Canadian Association of Occupational Therapists

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CJOT Abstracts
Volume 65, Number 5
December 1998

Le Fardeau perçu par les proches de personnes ayant des incapacités physiques
Claire Dumont,  Myreille St-Onge,  Patrick Fougeyrollas,  Lise-Anne Renaud

This study's goal was to measure the perception of burden in caregivers of people with physical disabilities, living at home and attending a Day Centre. Three aspects of burden were evaluated among 55 caregivers, as well as the perceived improvements since the client began attending the Day Centre. Analyses with socio-demographic variables were done and comparisons were made with a psychiatric clientele for which data was taken from a previous study. The results demonstrate that caregivers experienced a high burden when giving direct support and when being concerned about the person's well-being. Locomotion and mobility limitations are identified as a major source of burden. In general, burden related to physical disabilities was higher than burden related to psychiatric problems. Conclusions revolved around the importance of considering environmental factors and integrating burden measurement in physical impairment programmes evaluation.

Key words: caregiver burden, caregiver role strain, stress- psychological, family coping

Leisure in Occupational Therapy
Melinda Suto

Despite leisure's central position within occupational therapy models of practice, theoretical development from within occupational therapy remains limited. Historically occupational therapy has viewed leisure as an occupational performance area, quantifiable and discretionary time, and as activity used to achieve clients' targeted outcomes. Using social sciences literature and Primeau's (1996) ideas about the relationship between work and leisure, an argument is made for further theoretical development of leisure concepts and their application to occupational therapy.

A brief review of standardized leisure assessments reveals their emphasis on leisure as time or activity. In contrast, interdisciplinary advances in leisure studies pertinent to occupational therapy focus on understanding leisure as a subjective experience. Acknowledgement of the importance of leisure as a state of mind underscores the importance of creating meaning within occupations. Finally, the stages of the Occupational Performance Process (CAOT, 1997; Fearing, Law & Clark, 1997) provide a framework for demonstrating how leisure concepts and assessments guide occupational therapy practice.

Key words: leisure activities, occupational performance

Voluntarism as Occupation
Karen L. Rebeiro,  John Allen

An exploratory, single-case design was conducted to explore and describe the personal experience of a voluntarism occupation for one individual with schizophrenia who resides within the community. Non-participant observation and in-depth interviewing were utilized to explore the voluntarism experience of this individual. The findings suggest that voluntarism is both a meaningful and purposeful occupation for this individual. Volunteering is perceived to be a valued and socially acceptable occupation which allows for the individual to contribute to, and be a productive member of society. In addition, John (a pseudonym) perceived that his participation in a voluntarism occupation helped him to construct a socially acceptable identity and to maintain his preferred view of himself, as a competent individual, not as a mental health consumer. These findings suggest that participation in a voluntarism occupation may benefit some consumers of mental health services. While these findings were based upon the experiences of one person, occupational therapists are encouraged to consider voluntarism as therapy and as a means of enabling the occupational performance of their clients. Implications for further research are suggested.

Key words: consumer attitudes, exploratory research, mental health, occupation

The construction of family occupations: A study of families with children who have Attention Deficit/Hyperactivity Disorder
Ruth Segal

Families are the main caregivers of children who have special needs and are essential in the client-centred occupational therapy practice. They also provide the immediate social and cultural environments of their children who have special needs. A qualitative study of daily experiences and adaptations of 17 families with children who have attention-deficit/hyperactivity disorder is described in this paper. The analysis of interviews with parents revealed that they developed and used strategies to enable their children' occupational competence. Further, whenever parents reported on the success of these strategies, they also described changes in the daily routines of other family members. The interactions between these enabling strategies and the daily routines of family members are presented and discussed in this paper.

Key words: attention deficit disorder with hyperactivity, family coping, family involvement, human activities and occupations

Reliability of perceived competence measures for young school-aged children
Sheryl Klein  Joyce Magill-Evans

Client perceptions of competence provide the occupational therapist with information relevant to intervention goals and performance outcomes. The Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PCSA) (Harter & Pike, 1983) and the All About Me (AAM) (Missiuna, 1992) measure perceptions of competence in young school-aged children. Test-retest reliability of scores on the PCSA and AAM was examined using a sample of 24 Grade 1 and 2 children with motor and/or language delays. For intervals of 10 to 22 days, the PCSA and AAM had moderate to good reliability. Competence perceptions were more reliable than acceptance perceptions on the PCSA. The AAM, a measure of perceived physical competence, was correlated more highly to the PCSA physical subscale and competence factor score than to other PCSA subscales. In general, young children view themselves as being highly competent.

