is viewed as a starting point in the quality assurance cycle. The results of the study will initiate quality assurance and quality improvement in vocational assessment areas. Although the role of the occupational therapist is clearly delineated regarding vocational rehabilitation and the importance of the occupational therapy contribution recognised in this regard, could no information pertaining to standards and measurement criteria for work assessment areas be identified through a literature study. It was therefore decided to develop a standard statement and measurement criteria according to the Donabedian Model of Structure, Process and Outcome for vocational assessment areas in South Africa. Occupational therapists with at least one year experience of vocational rehabilitation of patients were requested to rate the proposed standard statements and measurement criteria. A survey method (adapted Delphi method) was used whereby the participants had to rate the proposed standard statements and measurement criteria on a four-point scale. The results obtained were used to draw up a standard statement and measurement criteria to ensure that quality assurance and quality improvement will become a reality in vocational assessment areas in South Africa.
AFRIKAANSE OPSOMMING: Die regte van persone met gestremdhede tot gelyke indiensneming word op nasionale en internasionale vlak erken. Die aanbieding van effektiewe werkrehabilitasieprogramme deur arbeidsterapeute is een van die belangrikste wyses waarop die situasie aangespreek kan word. Die lewering van hoë gehalte gesondheidsdienste word toenemend deur die verbruikers en die staat vereis. Dit impliseer dat standaarde vir die dienste vasgestel moet word om gehalteverbetering en gehalteversekering in gesondheidsdienste te vestig. Werkrehabilitasie van persone met gestremdhede en die kwessie van hoë gehalte dienste het die volgende vraag laat ontstaan: "Hoe kan die arbeidsterapeut verseker dat 'n hoë gehalte diens in 'n werkbepalingsarea gelewer word?". Die vraag handel spesifiek oor die bepaling van 'n persoon se werkvermoëns aangesien dié stap as baie belangrik binne die werkrehabilitasieprogram beskou word. Die stap(pe) wat hierna sal volg, salop besluit word na aanleiding van die resultate van die bepaling. Die doel van die studie is om 'n standaardstelling en generiese metingskriteria volgens Donabedian se model te identifiseer om die standaarde vir die Struktuur, Proses en Uitkoms van werkbepalingsareas in Suid-Afrika daar te stel. Die bogenoemde metingskriteria sal dit moontlik maak om die gehalteversekeringsiklus te inisieër. Gehalteversekering en gehalteverbeteringsaksies sal as gevolg hiervan in werkbepalingsareas kan plaasvind. Ten spyte van die feit dat die rol van die arbeidsterapeut in werkrehabilitasie duidelik uiteengesit is en die belang daarvan erken word, kon geen inligting oor 'n standaardstelling en metingskriteria vir werkbepalingsareas in die literatuur gevind word nie. Arbeidsterapeute met minstens een jaar ondervinding van werkrehabilitasie van pasiënte het hulle menings ten opsigte van 'n standaardstelling en metingskriteria uitgespreek. 'n Opname metode (gewysigde Delphi metode) is gebruik en deelnemers het op 'n vierpuntskaal hul voorkeure ten opsigte van 'n standaardstelling en metingskriteria aangedui. Die resultate wat op dié wyse bekom is, is gebruik om 'n finale standaardstelling en voorkeur metingskriteria voor te stel. Die gebruik hiervan in werkbepalingsareas sal daartoe lei dat gehalteversekering en gehalteverbetering in dié areas in Suid-Afrika tot uitvoer gebring sal word.

The national occupational therapy (OT) professional association of Canada expects graduates and practicing clinicians to demonstrate the knowledge, skills and attitudes to carry out evidence-based practice (EBP). Evidence-based OT practice involves a process whereby therapists combine expert judgment and clinical experience with available scientific evidence and client choices, to make a clinical decision for a given client. Although academic programs are urged to design curricula that will promote EBP competencies, there are currently no available guidelines to support faculty in the design of an EBP curriculum. Identifying the trajectories of EBP competencies as they develop across the levels of professional education in OT can inform the instructional design required to foster the necessary EBP knowledge and skills across the different levels. The purpose of this doctoral study was to compare EBP behaviours among OT students and expert OT clinicians on a written simulated case and identify the extent to which their practices reflected features of EBP. The practice behaviours of expert clinicians (n = 7) were identified and subsequently used to create a reference model for EBP. Then the EBP behaviours of students (n = 53) in three different academic levels in a professional Master's entry-level OT program and a new group of experienced clinicians (n = 9) were compared to the practice behaviours depicted in the reference model. The EBP reference model illustrates two types of decisions, those based on scientific evidence and those that were primarily driven by clinical experience. Comparisons of EBP behaviours of students and experienced clinicians showed that students had greater breadth of knowledge of EBP aspects taught in the OT program. Experienced clinicians' practice behaviours were most consistent with the decisions illustrated in the model in the aspects of EBP which appeared to depend upon clinical experience. This study has implications for both OT education and clinical practice. The reference model can be used as a practice framework to guide therapists through clinical decision-making in one area of OT practice. In OT education, the model can be used as a framework for teaching and assessment of expert decision-making. The identified gaps in students' knowledge can guide faculty as they monitor and update the EBP content within the OT curriculum.
L'association nationale regroupant les professionnels en ergothérapie du Canada s'attend à ce que les diplômés et les cliniciens fassent preuve des connaissances, des compétences et des attitudes requises pour exercer une pratique basée sur des données probantes (PBDP). Une telle pratique repose sur une démarche décisionnelle associant expertise, et expérience clinique aux données scientifiques à la disposition des cliniciens et aux choix de chaque client. Même si les programmes universitaires sont orientés vers la rédaction de cursus favorisant l'acquisition de compétences associées à une PBDP, il n'existe à l'heure actuelle aucune directive pour guider le personnel enseignant dans l'élaboration d'un cursus favorisant la PBDP. La détermination de l'évolution des compétences en PBDP à tous les niveaux de la formation professionnelle en ergothérapie peut éclairer la conception pédagogique nécessaire à l'acquisition des connaissances et compétences liées à la PBDP aux divers paliers. L'objectif de cette recherche de doctorat était de comparer les comportements typiques d'une PBDP chez les étudiants en ergothérapie et chez les cliniciens experts dans le cadre d'un exercice de simulation écrit et de déterminer à quel point leurs pratiques reflètent les caractéristiques de la PBDP. La description des comportements professionnels de cliniciens experts (n = 7) a permis de créer un modèle de référence de PBDP. Les comportements liés à la PBDP des étudiants (n = 53) à divers niveaux d'étude de maîtrise en ergothérapie et d'un nouveau groupe de cliniciens expérimentés (n = 9) ont alors été comparés aux comportements professionnels décrits dans le modèle de référence. Ce modèle de PBDP illustre deux types de décisions, celles qui sont fondées sur des preuves scientifiques et celles qui sont principalement motivées par l'expérience clinique. La comparaison des comportements typiques de la PBDP chez les étudiants et chez les cliniciens expérimentés a révélé que les étudiants avaient plus de connaissances sur les aspects de la PBDP enseignés dans le programme d'ergothérapie. Les comportements professionnels des cliniciens expérimentés correspondaient plus étroitement avec les décisions décrites dans le modèle comme étant des aspects de la PBDP qui semblaient liés à l'expérience clinique. Cette étude a des répercussions tant pour la formation en ergothérapie que pour la pratique clinique. Le modèle de référence peut servir de cadre décisionnel en pratique dans un domaine particulier de l'ergothérapie. Dans le programme de formation des ergothérapeutes, le modèle peut servir de cadre d'enseignement et d'évaluation de l'expertise décisionnelle. Les lacunes cernées quant aux connaissances des étudiants peuvent orienter le corps professoral qui fera le suivi et la mise à jour du contenu lié à la PBDP dans le cursus en ergothérapie.

