967 resultados para Preferred orientations


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Mode of access: Internet.

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Short stories.

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Thesis (Ph.D.)--University of Washington, 2016-06

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The reform of Australian mental health services has resulted in new models of care and changed work practices for all mental health professionals. Occupational therapists today are as likely to be working in multidisciplinary teams performing a range of generic clinical roles as they are to be working in specialist rehabilitation units. These kinds of changes have taken place in other countries, with anecdotal and some empirical evidence that the changes have resulted in concerns about loss of professional identity and roles. This study sought to identify the current work activities carried out by occupational therapists and to determine whether there was a discrepancy between their actual and desired work activities. It was expected that, overall, they would indicate a preference to do more specialist rehabilitation focused work and less generic case management work. A survey of 196 occupational therapists investigated their actual and preferred work activities in 55 specific roles across four broad categories (senior administration, specialist clinical, general clinical and community development). As expected, the participants indicated that they would prefer to be undertaking more specialist rehabilitation oriented work activities than they were actually doing. Contrary to expectations, they also wished to undertake more rather than less generic clinical work activities, to be more engaged in community development work and to take on more senior and administrative roles. They indicated a preference for less rather than more activity on only 5 of the 55 work roles examined. On examining a subset of 113 participants who reported that 50% or more of their time was spent in case management, there was greater evidence of resistance to generic clinical roles. It was therefore concluded that occupational therapists in Australia are seeking to deploy their specialist skills to a greater degree than the current practice environment permits. They have broadly accepted the generic roles required in multidisciplinary community case management, but those who are actually working in these roles are most likely to have reservations about this kind of work.

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In the Western developed nations, the changing pattern of mental health care provision has necessitated mental health staff adopting new approaches to service delivery across a diverse and expanding range of service settings. The impact of changed service delivery on Australian mental health professionals is an area that has not been well studied. The aim of the study was to identify the current clinical work activities performed by occupational therapists and social workers and whether there was a discrepancy between the actual and preferred work activities. The study also aimed to identify whether any discrepancy between their actual and preferred clinical work activities was associated with higher levels of stress. A cross-sectional survey of 304 (response rate 76.6%) occupational therapists and social workers in Australian mental health services was conducted. A work activities scale developed specifically for this study and the Mental Health Professionals Stress Scale were used to measure actual and preferred work activities and stress respectively. Both groups experienced a discrepancy between their actual and preferred work activities, with the occupational therapists and the social workers mostly wanting to undertake a diverse range of activities to a significantly greater extent than they currently were. As predicted, stress was associated with the discrepancy between the kind of work that the participants wanted to do and the kind of work that their job actually entailed. Health workers require assistance to adapt to their new work roles and to achieve a balance between generic and discipline-specific competencies. This has implications for education and professional training.

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Difficulty performing more than one task at a time is common in people with Parkinson's disease, resulting in interference with one or both tasks. While studies have shown that greater interference in gait occurs with more complex concurrent tasks, the impact of the type of concurrent task is unclear in the Parkinson's population. Thus the first purpose of this study was to investigate the effect of the concurrent task (calculation, language, or motor) on gait in people with Parkinson's disease. As visual cues are commonly used to aid stride regulation in people with Parkinson's disease, the second purpose of this study was to determine whether this method of increasing stride length was still effective if other tasks were performed simultaneously. Sixteen patients with Parkinson's disease and 16 gender- and age-matched controls performed six cognitive and motor concurrent tasks when seated, walking 10 m, and walking over visual cues. Stride length decreased in people with Parkinson's disease when performing the concurrent calculation and language tasks, but not with the motor task. The language task was more complex than the calculation task, thus the effect was not due to task complexity alone. Visual cues were effective in improving stride length whist maintaining velocity in people with Parkinson's disease, even when performed under dual task conditions. These findings highlight the importance of the task when assessing and retraining dual tasking during gait, and suggest that retraining dual tasking can occur whilst simultaneously using visual aids to regulate stride length.