Group items tagged

This article discusses the challenge OT is facing to validate and justify its services due to health care reform, funding caps, and decreased access to services. This can be difficult as the core of OT lies in evaluating and treating function, however, due to the wide scope of practice defining and measuring function in a unified way can be difficult. For example there are two widely used ways of looking at function: the top-down and the bottom-up approaches. There is also challenges because some facilities rely on "house assessments" versus utilizing standardized assessments. A more unified method of measuring and defining function needs developed in order to show OTs value across the board.

The objective of this study was to identify ethical dilemmas experienced by OTs and PTs working in the UK National Health Service. Little is known about clinical dilemmas OTs and PTS encounter. Without case material which reflects these realities it is difficult for professional organizations to produce ethical codes, for educators to prepare students for practice, and for clinicians to benefit from the experience of others. A four-page questionnaire was designed based on the results of the pilot study and distributed to OTs and PTs in the UK NHS. Emerging themes in OT found included: difficult or dangerous behavior in patients, unprofessional or incompetent staff, lack of respect for vulnerable patients, difficult/risky decisions about patient discharge.

This test could be used in acute care. This assessment offers a hospital version (MET_HV) that would be appropriate in the VA setting. This test was developed for use with a wider range of participants than the original version; it has more concrete rules, simplification of task demands and space provided on the instruction sheet for the patient to record the information they were to collect. There are 12 separate subtasks within four sets of simple tasks. These four task sets are as follows: 1. The patient must complete six specific errands (purchase 3 items, use the phone, collect and envelope from reception and send a letter to an external address), 2. The patient must obtain and write down four items of designated information (e.g. the opening time of a shop on Saturday), 3. The patient must meet the assessor outside of the hospital reception in 20 minutes after the test had begun and state the time, 4. The client must inform the assessor when he/she finishes the test. The test cannot be administered to patients confined to bed due to the nature of the questions. The test would be difficult to complete on patients instructed to only get up with help as they would have to have a nurse available at the time they need to meet some of the task requirements. Both validity and reliability have been established for this test for various populations (see citation for specifics).

This website provides a contact address for the purchase of this developmental profile. I found this to be an invaluable resource during my level II fieldwork, but found that it was difficult to order in print until I found this website.

This blog contains 16 motivational techniques to help engage difficult or resistant patients in the therapeutic process.

Individuals experiencing mental health disorders are susceptible to impairments in occupational functioning due to decreased concentration, memory, thought processes, insight, judgement, decision-making, reality orientation, regulating emotions, understanding perception, motivation, and psycho-motor activity. This is a quantitative study out of the South American Journal of Occupation Therapy that studied the effects of slow vs. fast tempo of music on symptoms of psychosis during occupation. There were 160 individuals with diagnosed psychological disorders in a psych hospital in South Africa. The subjects participated in a leatherwork activity while listening to either fast paced/upbeat music or low tempo/slow music. Attention/focus, ability to follow instructions, directedness towards the activity, and motivation were measured in groups of individuals who had psycho-motor agitation or psycho-motor inhibition psychosis. The study found that listening to music during an activity has the ability to improve all three variables in both agitation and inhibited-motor psychosis. Fast-paced tempo significantly improves attention in individuals with inhibited motor-psychosis. The ability to follow instructions improved in both fast and slow tempo music for both agitated and inhibited individuals. Directedness and motivation did not significantly improve in any of the groups. This study indicates that music can improve the ability to perform occupations and activities in individuals with mental health disorders. Music is very individualized and it may be difficult for OT practitioners to work with groups of individuals when introducing music. IT is important for an OT to gather a good understanding of a patient's preferences and determine if they would be a good candidate for the use of music during therapy. More research is recommended in this area to further determine the effects of music on occupation in this population.

This article discusses the process of clinical reasoning and the difficulties of teaching and/or learning this crucial skill. This document also presents a model for students to follow when attempting to develop solid clinical reasoning skills.

This article outlines the process of clinical reasoning and provides a framework for clinicians to utilize when attempting to teach clinical reasoning to students. This article was written with a focus on teaching junior doctors how to develop stronger clinical reasoning skills, but the same is applicable to occupational therapy students. Clinicians often know clinical reasoning when they see it but have a difficult time articulating and teaching it to their students. Clinical reasoning requires an individual to integrate and apply a variety of knowledge, weigh the presented evidence, critically think about all facets of the evidence, and finally to reflect upon the process utilized to arrive at the decision. Clinical reasoning encourages personal reflection and experience, which is why it is so difficult to teach to new grads/students that have little to no experience.

This article describes the challenges that OTs face when treating the whole person in an acute care setting. It is difficult to have other disciplines understand in this setting that mental gains are just as important if not more important to work on in this type of setting. A recent pt had a stroke and was high functioning before...pt had been in inpatient rehab for two weeks and treatment sessions weren't improving d/t mental state. Pt got a decent discharge date and therapy goals were attained in no time!

Beckie, T., Beckstead, J. (2010) aimed to study was to focus on the quality of life among women in a traditional cardiac rehabilitation program compared to those completing a tailored program that included motivational interviewing of behavior changes. The study included 252 participants over that age of 21 with myocardial infarction, Angina, CABG, and PCI were studied 3 days a week for 6 months. The participants were divided into two groups. The experimental group included the tailored program and motivational interviewing and the control group used a traditional cardiac rehabilitation program. The study had multiple limitations that included all women were of one ethnicity from a single institution in southeastern U.S. Lastly, studying the efficacy of a program like this is difficult and it is unaware to know if the treatments observed would persist beyond the 6 months. The tailored group showed a positive influence on the subjects QOL. Women with CHD may be better served by first identifying the important psychological and psychosocial variables that influence QOL.