Aktivitetsbalans innebär hur individen upplever sitt aktivitetsmönster, vilket är mängden av aktiviteter samt variationen av aktiviteter under en dag. Syfte: Syftet med studien var att beskriva hur individer med narkolepsi upplever aktivitetsbalans. Metod: En kvantitativ design användes med deskriptiv tvärsnittsstudie där data samlades in via enkät. Enkäten utgick från instrumentet Occupational Balance Questionnaire [OBQ] och innehöll 11 frågor med fyrgradig skattningsskala samt 4 frågor med fritextsvar. Det var 20 individer som deltog i studien varav 18 stycken är kvinnor och två är män. Deltagarna var mellan åldrarna 18- 56 år. Data analyserades med deskriptiv och analytisk statistik samt innehållsanalys då enkäten gav både kvantitativa och kvalitativa variabler. Resultat: Deltagarna skattade sin aktivitetsbalans som låg. Ingen signifikant skillnad på aktivitetsbalans mellan arbetande/studerande eller arbetslösa/sjukskrivna kunde visas i resultatet. Ingen signifikant skillnad av aktivitetsbalans kunde heller ses mellan ålder och kön på deltagarna, dock var majoriteten av deltagarna kvinnor. Den kvalitativa analysen resulterade i tre kategorier; brist av meningsfulla aktiviteter, aktiviteter som tar och ger energi och brist på vila, sömn samt återhämtning. Det centrala i alla kategorier var att deltagarnas brist på vila och återhämtning påverkar deras aktiviteter i stort och genomsyrar vardagen. Sociala sammanhang blev påverkade samt bortvalda då deltagarna inte hade energi att umgås med andra. Slutsats: Resultatet pekade på att individer med narkolepsi var i behov av mer stöd än det som ges i idag, stödet kan vara strategier och hjälpmedel. Därför finns ett intresse att fortsatt studera vilken typ av insatser eller strategier som kan möjliggöra aktivitet och en vardag i balans för denna grupp.

The purpose of this study was to discover attitudes and knowledge of four healthcare student groups toward occupational therapy in Iceland. A fact-sheet identifying philosophy, theoretical background, skills roles and occupational therapy working areas was developed. Pre-test and post-test questionnaires were used to measure any attitude and knowledge changes which might have occurred after reading the fact-sheet. The results demonstrated that the four student groups had obtained knowledge about occupational therapy during their university experiences; either from in class information or from field trips to occupational therapy departments. The questionnaire results indicated that students' attitudes toward cooperation with occupational therapists was positive. The overall outcome indicated that as a result of information gained from the fact-sheet, significant attitude and knowledge changes were demonstrated among the four student groups about occupational therapy in Iceland.

Syftet med denna litteraturstudie var att studera vilka möjligheter arbetsterapeuten har att främja förmågan till fortsatt arbete för personer med MS och RA.

Sökord: arbete, arbetsterapi, kronisk sjukdom, multipel skleros, reumatoid artrit

Bakgrund: MS och RA är kroniska sjukdomar som främst drabbar personer i arbetsför ålder. Symtomen från dessa sjukdomar påverkar personernas arbetsförmåga i olika stor utsträckning. Arbetsterapeutens roll är att möjliggöra för personer att utföra aktiviteter i det dagliga livet som anses vara meningsfulla för dem. Med sina bedömningar och insatser kan arbetsterapeuten bidra till att möjligöra detta för personer som har förlorat förmågor p.g.a. t.ex. sjukdom. Arbetsterapeuten kan använda Internationell Klassifikation av funktionstillstånd, funktionshinder och hälsa (ICF) som en referensram inom rehabilitering på personer med svårigheter att utföra ett arbete. Metod: Systematisk litteraturstudie, där sökningar gjordes i databaserna Amed, Cinahl och Medline (Ebsco). Samma sökord och sökkombinationer har använts i de olika databaserna. 11 artiklar har valts ut ifrån den systematiska sökningen och tre har samlats in via en manuell sökning. Sammanlagt utgör 14 artiklar resultatet i denna studie. Resultat: Studier visar på att arbetsterapeuten kan främja förmågan att fortsätta arbeta för personer med MS och RA. Detta genom att ordinera hjälpmedel, ge information, anpassa arbetsmiljön och arbetsuppgifter. Arbetsterapeuten kan använda instrument som Worker Role Interview (WRI) och Work Environment Impact Scale (WEIS), för att bedöma arbetsförmågan hos personer med olika nedsättningar. Resultatet visar också på att det finns gemensamma faktorer på kroppsstruktur/kroppsfunktionsnivå som påverkar arbetsutförandet för personer med MS och RA, så som fatige/trötthet, smärta och funktionsnedsättning. Även faktorer i den fysiska och sociala miljön påverkar arbetsutförandet på så sätt att de nedsättningar som sjukdomarna ger kunde t.ex. leda till att personerna har problem att ta sig till och från arbetet och utföra sina arbetsuppgifter som tidigare. Familj, arbetsgivare och kollegor kunde både upplevas stödjande och hindrande relaterat till arbetsförmågan. Slutsatser: Denna litteraturstudie visar att arbetsterapeuten med sina bedömningar och insatser kan främja förmågan till fortsatt arbete för personer med kroniska sjukdomar. Det finns gemensamma faktorer både på kroppsstruktur/kroppsfunktionsnivå och i den fysiska och sociala miljön som påverkar arbetsförmågan för personer med kronisk sjukdom. Denna kunskap kan arbetsterapeuten använda sig av i mötet med dessa personer.

