Canadian Association of Occupational Therapists

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CJOT Abstracts
Volume 65 • Number 4
October 1998

National Perspective
Themes to lead CAOT into the future
Lorna Reimer

Keywords: Presidential address, professional issues


Enjoyment experiences as described by persons with schizophrenia: A qualitative study
Heather A. Emerson, Joanne Valiant Cook, Helene Polatajko, Ruth Segal

Csikszentmihalyi’s (1990) assertion that persons with schizophrenia do not experience “flow” states provided the impetus for a study exploring the enjoyment experiences of nine persons with schizophrenia. Data were gathered using an audio taped semi-structured interview and analyzed using qualitative methods. Five themes emerged regarding the informants’ subjective experiences: excitement, accomplishment, relaxation, social connectedness, and being interested. The first two themes parallel flow states, disputing Csikszentmihalyi’s assumption that individuals with schizophrenia are unable to experience flow. The third theme may be a precursor to flow. The remaining two themes are distinct from flow, suggesting that for the informants in this study, enjoyment was a broader construct than flow.

Keywords:
Human activities and occupation, mental health, personal satisfaction


Disability income: The experiences of women with multiple sclerosis
Lyn Jongbloed

This paper examines the experiences of unemployed women with multiple sclerosis with three income support programmes, the Canada/Quebec Pension Plan, long term disability insurance and social assistance. Findings are based on ethnographic interviews with 23 women. Difficulties experienced with these programmes include the low level of benefits of two of the programmes, the earnings-based component of two of the programmes, and requirements in eligibility criteria that applicants be defined as permanently unemployable. The occupational consequences of disability income policies are mediated by marital and socio-economic status. For some, policies mean lives of poverty and marginalization, for others they mean lack of freedom to change jobs, to work part-time or hesitance to return to the work force. The ways in which social policies shape the individual experience of disability should inform occupational therapy intervention at the individual level. Therapists are also challenged to help create policy environments that will enhance client function.

Keywords:
Employment, income, mulitiple sclerosis, policies, social


Mediational techniques: Origins and application to occupational therapy in paediatrics
Cheryl Missiuna, Theresa Malloy-Miller, Angela Mandich

For a variety of reasons, occupational therapists are beginning to explore the use of cognitive, or “top-down” approaches during intervention. While these approaches have a long history within education and psychology, the steps involved in problem-solving and the techniques that are used to mediate a child’s occupational performance are unfamiliar to most therapists. In this paper, the historical underpinnings of cognitive approaches and mediational techniques are reviewed and the steps involved in teaching a child to problem solve are outlined. As each is described from the literature, it is interpreted and applied to paediatric occupational therapy practice. Finally, the problem-solving steps and techniques are combined to demonstrate usage of a cognitive approach in order to address a common occupational performance issue in childhood.

Keywords:
Cognitive therapy, mediation, problem-solving


Relation entre le comportement ludique et la capacité fonctionnelle chez l’enfant avec déficience motrice cérébrale
Mylène Dufour, Francine Ferland, Julie Gosselin

According to the Ludic Model, play is seen as the privileged way to develop the capacity for doing in a child with physical disabilities. In order to analyze the relationship between play behaviour (interest, capacities and playful attitude) and functional capacity, which could be linked with the concept of capacity for doing, an exploratory study has been carried out with 30 preschool children who have cerebral palsy. The Évaluation du comportement ludique (Ferland, 1994b) and the Pediatric Evaluation of Disability Inventory (Haley, Coster, Ludlow, Haltiwanger & Andrellos, 1992) have been used for this purpose. The results identify the relationship between the two concepts under study mainly by the ludic capacities. Ludic interest and attitude seem to be distinct and complementary dimensions.

Keywords:
Child play behaviour, occupational performance, paediatric occupational therapy, play


The Occupational Performance History Interview: Evidence for three underlying constructs of occupational adaptation
Trudy Mallinson, Lisa Mahaffey, Gary Kielhofner

The Occupational Performance History Interview (OPHI) was developed to gather data on a person’s past and current occupational functioning. The OPHI includes both a life history narrative component designed to render the life history from the client’s perspective and a rating scale designed to measure the client’s past and present occupational adaptation. Previous research documented the reliability of the OPHI, but there has been limited study of its construct validity. This study used Rasch analysis to determine the construct validity of a modified version of OPHI scale (OPHI-R).

Data previously gathered on 20 clients in a psychiatric setting were analyzed. The results indicate that the items of the OPHI-R do not effectively measure a single construct of occupational adaptation as originally thought. Rather, the OPHI-R items appear to measure three underlying constructs reflecting occupational competence, identity and environment. These findings suggest that revision of the OPHI scale should seek to capture these three underlying constructs for the measurement of occupational adaptation.

Keywords:
Interviews, life histories, occupational performance

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