This AJOT article is titled Intervention Planning Facets-Four Facets of Occupational Therapy Intervention Planning: Economics, Ethics, Professional Judgment, and Evidence-Based Practice. The article discusses four basic principles of occupational therapy and offers the perspectives of occupational therapists in applying these principles to everyday practice.

This article discussed how professional judgement, ethics, EBP, and economic constraints are interrelated in OT practice. Each need to be considered during intervention planning, however, some therapists may find this difficulty. A literature review found that overall there is a lack of evidence supporting OT practice and that it can be difficult to integrate research findings into treatment. One question mentioned was should clients be quantified and reduced to variables as each person is unique?. Practitioners need to remember that research provides guidance for interventions, rather than step by step how-tos. It is up to the OT to use their judgment and experience to incorporate it.

This study aimed to focus on the quality of life among women in a traditional cardiac rehabilitation program compared to those completing a tailored program that included motivational interviewing of behavior changes. The study included 252 participants over that age of 21 with myocardial infarction, Angina, CABG, and PCI were studied 3 days a week for 6 months. The participants were divided into two groups. The experimental group included the tailored program and motivational interviewing and the control group used a traditional cardiac rehabilitation program. The study had multiple limitations that included all women were of one ethnicity from a single institution in southeastern U.S. Lastly, studying the efficacy of a program like this is difficult and it is unaware to know if the treatments observed would persist beyond the 6 months. The tailored group showed a positive influence on the subjects QOL. Women with CHD may be better served by first identifying the important psychological and psychosocial variables that influence QOL.

This was a study that looked at more effective ways to train students in wheelchair transfers with more dependent patients. Typically, the curriculum allows for transfer practice using other peers. This study occurred in a high-technology laboratory with SimMan technology and mock hospital suite. The SimMan replicates what a dependent transfer patient would be like. The mock hospital suite simulated an acute care setting, complete with medical equipment, vital signs, lines and drains in place. Scenarios were developed for the students with the assistance of practicing occupational therapists. These scenarios included an acutely ill patient, a critical medical management event that occurred during bed-to-wheelchair transfer and occupational need. Students completed 66-88% of transfer items correctly and showed that simulated scenarios were more difficult that practitioners rated them. Student rated this simulation as an effective, more realistic teaching tool. Students attributed this kind of simulation as a positive contribution to curriculum and promoted greater procedural and clinical reasoning skills.

Guidelines to the Occupational Therapy Code of Ethics This is a really handy resource that provides a quick glance at the different elements of the Occupational Therapy Code of Ethics. It lists ten sections of professional behaviors under the code of ethics and each have a subset of behaviors which are appropriate under that section. The first professional behavior listed is honesty. "Professionals must be honest with themselves, must be honest with all whom they come in contact with, and must know their strengths and limitations" (AOTA, 2005). The second behavior listed is communication. "Communication is important in all aspects of occupational therapy. Individuals must be conscientious and truthful in all facets of written, verbal, and electronic communication" (AOTA, 2005). The third area of professional behavior is ensuring the common good. "Occupational therapy personnel are expected to increase awareness of the profession's social responsibilities to help ensure the common good" (AOTA, 2005). The fourth professional behavior is competence. "Occupational therapy personnel are expected to work within their areas of competence and to pursue opportunities to update, increase, and expand their competence" (AOTA, 2005). The fifth area of professional behavior is confidential and protected information. "Information that is confidential must remain confidential. This information cannot be shared verbally, electronically, or in writing without appropriate consent. Information must be shared on a need-to-know basis only with those having primary responsibilities for decision making" (AOTA, 2005). The sixth professional behavior area is conflict of interest. "Avoidance of real or perceived conflict of interest is imperative to maintaining the integrity of interactions" (AOTA, 2005). The seventh professional behavior area is impaired practitioner. "Occupational therapy personnel who cannot competently perform their duties after reasonable accommodati

This article examined what questions and clinical reasoning seasoned allied health professionals ask when posed with a challenging case. Clinical reasoning is crucial as a health care professional and the interesting aspect of this research was to determine how clinicians teach this valuable skill to students. The data illustrated that the popular method was a gradual exposure of clients and self reflection. Additionally, the study identifies and outlines various questions that students can ask themselves when dealing with a client. I really enjoyed this because I feel that these are the two methods that I have most employed in my development of clinical reasoning. I feel that the information in this article can be a great resource us as students, especially when we are dealing with a particularly difficult case.

This article examines the longitudinal effects that a specific OT and PT program within a specific university affect ethical decision-making in their students. The study examined two classes of students and administered the Defining Issues Test (DIT) which according to the article is suppose to be a fairly valid measure. The test was administered on the first day of class and then in the final semester of the students coursework. The results found that the formation of ethics can be a difficult process. The study states that age is a huge factor in this process. Students over 30 years old appear to have formed and be set in their own ethical decision making process. Also, the study found that with at least this program, the students were not provided with enough coursework and instruction in ethical decision-making. The authors suggest that programs provide three to twelve weeks of instruction on ethics as opposed to the typical intermittent instruction throughout coursework. Overall, I found this to be interesting to consider. Overall, I feel that the program is set-up really well. However, I must admit that I would be curious if we had a course that was specifically aimed at ethics. Perhaps this will occur when the program moves to a doctorate degree.