People who have suffered a stroke can become housebound and miserable because they cannot access suitable transport. They can have difficulty getting to the shops, doctors and hospital and this can have an effect on their quality of life. Occupational therapists routinely aim to help these people overcome their outdoor mobility problems by providing information and verbal instructions but these interventions do not appear to be effective. The aim of this research was to design and evaluate a new occupational therapy outdoor mobility intervention. The intervention was modeled on travel training that is provided for other conditions and the outdoor mobility experiences and needs of people with stroke. Qualitative semi structured interviews were used to investigate 24 peoples experiences of both using transport and their outdoor mobility after they had suffered a stroke. It was found that people wanted to travel for a variety of reasons; shopping, work, getting to the doctors, social reasons, meeting friends, visiting family and just for the sake of traveling. People were prevented from traveling because of physical difficulties such as stepping onto the bus, psychological problems such as confidence and environmental barriers such as the weather or lack of information. The results were used to define the main components of an Occupational Therapy Outdoor Mobility Intervention. A randomised controlled trial was used to evaluate the effects of this Occupational Therapy Outdoor Mobility Intervention (OTOMI) by comparing it to the routine occupational therapy intervention. Participants with stroke in the last 36 months were recruited from primary care services and randomly allocated to receive either the OTOMI or the routine occupational therapy. Participants in the OTOMI received up to seven individualised occupational therapy sessions. The sessions aimed to increase confidence, encourage use of different types of transport and provided tailor-made information. Outcomes were measured by postal assessment 4 and 10 months after recruitment. The primary outcome measure was a yes/ no question, Do you get out of the house as much as you would like? Secondary outcomes included the number of journeys, mood, performance of activities of daily living and leisure. 168 participants who had had a stroke in the last 36 months were recruited into the study over eighteen months, 82 in the control group and 86 to the OTOMI group. 10 people were unable to provide follow-up information at the four month assessment and 21 people at the ten month assessment. Intention-to-treat analyses were undertaken. For the principal outcome measure, participants who were dead at the point of assessment were allocated the worst outcome, and for others lost to follow up their baseline or last recorded responses were used. For the other analyses all missing values were imputed using baseline values. Participants in the treatment group were more likely to get out of their house as often as they wanted at 4 months (RR 1.72,95% CI 1.25 to 2.37) and at 10 months (RR 1.74,95 Cl 1.24 to 2.44). The treatment group recorded more journeys outdoors in the month prior to assessment at 4 months (intervention group median 37, control group median 14, Mann-Whitney p<0.01) and at 10 months (intervention group median 42, control group median 14, Mann-Whitney: p<0.01). At 4 months the NEADL mobility scores were significantly higher in the intervention group, but there were no significant differences in the other secondary outcomes. There were no significant differences in these measures at 10 months. The interview study demonstrated that participating in outdoor mobility is a major problem for people who have had a stroke. The randomised controlled trial demonstrated that a relatively simple and feasible, individualized, properly organised, focused and adequately resourced occupational therapy outdoor mobility intervention can increase participation in outdoor mobility activities, allowing people to get out of the house as much as they wish.

This research study investigated age as a predictor of success in the academic outcome and early professional performance of recent occupational therapy graduates. The study was divided into two parts. The analysis of age and academic performance in occupational therapy education initially provided a picture of mature student success when compared with the performance of younger students, but this finding was negated when the confounding variable of entry qualification was added to the analysis. The mature student data were strongly influenced by the superior academic performance of the students who had a previous degree on entry to occupational therapy education. When these degree-level entrants were removed from the age analysis, the academic performance of the remaining mature students did not differ significantly from that of the younger students. This result indicates that entry qualifications, in particular a previous degree, have a positive predictive affect on academic performance in occupational therapy education. The second part of the study investigated the impact of age on the early professional performance of recent occupational therapy graduates using a competency questionnaire adapted from the curriculum framework document for occupational therapy in the UK (COT, 1998). The hypotheses that age is a value-added factor in the early professional performance and level of threshold competence after graduation was partially upheld in the graduate self-ratings of competence but not in the employer ratings of new graduates in practice. No age differences were observed in the employer ratings of graduate abilities but academic performance at university was related to perceived levels of. competence. When graduates rated their self-perceived levels of competence, it was the mature graduates who consistently rated themselves as being more competent than their younger peers. The type of occupational therapy programme undertaken did not relate to either the employer or graduate ratings of competence. All respondents were provided with an opportunity to comment on the issue of professional competence. Mature students expressed high expectations of their professional competence yet were no different to all other new graduates in reporting stress when making the transition between being a student and qualified practitioner. A discrepancy in expectations of threshold competence was observed between the employer and the graduate comments.

This minor dissertation is built around the Vona du Toit Memorial lecture that was given, by the author, to the Occupational Therapy Association of South Africa (OT ASA) in July 1999. The central theme of both the lecture and the dissertation is professional transformation. the impetus for which is seen to reside in the axiology of the profession, starting with the morn! values, attitudes and beliefs of individual practitioners and moving towards a collectively revisioned professional ontology. It is proposed that the ·identification, analysis and resuscitation of the profession's ethos at an individual level will ultimately impact transformatively on the nature and characteristics of the profession collectively. Particular emphasis is placed on undergraduate ethics curriculum reform for the vision of transform3tion at an individual level to be realised. The dissertation documents the pilot phase of a dialectical research cycle (Reason 1981) during which the author developed perspectives about the ethical concerns that the occupational therapy profession in South Africa needs to consider in the light of its past during apartheid and in view of its future in a developing nation. It contains a conceptual analysis of the pivotal role that professional ethics and morality will have to play in effecting fundamental change in the philosophical, structural, political and education at dimensions of the profession in response to the unique demands of the African context and suggests practical educational strategies through which attitudinal transformation in undergraduate occupational therapy students may be achieved.

PURPOSE: This sequential embedded mixed methods study first identified the ways in which occupational therapy leaders experience leadership, then explored the ways in which those same leaders utilized their professional training as occupational therapists within their practice of leadership. METHODS: The twelve participants held formal leadership positions in either academia, clinical practice, or professional associations. The ecology of human performance model of practice was utilized to frame the research study. Data was collected through an initial interview with all 12 participants and through leadership artifacts and a second interview with six participants. RESULTS: Three themes resulted from thematic analysis of initial interview: leadership journey, leadership deconstructed, and personal approach to leadership. The leadership artifacts were analyzed using a coding frame, which included four dimensions: occupational perspective of leadership, connections, leadership approach, and team mindset. Thematic analysis of the second round of interviews resulted in three themes: how they do leadership, leadership interaction, and reflection on leadership action. CONCLUSIONS: The participants described the construct of leader as a role consisting of contextually discrete leadership occupations. A number of parallels were identified between the practice of occupational therapy and the practice of leadership. The development of a personal leadership identity was found to occur over time and required some form of either internal or external recognition of leadership ability or outcome. The structure of this mixed methods design included a combination of two qualitative methods, which was novel to the occupational therapy literature.

