Evidence for mental health occupational therapy: trends in the first decade of the new millenium (200-2013)

This article reports on the evidence for mental health occupational therapy in peer-reviewed journals from 2000 to 2013. Descriptive and inductive methods were used to address this question, with evidence from CINAHL, OTDBase, PSYCInfo, SCOPUS, and Google Scholar® included. Many articles (n = 1,747) were found that met the inclusion and exclusion criteria. A total of 47 different methods were used to develop evidence for mental health occupational therapy, and evidence appeared in 300 separate peer-reviewed journals. It takes on average 7 months for an article to progress from submission to acceptance, and a further 7 months to progress from acceptance to publication. More than 95% of articles published between 2000 and 2002 were cited at least once in the following decade, and around 70% of these citations were recorded in non-occupational therapy journals. The current evidence base for mental health occupational therapy is both substantial and diverse.

Occupational stress and job satisfaction in media personnel assigned to the Iraq War (2003)

This paper investigates occupational stressors amongst media personnel assigned to work on covering the Iraq War via interviews with 54 journalists from the BBC and Reuters, who worked in Iraq between February and April 2003. A range of stressors were identified that could be categorized into three main themes, control over the situation, support from management and grief from the death of colleagues. Journalists not embedded with military units were more likely to report negative physical and emotional health outcomes. The study concludes that hazardous work environments do not, by themselves, cause stress and poor job satisfaction. Rather, organizational factors, the imbalance between the ability to make decisions about how to carry out their job effectively and the perceived rewards of working in such environments appear to have a greater impact on work related stress.

Security networks and occupational culture: understanding culture within and between organisations

Security networks are organisational forms involving public, private and hybrid actors or nodes that work together to pursue security-related objectives. While we know that security networks are central to the governance of security, and that security networks exist at multiple levels across the security field, we still do not know enough about how these networks form and function. Based on a detailed qualitative study of networks in the field of ‘high’ policing in Australia, this article aims to advance our knowledge of the relational properties of security networks. Following the organisational culture literature, the article uses the concept of a ‘group’ as the basis with which to analyse and understand culture. A group can apply to networks (‘network culture’), organisations (‘organisational culture’) and sections within and between organisations (‘occupational subcultures’). Using interviews with senior members of security, police and intelligence agencies, the article proceeds to analyse how cultures form and function within such groups. In developing a network perspective on occupational culture, the article challenges much of the police culture(s) literature for concentrating too heavily on police organisations as independent units of analysis. The article moves beyond debates between integrated or differentiated organisational cultures and questions concerning the extent to which culture shapes particular outcomes, to analyse the ways in which security nodes relate to one another in security networks. If there is one thing that should be clear it is that security nodes experience cultural change as they work together in and through networks.

Occupational class differences in suicide: evidence of changes over time and during the global financial crisis in Australia

BACKGROUND: Previous research showed an increase in Australian suicide rates during the Global Financial Crisis (GFC). There has been no research investigating whether suicide rates by occupational class changed during the GFC. The aim of this study was to investigate whether the GFC-associated increase in suicide rates in employed Australians may have masked changes by occupational class.

METHODS: Negative binomial regression models were used to investigate Rate Ratios (RRs) in suicide by occupational class. Years of the GFC (2007, 2008, 2009) were compared to the baseline years 2001-2006.

RESULTS: There were widening disparities between a number of the lower class occupations and the highest class occupations during the years 2007, 2008, and 2009 for males, but less evidence of differences for females.

CONCLUSIONS: Occupational disparities in suicide rates widened over the GFC period. There is a need for programs to be responsive to economic downturns, and to prioritise the occupational groups most affected.

Individual, occupational, and workplace correlates of occupational health and safety vulnerability in a sample of Canadian workers

Objective: To describe OH&S vulnerability across a diverse sample of Canadian workers.
Methods: A survey was administered to 1,835 workers employed more than 15 hrs/week in workplaces with at least five employees. Adjusted logistic models were fitted for three specific and one overall measure of workplace vulnerability developed based on hazard exposure and access to protective OH&S policies and procedures, awareness of employment rights and responsibilities, and workplace empowerment.
Results: More than one third of the sample experienced some OH&S vulnerability. The type and magnitude of vulnerability varied by labor market sub-group. Younger workers and those in smaller workplaces experienced signficantly higher odds of multiple types of vulnerability. Temporary workers reported elevated odds of overall, awareness- and empowerment-related vulnerability, while respondents born outside of Canada had significantly higher odds of awareness vulnerability.
Conclusion: Knowing how labor market sub-groups experience different types of vulnerability can inform better-tailored primary prevention interventions.

