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Volume 75, Number 3
From the Editor
Origins of recent submissions and progress towards the CJOT vision
Bridges to Practice
Occupational integrity: Another perspective on “life balance”
Wendy Pentland, Mary Ann McColl
Background. An underlying premise of occupational science and occupational therapy is that humans do better with a balanced lifestyle. What life balance means, how to design it, and to recognize when one has it have not been defined. Purpose. Our intention is to offer another perspective on life balance, one that we believe is at the root of what the term means. Key Issues. We suggest the notion underlying life balance is the extent to which a person designs and lives in integrity with his or her own personal values, strengths and what has meaning for them. The term we propose is occupational integrity and that it be regarded as an essential precondition to life balance. Implications. Occupational integrity expands the focus of therapy beyond “doing” to interventions at the level of the person and identity, helping clients to identify their strengths, values and purpose, what is meaningful and satisfying for them, and then designing and living their lives in congruence with that.
Life balance, Values, Lifestyle, Occupation, Spirituality
Cultural and gender effects on children's activities preference in Israel
Batya Engel-Yeger, Tal Jarus
Background. Knowledge about factors that affect participation, as preference of activities, has major intervention implications. Purpose. To evaluate culture and gender effects on Israeli Jewish and Druze children's preference of activities performed outside mandated school. This study used the "Preference Assessment of Children" (PAC) (King et al., 2004). Findings. On most scales, the Jewish children showed significantly less interest in activities than the Druze children. Among the Jews, girls showed higher preference in most PAC scales than boys while among the Druze girls showed higher preference than the boys only in social skills. Implications. Culture and gender may influence children's preference of activity. More studies should elaborate the knowledge about individuals' preferred activities; understanding the factors that affect these preferences may enhance occupational therapy evaluation and intervention processes. Canadian occupational therapists, as health care professionals in a multicultural society, must develop cultural competency and explore people's experience as cultural beings.
Participation, Culture, Children
Living with parental multiple sclerosis: Children’s experiences and clinical implications
Merrill Turpin, Christine Leech, Louisa Hackenberg
Background. Health professionals need to understand how chronic illness affects all family members. Purpose. This study explored the everyday experiences of children who have a parent with multiple sclerosis. Methods. Exploratory, semi-structured interviews were conducted with eight Queensland children, aged 7 to14 years. Videotapes were transcribed verbatim and analysed inductively. Findings. Themes were labelled changing roles and responsibilities, emotional impact, and things that helped. Participants described taking on additional roles and responsibilities that restricted their participation in developmentally appropriate occupations, the emotional and practical impact of having a parent with MS and different methods they employed to cope with this impact. Implications. The findings emphasise the need for therapists to look beyond the diagnosed individual and see MS as a chronic illness affecting the whole family. Occupational therapists might assist parents and children to maintain their occupations through the provision of appropriate interventions and connection to referral networks.
Multiple sclerosis, Children’s experiences, Parental illness, Qualitative studies
Life experiences of young adults who have coordination difficulties
Cheryl Missiuna, Sandra Moll, Gillian King, Debra Stewart, Kathryn Macdonald
Background. Little is known about the impact of developmental coordination disorder (DCD) during adolescence and young adulthood. Purpose. This study explored the lived experiences of a nonclinical sample of nine university students who reported having significant coordination difficulties. Methods. A phenomenological approach was used that included two in-depth interviews asking participants to recall retrospectively their experiences throughout adolescence. Transcripts were coded to identify themes, and member-checking supported the credibility of findings. Findings. Strong pathways of resilience were found with participants who employed cognitive and behavioural strategies to manage their motor differences. Key themes emerged related to managing coordination differences including avoidance/withdrawal/adaptation, seeking compatible activities, using humour, and persevering. As adolescents matured, changing social contexts affected their self-efficacy and others’ perceptions of them. Implications. The findings of this study challenge occupational therapists to move beyond impairment-based interventions to ecological interventions that facilitate social and community participation.
Developmental coordination disorder, Resilience, Participation, Adolescence
The wheelchair procurement process: Perspectives of clients and prescribers
W. Ben Mortenson, William Miller
Background. Increasing choices in assistive technology have made the process of procuring a wheelchair more complex and challenging. Purpose. To explore the intricacies of the procurement process from the perspectives of clients and therapists. Methods. Thirty-four participants were interviewed, including 13 wheelchair prescribers, 14 wheelchair users, and 7 wheelchair associates (family members and caregivers). Findings. Analysis revealed five main themes. “Who decides?” described varying degrees of client involvement in the procurement process. “Expert knowledge” reflected the expert knowledge that all parties possessed. “Form versus function” captured the primary and, at times, conflicting outcomes that participants wanted to achieve. “Fitting in” depicted the environmental factors that affected wheelchair procurement. “(Re)solutions” illustrated strategies that participants felt improved the process. Implications. This study reveals clients’ experiences with wheelchair procurement, identifies potential issues therapists may encounter, and suggests possible remedies they might consider when prescribing wheelchairs within a client-centred framework.
Assistive technology, Client-centred practice, Mobility assessment
Through the eyes of students: Ethical tensions in occupational therapy practice
Elizabeth Anne Kinsella, Anna Ji-Sun Park, Josephine Appiagyei, Emmeline Chang, Donald Chow
Background. Many researchers have expressed concerns about ethical tensions in occupational therapy practice; yet little research has considered this topic from the perspective of students. Purpose. The purpose of this study was to examine the nature of ethical tensions witnessed or experienced by occupational therapy students during practice education. Method. A phenomenological approach was used, and in-depth interviews were conducted at a Canadian university with 25 occupational therapy students. Findings. Four major themes emerged from analysis of the data. These include systemic constraints, conflicting values, witnessing questionable behaviour, and failure to speak up. Implications. The findings of this study raise awareness about ethical tensions in occupational therapy practice witnessed or experienced by students. Critical reflection on the findings highlights implications for professional practice and education and points to the need for further research, particularly in the area of policy and practice.
Ethics, Ethical tensions, Professional practice, Professional education, Policy
Occupational well-being: Rethinking occupational therapy outcomes
Susan Doble, Josiane Caron Santha
Background. Outcomes in occupational therapy focus largely on increasing and enhancing the quality of clients’ occupational performance, and thus, the importance of clients’ subjective experiences of their occupations are often overshadowed. Purpose. In this paper, the concept of occupational well-being is introduced. Our intent is to extend the focus beyond occupational performance and draw attention to individuals’ subjective occupational experiences. Key Issues. We contend that occupational well-being is enhanced when individuals’ occupational needs, including their needs for accomplishment, affirmation, agency, coherence, companionship, pleasure, and renewal are consistently met. Implications. Occupational therapists can play a vital role in enabling clients to compose or re-orchestrate their occupational lives so they are able to meet their occupational needs more consistently. This role may be fulfilled by intervening directly with clients or by indirectly influencing clients’ occupational lives or society at large to effect changes at an environmental or organizational level.
Well-being, Occupational performance, Occupational needs, Occupational well-being, Meaning
Letters to the Editor