The purpose of this capstone project is to develop an evidenced-based, innovative, and comprehensive occupational therapy evaluation and intervention protocol for breast cancer care. The contents of this paper will include an introduction into the current care provided to survivors, literature review on best practice in breast cancer care, outline of the procedures completed to discover what best practice care should be, results of these procedures, discussion of the results, and conclusion with proposed program and recommendations for further investigation. The concern investigated is the inconsistencies in care provided to survivors from the time of diagnosis throughout their lifespan or survivorship. A body of growing evidence supports the important need to address functional performance from the point of diagnosis through treatment and survivorship. A model of rehabilitation-based care has been put forward by the American Cancer Society as an optimal construct, however, there are significant inconsistencies in how this model is being leveraged to support breast cancer patients. These inconsistencies occur from cancer center to cancer center and even from physician to physician within the same cancer center. Participants in this capstone project include experts from the on-site residency, interviews with subject-matter experts and survivors as part of a focus group. The essential features of the methods used to discover best practice include a literature review, onsite residency, participation in an International Cancer Summit, continuing education, and completion of a focus group. Results indicate that additional services are needed in order to have an evidenced-based, innovative, and comprehensive occupational therapy breast cancer program. Conclusions provided aim to diminish inconsistencies in the current care being provided to this population.

"February 2008" A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Occupational Therapy. Typescript Project Advisor : Max Ito Older adults may undergo changes in occupational participation patterns due to the process of aging, to institutionalization, or to illness. Measuring occupational participation of older adults using a client-centered approach has become a professional mandate for occupational therapists. The Activity Card Sort was developed to measure the level of client activity participation in instrumental, socio-cultural, and leisure activities. With the authors' permission, a valid method of translation and cultural adaptation of the ACS was developed based on a sample of older Puerto Rican adults and occupations relevant to this population derived from a previous study. The final version used in this analysis included 82 picture cards of older adults participating in typical Puerto Rican occupations which clients were to sort into five categories. The purpose of this study was to determine the validity and reliability of the translated and culturally-adapted Puerto Rican Spanish version of the Activity Card Sort (PR-ACS) for older Spanish-speaking adults living in Puerto Rico. This study included 146 participants, two groups of 106 community-living, healthy older adults aged 60 or older and 40 adults with multiple sclerosis (MS) aged 50 or older. The study explored evidence of validity by examining the relationship of the PR-ACS current activity scores with other variables. Reliability evidence included test-retest and internal consistency. Results showed that the PR-ACS was able to discriminate between clients with different levels of functioning (t = 6.86; p = .00), and was positively associated with the Puerto Rican Version of the RAND 36-Short Form Health Survey (r = 0.66; p = .00). Good test-retest reliability (r = 0.82) and high internal consistency of the total scores of the combined sample (r = 0.91) and the sample of healthy older adults (.91) were demonstrated, as well as good internal consistency of these scores for the sample of individuals with MS (.77). The findings suggest the PR-ACS is a reliable and valid instrument to use with the Puerto Rican elderly population.

Thesis (MOccTher)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: As a South African occupational therapist (OT) trained to provide occupational therapy using a sensory integration approach (OT/SI), to children and their families, I have personal experience of different parent perceptions and experiences regarding OT/SI as a treatment approach to improving their children’s occupational performance. This made me question the various factors that may influence a parent’s perceptions and experiences, and how these factors may ultimately influence the outcome of OT/SI intervention for the child and family. Additionally, I wanted to know what OT/SI intervention was like for parents of a child with difficulties processing and integrating sensory information and what changes should be made to ensure we are meeting both child and parents’ needs. To date, no research exists regarding parents’ perceptions and experiences of OT/SI intervention in South Africa. Despite this, OT/SI intervention is widely used among South African paediatric occupational therapists. This study focused on the lived experience of OT/SI intervention for parents in the Western Cape, South Africa. The purpose of this study was to explore and describe South African parents’ perceptions and experiences of OT/SI intervention received. This study not only sought to explore whether parents thought OT/SI intervention was valuable or not, but also to understand the meaning, the broader context and the process by which parent’s opinions had come into being, and how these may have influenced the meaning ascribed to the intervention. The study sample consisted of nine parents, including mothers and a father, of children with difficulties processing and integrating sensory information, who lived in various regions of the Western Cape, South Africa. Purposive sampling was used to select participants in this study. Using a qualitative, phenomenological approach, data was collected during face=to=face interviews, participant observation and researcher’s field notes. Four themes that pertain to the aims of the study were revealed during the analysis. They included: “It was tough because we didn’t understand”, “Just suddenly everything made so much sense”, “Mobilized my child into the world”, and “OT/SI intervention facilitators proposed by participants”. These themes describe the progression of the participant’s perceptions and experiences before OT/SI intervention, during intervention, and after having received the intervention, as well as the recommendations they proposed to facilitate OT/SI intervention in South Africa. I found that factors such as poor awareness and understanding of OT/SI intervention amongst the participants negatively influenced their understanding of their child’s occupational performance, their role as parents and their social performance as a family in various social contexts. Key points of transformation were identified during the ‘input phase’ of OT/SI intervention, which either facilitated or created a barrier in the participants’ shift to the ‘after phase’ of OT/SI intervention. Despite the barriers, all participants perceived and experienced a shift to the ‘after phase’ of OT/SI intervention. For some participants, this shift included changes they perceived in their child, which influenced social performance of the child and family. However, for the majority of participants, this shift meant a number of factors: a better understanding and expectations of their child; changes in their child’s abilities, activities and self=worth; changes in themselves as parents and how this influenced their parent=child relationship; as well as changes in their child’s and family’s social performance in various contexts. Insight gained from the participants’ recommendations and my interpretation of findings, allowed recommendations to be made in an attempt to overcome the barriers and promote the facilitators that will make a difference to OT/SI intervention in South Africa. Recommendations were made within two contexts: the broader social context of South Africa and the context of OT/SI intervention received by children and their parents.
AFRIKAANSE OPSOMMING: As ‘n Suid=Afrikaanse arbeidsterapeut (AT), opgelei om arbeidsterapie met ‘n sensoriese integrasie benadering (AT=SI) te verskaf aan kinders en hul families, het ek persoonlike ondervinding van verskeie ouers se persepsies en ervarings omtrent AT=SI as ‘n behandelingsbenadering om die kind se arbeidsprestasie te bevorder. Dit het my laat wonder watter faktore die ouer se persepsies en ervarings sou beïnvloed, asook hoe hierdie faktore die uitkoms van die AT=SI behandeling vir die kind en die familie sou beïnvloed. Ek wou ook uitvind hoe die ouer van ‘n kind met SIA (SID), AT=SI intervensie beleef het en watter veranderinge behoort aangebring te word om te verseker dat beide die kind en die ouers se behoeftes nagekom word. Tot dusver bestaan daar geen navorsing aangaande die ouer se persepsies en ervarings van AT=SI intervensie in Suid=Afrika nie. Ten spyte hiervan word AT=SI alom gebruik deur pediatriese arbeidsterapeute in Suid=Afrika. Hierdie studie fokus dus op ouers se persoonlike ervaring van AT= SI intervensie in die Wes=Kaap, Suid=Afrika. Die doel van hierdie studie was om die persepsies en ervarings van Suid=Afrikaanse ouers wat AT= SI intervensie ontvang het, te ondersoek. Hierdie studie het nie net gepoog om vas te stel of die ouers gedink het dat AT=SI waardevol was aldan nie, maar ook om die betekenis, die breër konteks, en die proses waardeur hul opinies gevorm is en hoe dit hulle beïnvloed het, te verstaan. Die steekproef het bestaan uit nege ouers, insluitend moeders en ‘n vader, van kinders met SIA (SID), woonagtig in verskillende streke in die Wes=Kaap, Suid=Afrika. ‘n Doelgerigte steekproef is gebruik om die deelnemers vir die studie te kies. ‘n Kwalitatiewe=fenomenologiese benadering is gebruik om data in te samel deur aangesig=tot=aangesig onderhoude, waarneming van deelnemers, asook die navorser se veldnotas. Vier temas wat direk verwant was aan die doelwitte van die studie, is tydens die analise van die data geïdentifiseer. Dit het die volgende ingesluit: “Dit was moeilik want ons het nie verstaan nie”, “Ewe skielik het alles so baie sin gemaak”, “My kind in die wêreld gemobiliseer ”, “AT=SI intervensie fasiliteerders voorgestel deur die deelnemers”. Hierdie temas beskryf die vordering van die deelnemers se persepsies en ervarings voor die aanvang van AT=SI intervensie, gedurende die intervensie en ook nadat intervensie voltooi is, asook die aanbevelings wat hulle gemaak het om AT=SI intervensie in Suid=Afrika te fasiliteer. Ek het bevind dat faktore soos deelnemers se swak bewustheid en begrip van AT=SI intervensie, hul begrip van hul kind se arbeidsprestasie, hul rol as ouers en hul sosiale optrede as ‘n familie in verskeie sosiale kontekste, negatief beïnvloed het. Kernpunte van verandering is geïdentifiseer gedurende die ‘inset=fase’ van die AT=SI intervensie, wat die deelnemers se vordering na die ‘na= fase’ van AT=SI intervensie òf gefasiliteer het, òf bemoeilik het. Ten spyte van die struikelblokke het alle deelnemers ‘n skuif na die ‘na=fase’ van AT=SI intervensie waargeneem en ervaar. Vir sommige deelnemers was hierdie skuif die veranderde optrede wat hulle in hul kind waargeneem het, wat die kind en familie se sosiale gedrag verander het. Vir die meerderheid deelnemers het hierdie skuif egter ‘n aantal faktore ingesluit: ‘n beter begrip en verwagting van hulle kind; veranderinge in hulle kind se vermoëns, aktiwiteite en eiewaarde; veranderinge in hulself as ouers en hoe dit hul ouer=kind verhouding beïnvloed het; asook veranderinge in die kind en familie se sosiale gedrag in verskeie kontekste. Die deelnemers se voorstelle en my interpretasie van die bevindinge het my in staat gestel om voorstelle te maak om die struikelblokke te probeer oorkom en die fasiliteerders aan te moedig wat die verskil gaan maak in AT=SI intervensie in Suid=Afrika. Aanbevelings is gemaak vir twee areas: die wyer sosiale konteks van Suid=Afrika, asook die konteks van die AT=SI intervensie wat ontvang word deur kinders en hulle ouers.