Itinerant foreign harvest workers in Australia: the impact of precarious employment on occupational safety and health

Horticulture work in many high-income economies is increasingly performed by temporary migrant workers from low-wage economies. In Australia, such work is now performed predominantly by international backpackers – young well-educated workers with mostly sound English language skills. These workers are drawn to harvesting work by a government scheme which provides an incentive for completing a specified number of days work in horticulture. This article examines the health and safety experience of these workers, through focus groups, interviews and an online survey. Notwithstanding their distinctive backgrounds, the harvesting experience of these temporary migrant workers is similar to that of low-skilled migrants working in other high-income countries. Health and safety risks associated with work organisation and payment systems, and a lack of compliance with OHS legal requirements, are commonplace but potentially compounded by a sense of invincibility amongst these young travellers. Furthermore, a growing pool of undocumented workers is placing downward pressures on their employment conditions. The vulnerability associated with work and earnings uncertainty, and the harsh environment in which harvesting work occurs, remains a constant notwithstanding the background of these workers.

Comparison of a traditional and non-traditional residential care facility for persons living with dementia and the impact of the environment on occupational engagement

BACKGROUND: Dementia residential facilities can be described as traditional or non-traditional facilities. Non-traditional facilities aim to utilise principles of environmental design to create a milieu that supports persons experiencing cognitive decline. This study aimed to compare these two environments in rural Australia, and their influence on residents' occupational engagement. METHODS: The Residential Environment Impact Survey (REIS) was used and consists of: a walk-through of the facility; activity observation; interviews with residents and employees. Thirteen residents were observed and four employees interviewed. Resident interviews did not occur given the population diagnosis of moderate to severe dementia. Descriptive data from the walk-through and activity observation were analysed for potential opportunities of occupational engagement. Interviews were thematically analysed to discern perception of occupational engagement of residents within their facility. RESULTS: Both facilities provided opportunities for occupational engagement. However, the non-traditional facility provided additional opportunities through employee interactions and features of the physical environment. Interviews revealed six themes: Comfortable environment; roles and responsibilities; getting to know the resident; more stimulation can elicit increased engagement; the home-like experience and environmental layout. These themes coupled with the features of the environment provided insight into the complexity of occupational engagement within this population. CONCLUSION: This study emphasises the influence of the physical and social environment on occupational engagement opportunities. A non-traditional dementia facility maximises these opportunities and can support development of best-practice guidelines within this population.

Occupational therapists' experiences of career progression following promotion

BACKGROUND/AIM: The recruitment and retention of a skilled occupational therapy workforce is highlighted as a key issue for the profession, and yet there have been relatively few studies into the career progression of occupational therapists. METHODS: A qualitative, naturalistic approach was adopted to answer the research question, using semi-structured interviews to gather data. Eleven purposefully selected participants at an Australian health service were interviewed as part of this study. Categories representing the most common themes and topics supplied by participants within their individual interviews were identified and consolidated by the research team. The trustworthiness of this study was supported by strategies to maximise its credibility, dependability and confirmability. RESULTS: Four main themes were elicited from the data - (i) Readiness for progression, (ii) Tools and processes, (iii) Expectations and (iv) What I wish I had known first. Within these themes, related findings were also identified by both Grade 2 and Grade 3 staff. CONCLUSIONS: This study indicates that the readiness of occupational therapists to climb the career ladder is influenced by the tools and processes they can utilise, and the expectations they have around the realities of their new position. With hindsight, participants highlighted some things they wish they had known at the time of transition, which appeared to have been implicit. SIGNIFICANCE OF STUDY: This study is the first to address the common issues for occupational therapy staff around progression between grade levels. It therefore provides a basis for further research in other practice settings and for the development of supports for therapists climbing the career ladder.

Occupational therapy with people with depression: using nominal group technique to collate clinician opinion

AIMS: This aim of this study was to obtain a consensus from clinicians regarding occupational therapy for people with depression, for the assessments and practices they use that are not currently supported by research evidence directly related to functional performance. The study also aimed to discover how many of these assessments and practices were currently supported by research evidence.

METHODS: Following a previously reported systematic review of assessments and practices used in occupational therapy for people with depression, a modified nominal group technique was used to discover which assessments and practices occupational therapists currently utilize. Three online surveys gathered initial data on therapeutic options (survey 1), which were then ranked (survey 2) and re-ranked (survey 3) to gain the final consensus. Twelve therapists completed the first survey, whilst 10 clinicians completed both the second and third surveys.

