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Volume 76, Number 5
Table of Contents
From the Editor
An assignment for students highlights research-practice gaps, again
Bridges to Practice
Identifying occupational performance issues with older adults: Therapists’ perspectives
Barry Trentham, Lynda Dunal
Background. Identifying occupational performance issues is an essential component of the occupational therapy process. Little attention has been paid to therapists’ management of this aspect of geriatric practice. Purpose. This study explored therapists’ approach to identifying occupational performance issues (OPI) with older adults. Methods. Information gathered from semi-structured interviews was analyzed using Polkinghorne’s (1995) analysis of narrative method. Findings. The study demonstrated how therapists prepare clients to engage in the OPI identification process; use interviewing strategies to build trust; and tap into client narratives to foster hope in occupational possibilities. Implications. Findings suggest that therapists require a complex set of highly skilled strategies to engage clients in OPI identification through tapping into aspects of the client’s motivational influences, occupational histories, therapy expectations, and generational attitudes about aging. Further study is required to identify ways to overcome structural barriers to more occupational and narrative-based approaches to identifying occupational performance issues.
Measurement issues, Assessment, Older adult care, Patient-centred care
Group constraint-induced movement therapy: Motor and functional outcomes in individuals with stroke
Eun-young Yoo, Min-ye Jung, Heung-seok Park, Jung-ran Kim, Hye-Seon Jeon
Background. Strokes frequently cause limitations of the upper extremity and in performance of activities of daily living (ADL). Constraint-induced movement therapy (CIMT) is designed to enhance the use of the hemiplegic arm. Purpose. To assess the effects of group CIMT on upper-extremity motor function and performance level of motor and process skills for instrumental activities in daily living (IADL) in community-dwelling individuals whose stroke occurred at least six months earlier. Methods. Eight adults with stroke participated in this study. Group-based CIMT was administered for two weeks, five times per week, with two-hour intensive daily training. Findings. The Fugl-Meyer Assessment (FMA) score and the Assessment of Motor and Process Skills (AMPS) scores improved after intervention. Implications. The results of this study suggest that relatively brief group-based CIMT may be an effective intervention for improving motor function of the affected upper-limb and the level of IADL in individuals who have had stroke.
Constraint-induced movement therapy, Group therapy , Rehabilitation, Stroke
A model of professional thinking: Integrating reflective practice and evidence based practice
Katrina Bannigan, Alis Moores
Background. Internationally, occupational therapists operate in increasing complex health and social care settings. To function in this environment, high-level thinking skills are required. Reflective practice and evidence-based practice are two key skills that shape the way occupational therapists think. Purpose. To integrate reflective practice and evidence-based practice so that their complementary qualities form part of a model of professional thinking. Key issues. Reflective practice and evidence-based practice skills both contribute to clinical reasoning. The “model of professional thinking” can enable occupational therapists to integrate these two skills into their professional thinking. Implications. Rather than teaching reflective practice and evidence-based practice as discrete subjects, “professional thinking” should be taught as an overarching topic within curricula. This may mean changes to the organisation and delivery of curricula, including practice placements. This model of professional thinking will need to be evaluated.
Clinical decision making, Evidence-based occupational therapy practice, Reflection, Curriculum development, Thinking
An evaluation of a workshop about obesity designed for occupational therapists
Mary Forhan, Mary Law
Background. The evaluation of knowledge translation activities designed to increase knowledge for occupational therapy practitioners is required to advance evidence-based practice. Purpose. This study examines the development, implementation, and evaluation of a workshop aimed at raising awareness about obesity and the role for occupational therapy interventions with an obese population. Methods. Fifty-one occupational therapists participated in interactive workshops. Measures of beliefs and attitudes toward obese persons and readiness to work with obese clients were completed. Findings. Analysis revealed a change in beliefs about obese persons but no changes in attitudes. Participants reported feeling better informed about obesity and more prepared to work with clients with obesity. The potential for occupational therapy interventions to enable occupation for persons with obesity was recognized. Implications. This study provides evidence to support the use of interactive workshops for the purpose of translating knowledge using an approach that is relevant to occupational therapy practice
Continuing education, Knowledge translation, Evidence-based occupational therapy practice
Client insights on knowledge use and access in return to work
Lynn Shaw, Karen Bondy, Jillian Dodman
Background. An emerging trend in work practice is to move knowledge into the hands and minds of the end-users—our clients. Purpose. The purpose of this study was to investigate clients’ perspectives on their experiences, needs, and preferences for accessing and using information to make decisions in resuming work and living with disability. Methods. Data from a grounded theory study with a sample of 14 participants with chronic disabilities from three regions across Canada were analyzed using the constant comparative method. Findings. Barriers revealed the pervasive struggles of clients in accessing and communicating information. Clients need places, resource people as well as access to diverse formats, and material to support knowledge use. Clients engaged themselves in interpreting or acting upon knowledge through planning for contingencies, appraising the self in context, and reflecting and learning from others. Implications. Findings advance the conceptual understanding of knowledge translation principles and processes needed to support clients in making decisions about return-to-work. Opportunities for policy change and for occupational therapists to support knowledge brokering and translation are elaborated.
Knowledge translation, Patient-centred care, Chronic disease, Job re-entry
Friendships of adolescents with physical disabilities attending inclusive high schools
Margaret Jamieson, Nancy L. Hutchinson, Jennifer Taylor, Kelly P. Westlake, Derek Berg, Will Boyce
Background. Adolescents with physical disabilities (PD) report difficulties making friends. Education in inclusive high schools may help to minimize these challenges. Purpose. This paper begins to answer the question: What is the nature of the friendships of adolescents with PD attending inclusive high schools? Methods. Standard qualitative methods were used to analyze the data of three multi-perspective case studies that included interviews of three adolescents with PD and their nominated friends, parents, and teachers. Based on these analyses, we describe the activities and the quality of the adolescents’ interactions and relationships. Findings. Three unique patterns of friendship were identified: an extensive network of friendships, a core group of friends with an avid interest, and few friendships in or out of school. Implications. Successful development of friendships among adolescents with and without PD is complex and influenced by personal, environmental, interactional, and relationship factors.
Friendship, Adolescence, Disabled, School health, Case studies