Thesis (MPhil )-- Stellenbosch University, 2012.
ENGLISH ABSTRACT: Fieldwork is an essential part of the occupational therapy student’s education, and optimal learning is dependent on effective facilitation by a clinical Occupational Therapist. This study explored the lived experience of the clinical Occupational Therapists in their role as clinical educators by means of a phenomenological inquiry. Ten semi-structured interviews were conducted with clinical Occupational Therapists involved in clinical education. The data was analysed by using thematic content analysis, and was discussed according to the Lived Experience of a Clinical Educator Model. The results indicated that the clinical OTs’ sense of self, which revealed strong humanistic values, acted as the core element influencing the way in which they related to others and were able to juggle many roles in order to perform their role as clinical educator. It furthermore influenced the ways in which they managed balance and harmony in the workplace, as well as the process of growth and development. Incongruence during the performance of their roles as clinical educators was mainly caused by insufficient collaboration between the clinical educators and the university, the prescriptive nature of the fieldwork curriculum, workload pressures, the students’ attitudes and their lack of knowledge, as well as insufficient training of new clinical educators. The results may be helpful in fostering a collaborative relationship between the university and the clinical Occupational Therapists, as well as renewed attention to growth and development, all of which will benefit the students’ education.
AFRIKAANSE OPSOMMING: Kliniese werk vorm ‘n essensiële deel van die arbeidsterapie-student se opleiding en dit is noodsaaklik dat die leerproses effektief gefasiliteer word deur ‘n bekwame kliniese Arbeidsterapeut. Hierdie studie het die Arbeidsterapeute se belewing van hul rol as kliniese opvoeders nagevors deur middel van ‘n fenomenologiese ondersoek. Tien semigestruktureerde onderhoude is met kliniese Arbeidsterapeute, tans betrokke by kliniese opleiding, gevoer. Die data is verwerk deur middel van tematiese inhouds-analise en is bespreek aan die hand van die Lived Experience of a Clinical Educator Model. Die resultate het aangedui dat die kliniese terapeute se bewustheid van hulself (‘sense of self’) die kern element vorm wat hul verhoudings, sowel as die wyse waarop hulle al hul onderskeie rolle en take behartig, beïnvloed. Sterk humanistiese waardes kom voor in hierdie kern element. Dit is verder bepalend in die wyse waarop die Arbeidsterapeute balans en harmonie in hul werkplek verseker, sowel as hul professionele groei en ontwikkeling. Inkongruensie tydens die rolvervulling word veroorsaak deur onvoldoende samewerking tussen die universiteit en kliniese opvoeders, ‘n voorskriftelike kurrikulum, werksdruk, studente se negatiewe houding en gebrek aan kennis, sowel as onvoldoende opleiding van die terapeute wat nuut begin met kliniese opleiding. Die resultate mag in die toekoms behulpsaam wees in die totstandkoming van ‘n samewerkende verhouding tussen die universiteit en kliniese terapeute, met genoegsame aandag wat geskenk word aan professionele groei en onwikkeling. Dit kan tot voordeel van die studente se leerproses aangewend word.