MAJOR FINDINGS: Only 30% of the assessments and practices identified by the clinicians were supported by research evidence. A consensus was obtained on a total of 35 other assessments and interventions. These included both occupational-therapy-specific and generic assessments and interventions. Principle conclusion. Very few of the assessments and interventions identified were supported by research evidence directly related to functional performance. While a large number of options were generated, the majority of these were not occupational therapy specific.

Transformation from student to occupational therapist : using the Delphi technique to identify the threshold concepts of occupational therapy

BACKGROUND/AIM: Understanding and facilitating the transformation from occupational therapy student to practitioner is central to the development of competent and work-ready graduates. However, the pivotal concepts and capabilities that need to be taught and learnt in occupational therapy are not necessarily explicit. The threshold concepts theory of teaching and learning proposes that every discipline has a set of transformational concepts that students must acquire in order to progress. As students acquire the threshold concepts, they develop a transformed way of understanding content related to their course of study which contributes to their developing expertise. The aim of this study was to identify the threshold concepts of occupational therapy. METHOD: The Delphi technique, a data collection method that aims to demonstrate consensus in relation to important questions, was used with three groups comprising final year occupational therapy students (n = 11), occupational therapy clinicians (n = 21) and academics teaching occupational therapy (n = 10) in Victoria, Australia. RESULTS: Participants reached consensus regarding 10 threshold concepts for the occupational therapy discipline. These are: understanding and applying the models and theories of occupational therapy; occupation; evidence-based practice; clinical reasoning; discipline specific skills and knowledge; practising in context; a client-centred approach; the occupational therapist role; reflective practice and; a holistic approach. CONCLUSION: The threshold concepts identified provide valuable information for the discipline. They can potentially inform the development of competencies for occupational therapy and provide guidance for teaching and learning activities to facilitate the transformation to competent practitioner.

Identifying educational priorities for occupational therapy students to prepare for mental health practice in Australia and New Zealand: opinions of practising occupational therapists

BACKGROUND: The effective preparation of occupational therapy students for mental health practice is critical to facilitate positive consumer outcomes, underpin optimal practice and support new graduates' professional identity. This project was established to determine a set of 'educational priorities' for occupational therapy students to prepare them for current (and future) entry-level practice in mental health, from the perspective of mental health occupational therapists in Australia and New Zealand. METHODS: The study included two phases. In Phase One, participants identified what they considered to be important educational priorities for occupational therapy students to prepare them for practice in mental health. For Phase Two, an 'expert panel' was assembled to review and rank these using a Policy Delphi approach. RESULTS: Eighty-five participants provided educational priorities in Phase One. These were grouped into a total of 149 educational themes. In Phase Two, the expert panel (consisting of 37 occupational therapists from diverse locations and practice settings) prioritised these themes across three Delphi rounds. A final priority list was generated dividing educational themes into three prioritised categories: 29 'Essential', 25 'Important' and 44 'Optional' priorities. Highest-ranked priorities were: clinical reasoning, client-centred practice, therapeutic use of self, functional implications of mental illness, therapeutic use of occupation and mental health fieldwork experience. CONCLUSION: The priority list developed as part of this project provides additional information to support the review of occupational therapy curricula across Australia and New Zealand to ensure that new graduates are optimally prepared for mental health practice.

Occupational tasks and changes in the wage structure

This paper argues that changes in the returns to occupational tasks have contributed to changes in the wage distribution over the last three decades. Using Current Population Survey (CPS) data, we first show that the 1990s polarization of wages is explained by changes in wage setting between and within occupations, which are well captured by tasks measures linked to technological change and offshorability. Using a decomposition based on Firpo, Fortin, and Lemieux (2009), we find that technological change and deunionization played a central role in the 1980s and 1990s, while offshorability became an important factor from the 1990s onwards.

Inflation and occupational choices

This paper studies the impact of (high rates) of infiation on ocupational choices in a model where the demand for labor is derived from a production technology that uses capital, productive labor, and managerial services done by administrative labor and money; while the supply of both kinds of labor is rigid in the short-run due to irreversible professional choices. The dynamic path of the economy after stabilization plans exhibits the main sty!ized facts reported in the literature inc1uding an initial consumption boon followed by a gradual adjustment. In its open economy version, the initial phase of the transitional dynamics exhibits capital infiight. The model also generates an increase of income inequality during the trasitional dynamics.