Key words: child, self-efficacy, reliability of tests

Self-care, productivity and leisure limitations of people with multiple sclerosis
Marcia Finlayson,  Michelle Winkler Impey,  Cameron Nicolle,  Jeanette Edwards

As part of the activities of the Social Action Committee of the Multiple Sclerosis Society (Manitoba Division), a large mail-out survey was conducted in the spring of 1995. The purpose of the survey was to gather demographic, health, social and financial information from members who have multiple sclerosis to support various government lobbying efforts and to plan individual and family services. The response rate for the 720 surveys sent was 65%. This paper presents descriptive analysis exploring the occupational performance limitations experienced by the survey respondents based on the Model of Occupational Performance (CAOT, 1991). The prevalence of limitation was found to vary by specific occupation, by type of multiple sclerosis, by area of occupational performance, but not by fatigue status. The study findings have assessment and intervention implications for occupational therapists who work with people with multiple sclerosis in both institutional and community settings.

Key words: multiple sclerosis, occupational performance

Clinical Report

The Driver Information Data Base
Peter Klavora,  Margaret Young,  Ronald J. Heslegrave

Driver Rehabilitation Services at Bloorview MacMillan Centre in Toronto (BMC), and a number of other similar centres across Ontario, provide important assessment and services for those with various physical and medical disabilities. Each year, the centre at BMC sees approximately 700 to 800 clients. Until 1996 the client information filing system consisted predominantly of paper reports filed alphabetically by hand. The major purpose of this project was to implement a comprehensive computer database programme. This paper presents (1) the organization and implementation of the computer database programme at Bloorview MacMillan Centre in Toronto; and (2) the programme's implications for service providers, administrators, and researchers.

Key words: data management, driver assessment, driver rehabilitation

International Perspective

Reflections on doing, being and becoming
Ann Allart Wilcock

Occupation, and its relationship with health and well-being, is very complex. It can, and must be described in many different ways by the profession within which it is so central that it provides its nomenclature. A simple way to talk about occupation which appears to appeal to a wide range of people is as a synthesis of doing, being, and becoming. In this paper I reflect on how a dynamic balance between doing and being is central to healthy living and wellness, and how becoming whatever a person, or a community, is best fitted to become is dependent on both.

Doing is so important that it is impossible to envisage the world of humans without it. People spend their lives almost constantly engaged in purposeful doing even when free of obligation or necessity. It provides the mechanism for social interaction, technological and societal development and growth, forming the foundation stone of community, local and national identity, to the extent of government or to achieve international goals. In our profession doing is often used as a synonym for occupation but, by itself, can give a less than complete idea of the broad notions and concepts that occupation embraces.

Being encapsulates such notions as existing, living, nature and essence. It is about being true to ourselves, to our individual nature, and enjoying bringing and sharing what is distinctive about us to our relationships and all that we do. To be in this sense requires that people have time to discover themselves, to think, to reflect, to balance doing with being and, to simply exist. If people are encouraged to understand themselves as occupational beings and to develop their unique strengths they may be enabled to be responsive to their wellness needs.
Becoming is a concept that sits well with enabling occupation and with ideas about human development, growth and potential. It adds to the idea of being a sense of future, and holds the notions of transformation and self actualisation. Occupational therapists are in the business of helping people to transform their lives through enabling them to do and to be. We are part of their process of becoming and we should constantly bear in mind the importance of this task. To achieve well-being people need to be enabled towards what they are best fitted to become.

In combination doing, being and becoming are integral to occupational therapy philosophy, process and outcomes, and some attention is given to how we might best utilize these in self growth, in professional practice, student teaching and learning, or towards social change for healthier lifestyles. They are also considered in terms of ecological and global concerns for the future. For our profession to become what it has the potential to become, what it is best fitted to become, means that it has 'to do' and 'to be' true to itself, to its essence, to its own nature, to the beliefs that it rests upon.

Key words: empowerment, human activities and occupations, personal satisfaction

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