Thesis (Sc.D.)--Boston University
Occupational therapists recognize that families are central to the wellbeing of children and that incorporating parent perspectives into intervention is an essential component of the therapy process. Although family-centered outcomes are specifically espoused in the pediatric occupational therapy literature, parent perspectives have not been the focus of efficacy studies. This collection of papers reports three sets of findings designed to understand parents' perspectives related to occupational therapy using sensory integration approaches. In both studies, interviews with parents were conducted, audiotaped, transcribed, and analyzed using grounded theory methods. The first study reported here describes parents' point of view regarding their hopes for outcomes prior to their children's participation in occupational therapy using a sensory integration approach. These parents identified two overarching directions for therapy. One focus for change was their children. Three themes pertinent to the occupation of children; social participation, self regulation, and perceived competence, were identified. Parents also include themselves as both agents and recipients of change. The second and third papers describe parents' point of view after their children have been discharged from therapy. The parents' perceptions of the benefits of therapy for their children are categorized into three interrelated constructs: abilities, activities, and reconstruction of self-worth. For themselves, parents value understanding their children's behavior in new ways. This shift in understanding is hypothesized to facilitate a change in expectations for themselves and their children. Further, parents value having their parenting experience validated and being able to support and advocate for their children. The parents' actual experience of sitting in the waiting room while their children received occupational therapy also emerged as a powerful theme. Through their interactions with one another, sharing stories, experiences, parenting challenges, and resources, the particular group of parents interviewed for the second study gave and received naturally occurring support for parenting children with sensory integration dysfunction. Implications for expanding the definition of family-centered intervention and for future research are proposed.

Syftet med studien var att kartlägga hur mindfulness kan användas inom arbetsterapi. Stress, depression, ångest och långvarig smärta är klientgrupper som stadigt ökar. I denna litteraturstudie var det av relevans att undersöka hur mindfulness kan användas inom arbetsterapi, då det visat ha goda effekter inom bland annat psykiatri och kognitiv beteendeterapi. Mindfulness med dess fokus på medveten närvaro, ökad insikt och med ett objektivt och accepterande förhållningssätt kan bidra till ökad delaktighet och med ett större engagemang för klienten i aktivitet. Dataanalysen utgjordes av åtta vetenskapliga artiklar med anknytning till mindfulness och arbetsterapi och mynnade ut i kategorierna Mindfulness som intervention, Resultat av mindfulness som intervention och Begräsningar med mindfulness som intervention. I resultatet framkom att mindfulness som intervention visade på positiva effekter där hantering av svåra situationer blev lättare och symtom för ohälsa inom stress, långvarig smärta, depression och ångest upplevdes ha mindre negativ inverkan på hälsan. En artikel visade att mindfulness inte hade någon effekt för klienter med depression och ångest. Majoriteten av de analyserade artiklarna visade på god effekt både för stressrelaterad ohälsa, depression, ångest, långvarig smärta och för föräldrar till barn med Autism Spektrum Tillstånd. Sammanfattningsvis skulle mindfulness som intervention kunna ge fördelar inom arbetsterapi då ett gemensamt fokus ligger kring delaktighet och engagemang i aktivitet. Mindfulness kan utifrån resultatet bidra till ökad livskvalitet där klientens vardag består av meningsfulla aktiviteter. Med mindfulness integrerat i de vardagliga aktiviteterna eller som meditation kan flertalet klientgrupper gynnas.
The purpose of this study was to examine how mindfulness could be used in occupational therapy. Stress, depression, anxiety and chronic pain are common diseases in the Swedish population. In this literature review it was of relevance to examine how mindfulness could be used in occupational therapy since research in other areas such as psychiatry and cognitive behaviour therapy have shown positive effects using mindfulness. Mindfulness is primarily focused on awareness, insight, ability to obtain an objective perspective and to hold acceptance which for the client can lead to increased participation and a greater engagement in occupations. A number of databases were used in order to find articles which responded to the purpose of this study. A total amount of eight articles were found and analyzed. The articles resulted in the categories Mindfulness as an intervention, Results of mindfulness as an intervention and Limits using mindfulness. The results showed positive effects using mindfulness as an intervention for clients having stressrelated illness, chronic pain, depression and anxiety. Difficult and challenging situations became easier to handle and with less negative effect on the clients health. One article showed that mindfulness had no effects for clients with depression and anxiety. The majority of the articles which were analyzed showed that mindfulness had positive effects for stressrelated illness, depression, anxiety, chronic pain and for parents to children with Autism Spectrum Disorder. The conclusion came out in a way that occupational therapy could benefit by using mindfulness as an intervention with its primarily focus on participation and engagement in occupations. According to the results in this study mindfulness could bring a higher quality of life for the client by participating in meaningful occupations in their daily lives. With mindfulness integrated in the clients daily occupations or to meditate for mindfulness practice, several client groups could benefit from this form of intervention.

Health and wellness is essential to each individual's quality of life. The importance of health and wellness is not only of an individual concern but also a population-based societal concern. Currently there is growing epidemic or obesity as 65% of American adults are either overweight or obese. The work setting is an ideal location to foster healthy behaviors as most adults spend the majority of their day there. The need for health-related activities is supported in many different types of workplaces, especially in higher education settings. This study aimed to explore the relationship of a health promotion program using pedometers on the health-related indicators of the SF-36v2 and vital functioning of the participants in a college setting. The association of participant's health promotion level to changes in health-related indicators and vital functioning was also explored.

A pre-test post-test experimental design was conducted with a convenience sample of 29 participants. All 29 participants completed the pre-test, the 6 week health promotion program using pedometers, and the first post-test (post-test 1). Only 15 individuals completed the second post-test (post-test 2) which was administered six months after the completion of the health promotion program. Paired sample t tests analyzed the difference in scores of each participant from pre-test (baseline) to post-test 1. The paired sample t tests reported a significant improvement in the component summary and subtests of the SF 36v2 such as the mental health component summary (p = .013), physical functioning (p = .015), vitality (p = .033), and mental health (p = .005). The linear regression analysis revealed mental health component summary scores were a highly significant predictor of vitality (β = 1.075, p = .001), accounting for 50.5% of the variance in vitality. Vitality is unique to each individual. This construct can affects one's ability to activity engage in their roles and occupations.

Health and wellness support role performance. The roles of most adults consist of worker, friend, and family member. Fulfillment of roles and meaningful activities supports balance and quality of life. Having the physical and mental capability to perform one's roles in a variety of contexts leads to engagement and satisfaction. Sustenance of a healthy lifestyle via physical activity is also an integral component of wellness. Utilizing technology and support within the social, virtual, and physical environments have all been shown by this study to improve quality of life indicators. Improvements were noted to statistically support the use of pedometers, points of decision prompts, and email correspondence to increase physical activity levels as well as stages of health promotion.

