Canadian Association of Occupational Therapists

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CJOT Abstracts
Volume 70, Number 4
October 2003



National Perspective

Seeing beyond the clouds: Best practice occupational therapy 
by Jenny Strong

Key words Occupational therapy practice • Theory-practice relationship • Professional practice, evidence-based

Muriel Driver Memorial Lecture
Why crafts? Influences on the development of occupational therapy in Canada from1890 to 1930
by Judith Friedland

Key words Historical research • Handicrafts • Occupational therapy practice

The effectiveness of community-based occupational therapy education and functional training programs for older adults: A critical literature review
by Seanne Wilkins, Bonny Jung, Laurie Wishart,  Mary Edwards & Shelley Gamble Norton

Background. This paper examines the results of a critical literature review describing the provision of education and functional training programs by occupational therapists with older adults to maximize their occupational performance. Purpose. The critical review addressed the following question: What is the effectiveness of education and functional training programs in improving occupational performance and quality of life for older adults? Review methods are described and the outcomes of  the critical review discussed. Results. The results indicate that there is evidence that programs are effective in three areas: prevention of functional decline and falls, stroke and rheumatoid arthritis. Methodological limitations exist in some studies. There are several randomized controlled studies in this area, though the description of specific occupational therapy interventions is often vague and the programs could not be easily duplicated by occupational therapists. Practice implications. Occupational therapists are provided with information through this critical review to facilitate evidence-based practice when working with older adults.

Key words Occupational therapy practice, evidence based • Rehabilitation, community-based • Gerontologic care

The efficacy of pre-operative home visits for total hip replacement clients
by Annette Rivard, Sharon Warren , Don Voaklander & Allyson Jones

Background. There is increasing realization among health care administrative decision makers and service providers that we must measure the true value of expensive services by demonstrating the achievement of identified goals. Purpose. The objective of this study was to determine whether clients who received the home-based intervention for a hip arthroplasty would result in a more timely discharge home from hospital. Method. Two hundred and eight clients receiving a total hip replacement at two acute care hospitals comprised the sample. One hospital included the more costly home-based pre-operative teaching by an occupational therapist as part of its protocol while the other provided comparative occupational therapy intervention within its hospital based pre-admission clinic. Discharge disposition and length of hospital stay were measured. Results. Though no significant difference in either of these outcomes was found, a number of issues were raised indicating the complexity of resource allocation to this client population and the importance of the qualitative dimensions of care. Practice Implications. The location for pre-operative teaching for total hip replacements was not found to impact the length of hospital stay nor whether clients are discharged directly home.

Key words Arthroplasty, replacement, hip • Home occupational therapy • Health resource utilization

Lorsque l’enseignement supérieur s’intéresse au renouvellement des pratiques en réadaptation : étude de besoinsby Marie-José Durand & Marlène Falardeau

Background and purpose. In order to meet the new challenges facing the professional practice in rehabilitation, a study of practitioners in the rehabilitation field in Québec was undertaken to evaluate their needs in terms of continuing education in graduate level studies. Method. A total of 99 participants were involved in focus groups and phone interviews. An analysis of the content of the discussions was performed. Results. According to this analysis, the participants wished to develop skills that could be divided into two main categories of competencies : the development of the “self as a tool”, that is improving the practitioner’s ability to show insight into his professional practice, and the “self as a service provider”, that is developing knowledge in the cognitive area associated with the improvement in the quality of service. In addition, the participants favored different teaching methods, such as intensive teaching preferably on week-ends as well as short term training programs (9 to 15 credits). Practice implications. This study succeeded in identifying the special needs of practioners in order to face the changes in health services. The need to create a graduate program in rehabilitation was highlighted and the participants were enthusiastic at the thought of the creation of such a program.

Key words Needs study • Graduate studies • Rehabilitation

Knowledge use among occupational therapists for infant feeding assessmentsby Kala Subramaniam & Denise Reid

Background. Canadian occupational therapists practice in a variety of clinical settings and use different assessment approaches. To understand best practice, this study explored therapists’ knowledge use for infant feeding assessments. This was chosen as one specific area of practice to study knowledge use. Purpose.The purpose of this qualtitative study was to investigate what therapists assess and what procedures they use to carry out their assessments. Method. Semi-structured interviews were conducted with 13 therapists with experience evaluating infant feeding. A constant comparative method of data analysis was used to identify common themes. Results. Three themes emerged: the value of medical information, the importance of doing by observing and the need for an adaptive trial and error approach. Practice Implications. These findings suggest therapists’ experiential knowledge shape their best practice. This study informs us about the everyday knowledge used by therapists working with infants on feeding issues and helps us to understand why assessment practices may vary amongst therapists and across clinical settings.

Key words Paediatric occupational therapy • Infant feeding • Qualitative studies

Look Beyond
Reflections in and on the mirror
by Kelly Morphet

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