Sjukskrivningar pga. stressrelaterad ohälsa fortsätter att öka frekvent i samhället. Inom arbetsterapi anses ett balanserat aktivitetsmönster att vara en förutsättning för upplevelsen av hälsa och välmående. Kunskap om aktivitetsbalans och aktivitetsvärden är en viktig del av arbetsterapeuters arbete med personer som lider utav aktivitetsohälsa. Syftet med studien var att undersöka om och i så fall vilka sociodemografiska faktorer som påverkar sambandet mellan hälsa, aktivitetsvärden och aktivitetsbalans för personer med aktivitetsohälsa. Metod. Kvantitativ tvärsnittsstudie där data från totalt 218 personer samlades in, varav 192 kvinnor, 22 män och 4 hen. Data samlades in med hjälp av enkäter inför en arbetsterapeutiskintervention. De instrument som användes i studien var Oval-pd, OBQ, EQ5D samt en sociodemografisk enkät. Data analyserades genom regressions och moderationsanalyser. Resultatet visade att deltagarna generellt upplevde låga värden inom både aktivitetsbalans, aktivitetsvärde samt självskattad hälsa inför interventionen. Det fanns statistisk signifikanta samband mellan aktivitetsbalans och självskattad hälsa, varav tre moderatorer identifierades stärka det sambandet. Inget samband fanns mellan aktivitetsvärde och upplevd hälsa kunde ses, däremot identifierades att det fanns ett statistiskt signifikant samband för två moderatorer. Slutsats. Att vara kvinna, högutbildad eller sambo påverkar signifikant sambandet mellan aktivitetsbalans och upplevd hälsa. Vidare att vara kvinna eller sjukskriven på del/heltid påverkar signifikant sambandet mellan aktivitetsvärde och upplevd hälsa. Detta är ett viktigt område som behöver fortsatt forskning kring vad som kan påverka, och vara en bidragande orsak, till att personer utvecklar psykisk ohälsa pga. sin vardag. Det är viktigt för att kunna utveckla och implementera nya interventioner, samt belysa mer hälsofrämjande insatser.
Sick leave due to. Stress-related ill-health continues to increase frequently in the society. In occupational therapy, a balanced activity pattern is considered important for the experience of health and well-being. Knowledge of occupational balance and occupational values ​​is an essential part of occupational therapists' work with people who suffer from occupational ill health. The purpose of this study was to investigate if and if so, what socio-demographic factors affect the relationship between perceive health, occupational values ​​and occupational balance for people with occupational ill health. Method. Quantitative cross-sectional study in which data from a total of 218 persons were collected, of which 192 were women, 22 men and 4 other. Data were collected with the help of surveys prior to an occupational therapy intervention. The instruments used were Oval-PD, OBQ, EQ5D and a socio-demographic questionnaire. Data were analyzed by regression and moderation analyzes. The results showed that participants generally experienced low values ​​in both the occupational balance, occupational value and self-assessed health prior to the intervention. There was a statistically significant association between occupational balance and self-assessed health, of which three moderators were identified to strengthen that relationship. There was no correlation between occupational value and perceived health, however, two moderators was identified who statistically significant effect the association. Conclusion. Being a woman, highly educated or cohabiting significantly influences the relationship between occupational balance and perceived health. Furthermore, being a woman or being sick on part/full time significantly affects the relationship between occupational value and perceived health. This is an important area that needs further research on what can affect, and be a contributing cause of, people developing mental illness due to their everyday life. It is important to be able to develop and implement new interventions, as well as highlight more health-promoting efforts.

"Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Occupational Therapy Department, College of Allied Health, Nova Southeastern University 2001."--T.p.

The purpose of this study was to describe involvement in everyday activities for people with opioid replacement therapy. To answer the purpose, an empirical qualitative design was chosen that is appropriate for capturing a person's own thoughts, feelings, experiences, experiences and opinions and the world in which he lives with the person's own words. Data were collected through interviews with people who have opioid replacement therapy. The collected data consisted of six interviews analyzed based on a latent qualitative content analysis. Analysis of data resulted in an overall theme; Living in life does not survive life and four categories; A struggle to adapt to something new and find structure in everyday life. To dare to believe in his ability. To get professional support along the way. The importance of the social environment for breaking old life. The result showed that involvement in everyday activities is a major challenge and a struggle that depends both on the support people receive from care and social services in their change process, their confidence in their own ability and how to succeed in creating a new identity and how the social environment around them look. Conclusions that can be deduced from the results of the study can give implications for people who have opioid replacement therapy to help build new life in addition to receiving medication. It is a struggle to adapt and create a new identity and in that work, occupational therapy can perform an important role.
Syftet med denna studie var att beskriva engagemang i vardagliga aktiviteter för personer med läkemedelsassisterande behandling vid opiatberoende. För att besvara syftet valdes en empirisk kvalitativ design som är lämpligt för att fånga en persons egna tankar, känslor, upplevelser, erfarenheter och åsikter och den värld den lever i med personens egna ord. Data insamlades genom intervjuer med personer som har läkemedelsassisterande behandling vid opiatberoende. Insamlad data bestod av sex intervjuer som analyserades utifrån en latent kvalitativ innehållsanalys. Analys av data resulterade i ett övergripande tema; Att leva i livet inte överleva livet och fyra kategorier; En kamp att anpassa sig till något nytt och finna struktur i vardagen. Att våga tro på sin förmåga. Att få professionellt stöd på vägen. Den sociala miljöns betydelse för att kunna bryta med det gamla livet. Resultatet visade att engagemang i vardagliga aktiviteter är en stor utmaning och en kamp som både beror på vilket stöd personerna får av vård och socialtjänst i sin förändringsprocess, deras tilltro till sin egen förmåga och hur det lyckas skapa en ny identitet samt hur den sociala miljön runt dem ser ut.  Slutsatser som kan dras utifrån studiens resultat kan ge implikationer för att personer som har läkemedelsassisterande behandling vid opiatberoende vill ha hjälp med att bygga upp det nya livet utöver att de får mediciner. Det är en kamp att anpassa sig och skapa en ny identitet och i det arbetet kan arbetsterapi spela en viktig roll.

The aim of the research was to investigate the concepts of, and attitudes towards, people with physical disabilities held by occupational therapy (OT) students, so that a theory of professional attitudes and professional action could be developed. The research was building on previous research by the author, which found that OT students tended to have a maternalistic and nurturing view of disabled people, and also as a response to issues raised by the social model of disability which questioned whether OT was an oppressive or empowering profession. Utilising an integrated methodology, the research sought to address the following research questions: what, amongst OT students, is a 'professional' attitude towards disabled people? are the attitudes of OT students towards disabled people any different from those of other students? do these attitudes change over time? are there any differences in the 'personal' and 'professional' attitudes of OT students towards disabled people? how accepting of disabled people are OT students, would they be willing to work with disabled people as colleagues? is there an hierarchy of relationships for people with different impairments? what does the 'professional' attitude mean in practice? how does this 'professional' attitude develop? what factors influence its development? does contact with disabled people have any effect on attitudes? do OT students express attitudes and values which oppress or empower their disabled clients? A case study approach was used with a variety of data collection methods. The main focus of the study was the collection of data, using a questionnaire and a series of interviews, from a cohort of OT students throughout the 3 years of their OT degree. The questionnaire included the Attitudes Towards Disabled People Scale, a suitability for OT training scale, and a semantic differential exploring stereotypes of disabled people. Data were also collected from other groups of OT students comparing personal and professional attitudes and attitudes in terms of social distance, using the Disability Social Distance Scale. Comparative data was collected from non-OT students. In order to explore attitudes in greater depth a small group of students was selected from the main OT cohort and interviewed about their attitudes and approaches to disabled people at 3 points during their studies. Analysis of the data revealed that the OT students held highly positive personal and professional attitudes towards disabled people. These attitudes were also demonstrated by the use of an empowering, client-centred approach to OT interventions. However, the OT students had a tendency to focus on an individualistic and personal tragedy approach to disability. This individualistic approach might result in oppressive practice. The findings were used to develop a conceptual framework for OT interventions with disabled people which should allow therapists to articulate and develop their practice within an empowering framework.

The overall aim of this thesis was to describe occupational therapy practice for clients with cognitive impairment following acquired brain injury (CIABI) from the perspective of practicing occupational therapists (OTs). To fulfill this aim, qualitative and quantitative approaches were used including interviews (Study I) and questionnaires (Studies II -IV). Based on the qualitative descriptions generated in Study I, a questionnaire was developed and evaluated for content validity and test-rest validity (Study II). The questionnaire was then used in a survey (Study III). The reactive Delphi technique was used to empirically define the aspects that OTs found to be consistent with the concept of therapeutic use of self (Study IV). The results showed that a predominant practice pattern was the use of ADL activities for intervention regardless of whether limitations in occupational performance or cognitive function were assessed, or whether the approach to therapy was remedial or compensatory. General ADL-instruments were used more than instruments focused on impairment level. Therapies covering a wide range of cognitive impairments, and abilities important to organizing and executing occupational performance were commonly targeted. Therapies targeting clients’ activity limitations were prioritized before remediating impairment. Therapeutic use of self was regarded as being important and the results identified clientspecific aims not earlier described in relation to therapeutic use of self. Another prominent practice pattern was the collaborative approach toward clients, relatives, and other staff. Theories used to support practice were primarily general. Occupational therapy practice for clients with CIABI was found to be complex, and the practice patterns were affected by circumstances such as the ‘hidden’ nature of the cognitive impairments, perceived lack of knowledge, and organizational issues. The results of this thesis can be used as a foundation for further research on practice patterns or the specific therapies used. It can facilitate discussions on strengths and weaknesses witcurrent practice, the need for development, and research utilization.

The focus of this thesis was to understand the influence of a conceptual model of practice upon occupational therapists in a British health and social care setting. Case study methodology was used to explore the clinical practice of Occupational Therapists (OTs) in one county in England who implemented the Canadian Model of Occupational Performance (CMOP) (CAOT 1997a, 2002). The research focused upon a deeper understanding of the complex interactions between individual factors and the case being examined. This required examination of three sources of data, namely meeting minutes, artefacts and participant interviews. Each was examined separately and then themes from all three units were examined to identify themes from across the dataset to understand inter-relationships to support the development of theoretical propositions and contribute to theory building. This study identified that use of a single model, the CMOP actively encouraged practice development in this county and was a dynamic and multifaceted social process.

Thesis (MOccTher (Interdisciplinary Health Sciences. Occupational Therapy))--University of Stellenbosch, 2005.
According to the Occupational Therapy Practice Framework (2002), the objective of occupational therapy is to help people to participate in activities of daily life which are purposeful and meaningful to them and in which they are expected to participate. According to educators, learners are increasingly experiencing problems with performing academic tasks, and learning barriers, especially with regard to visual perception, are on the increase. Various external factors, such as educational policy pertaining to inclusive education and a younger age for school admission, as well as internal factors, such as learning readiness, may contribute to the occurence of learning barriers that can restrict the academic progress of learners. Learners are increasingly being referred to occupational therapists. Occupational therapists also provide guidance to learner supporters. Occupational therapists refer learners with visual perception problems with possible eye tracking problems for vision therapy, after which occupational therapy is resumed. Meanwhile, learners still have to function in the school environment, which means that incorrect capturing of information processing can take place. According to literature, the promotion of eye movements is regarded as part of occupational therapy services in the USA. In South Africa the proposed model by Fishman-Hellerstein and Fishman (1999: 148) of cooperation between optometrists and occupational therapists is followed. In this approach eye movements are regarded as underlying building blocks of visual perception and the effect of eye movements on the academic performance of learners is clearly described (Green, 2001). There is a shortcoming in the literature where eye movements are promoted as integral to a visual perception programme. Occupational therapy needs to investigate effective methods of intervention that are time and cost effective in order to address the growing problem, especially in South Africa. A clinical experimental field trial with a convenience sample was used to investigate the effect of occulomotor exercises in combination with a visual perception programme on the visual perception of seven-year-old learners with visual perception problems. The study population was seven-year-old learners with visual perception learning barriers from neighbouring schools with foundation phase education. Inclusion and exclusion criteria were applied. Sifting procedures included questionnaires to parents and educators, “Beery-Buktenica Developmental Test of Visual-Motor Integration” 4th edition of Beery (1997) for visio-motor integration, and a screening test by an optometrist. A visual perception programme was presented to the control groups and the experimental groups over ten sessions. An eye exercise of 15 minutes was included with the experimental groups. The Developmental Test of Visual Perception, 2nd edition, by Hammill, Pearson and Voress (1993) was used as measuring instrument in the pre-test and post-test to determine effectiveness, which was statistically indicated by using the repeated measures ANOVA. The results indicated no significant difference between the visual perception programme with eye exercises and the one without. Two tests of the sub-ability of visual perception showed a tendency towards improvement. The educators indicated that the learners benefited functionally from the programme and that it made a difference in academic performance. Behaviour and emotional events may have influenced the results of the study because of external factors. It is recommended that the study be repeated with a larger sample and a longer programme presented over six months to a year. Occupational therapists can include eye exercises integral to activity participation by adapting activities and through the optimal use of space for activities so that the learner would have to adapt to it visually.

This qualitative study explored the experience of professional transition from student to practitioner among six Canadian occupational therapists in the first year of their career, with a focus on how beginning practitioners learn about doing practice. A sociocultural theory of learning provided the framework to understand the role of context and activity in learning. Data collection consisted of two semi-structured interviews and a series of journal entries. An initial interview was conducted with each participant beginning in their third to fifth month of practice to discover their perception of transition, their learning needs, and the role of collaborative interactions in supporting their learning. Each participant then maintained a journal of their experience of transition and their learning experiences for one month A second interview was held with the participants in their eighth to tenth month of practice, which focussed on their change in knowledge and skills. The transitional experiences of the research participants revealed that the support of colleagues and peers was critical to their learning and eased their adjustment to practice. They preferred to learn from an experienced occupational therapist, and the availability of this support influenced the new practitioners' choice of their first job. In their initial months of practice they struggled with their lack of practical experience, responsibilities of client care, challenges to client-centred practice and competing work demands. Their relationship with clients was particularly valuable to the participants' learning and professional identity. Mentoring and implementing practical learning experiences in the university curriculum were suggested as strategies for easing the transition from student to therapist. The role of client interaction as a valuable source of learning was also recognized.