Clinical reporting by occupational therapists and speech pathologists: Therapists' intentions and parental satisfaction

This study employed a qualitative research design to explore therapists' and parents' perspectives of paediatric occupational therapy and speech pathology assessment reports. Aims of the study were to explore the intentions of therapists when writing reports, to expand upon existing literature on parental satisfaction and preferences with respect to paediatric clinical reports, to highlight documentation practices that would serve to maximize parental use of allied health reports, and to develop specific guidelines on how reports can be written to ensure they are useful and beneficial to therapists and parents. Participants were 15 parents of children who had been assessed at 1 of 2 university clinics and subsequently received a written report, and 11 therapists employed at the same university clinics. Questionnaires were used to seek information from therapists concerning the purpose of assessment reports and essential aspects to include when writing reports for parents. In-depth interviews were used to seek information about how understandable and beneficial clinical reports were to parents. The data were subjected to thematic analysis. From comments of therapists' intentions and parents' stated needs, and in accordance with literature reviewed, guidelines were identified for the production of parent-oriented reports. Conclusions drawn from this study can be specifically applied to services producing paediatric occupational therapy or speech pathology assessment reports, but are widely relevant to paediatric allied health services. (author abstract)

The application of cognitive orientation to daily occupational performance (CO-OP) with children 5-7 years with developmental coordination disorder

There has been an increase in the use of cognitive frameworks in occupational therapy with children with developmental coordination disorder (DCD). Investigations into the utility of one such cognitive approach, namely Cognitive Orientation to (daily) Occupational Performance (CO-OP), with children with DCD have shown the intervention to be effective with children over 7 years. However, there has been limited research into its utility with younger children. This paper presents two case studies to demonstrate the use of CO-OP with children aged 5-7 years. Two boys with DCD engaged in 10 sessions of CO-OP. These younger children were found to be able to use the global framework (Goal, Plan, Do, Check) to improve their task performance, to develop plans using domain-specific strategies and to engage in checking strategies. Issues relating to attention, motivation and goal setting are discussed in the context of the two case studies.

Evidence-based practice and rehabilitation: occupational therapy in Australia and New Zealand experiences

Evidence-based practice has become the dominant paradigm in the delivery of rehabilitation programme. However, occupational therapists in Australia and New Zealand have been slow in making the transition to become evidence-based practitioners. Collaboration between the university/ tertiary institute and clinical setting is one way that clinicians can be assisted with incorporating research into their practice. Two case examples are presented outlining how collaborative practice can result in improved out.. comes for all concerned.

The effect of pre-clinical fieldwork subject on the confidence and professional skills of undergraduate occupational therapy students

Objectives: This study investigated the effect of a pre-clinical fieldwork subject on the confidence and professional skills of undergraduate occupational therapy students during their first full-time clinical fieldwork placement. Methods: Participants were 31 third year students enrolled in the pre-clinical fieldwork subject (experimental group), and 25 students not enrolled in the subject (control group). Both quantitative and qualitative methodologies were employed to address the research question. Student anxiety levels were measured using the State-Trait Anxiety Inventory (STAI) and compared at three different intervals - prior to commencing the university semester, prior to commencing full-time practical placement, and following this full-time placement. Individual interviews were conducted with six students (three from the experimental group, three from the control group) to explore their perceptions regarding confidence levels and skill proficiencies during full-time placement. At each data analysis interval, responses for both groups were compared using independent samples t-tests. Responses were compared over time using analysis of variance (ANOVA). The qualitative data were subjected to thematic and content analysis. Results and Conclusions: In general, student anxiety levels did not differ between the experimental and control groups over time. However, qualitative results suggest that students who were enrolled in the pre-clinical subject have greater confidence and competence with occupational therapy skills, and have heightened awareness of the expectations on full-time placement.

Sources of stress experienced by occupational therapists and social workers in mental health settings

This study examined the sources of stress experienced by occupational therapists and social workers employed in Australian public mental health services and identified the demographic and work-related factors related to stress using a cross-sectional survey design. Participants provided demographic and work-related information and completed the Mental Health Professionals Stress Scale. The overall response rate to the survey was 76.6%, consisting of 196 occupational therapists and 108 social workers. Results indicated that lack of resources, relationships and conflicts with other professionals, workload, and professional self-doubt were correlated with increased stress. Working in case management was associated with stress caused by client-related difficulties, lack of resources, and professional self-doubt. The results of this study suggest that Australian occupational therapists and social workers experience stress, with social workers reporting slightly more overall stress than occupational therapists. Copyright © 2005 Whurr Publishers Ltd.

Occupational therapy and clinical research in mental health rehabilitation

Practitioners working in Australian mental health services are faced with the challenge of providing appropriate evidence-based interventions that lead to measurable improvement and good outcomes. Current government policy is committed to the development of strategic mental health research. One focus has been on under-researched practice areas, which include the development of psychosocial rehabilitation systems and models that facilitate recovery. To meet this challenge, an Australian rehabilitation service formed a collaborative partnership with a university. The purposes of the collaboration were to implement new forms of service delivery based on consumer need and evidence and to design research projects to evaluate components of the rehabilitation programme. This article examines the process of developing the collaboration and provides examples of how research projects have been used to inform practice and improve the effectiveness of service delivery. Challenges to the sustainability of this kind of collaboration are considered.

Australian occupational therapists' use of an online evidence-based practice database (OTseeker)

Introduction: Online databases can support the implementation of evidence-based practice by providing easy access to research. OTseeker (www.otseeker.com), an electronic evidence database, was introduced in 2003 to assist occupational therapists to locate and interpret research. Objectives: This study explored Australian occupational therapists' use and perceptions of OTseeker and its impact on their knowledge and practice. Methods: A postal survey questionnaire was distributed to two samples: (i) a proportionate random sample of 400 occupational therapists from all states and territories of Australia, and (ii) a random sample of occupational therapists working in 95 facilities in two Australian states (Queensland and New South Wales). Results: The questionnaire was completed by 213 participants. While most participants (85.9%) had heard of OTseeker, only 103 (56.6%) had accessed it, with lack of time being the main reason for non-use. Of the 103 participants who had accessed OTseeker, 68.9% had done so infrequently, 63.1% agreed that it had increased their knowledge and 13.6% had changed their practice after accessing information on OTseeker. Conclusion: Despite OTseeker being developed to provide occupational therapists with easy access to research, lack of time was the main reason why over half of the participants in this study had not accessed it. This exploratory research suggests, however, that there is potential for the database to influence occupational therapists' knowledge and practice about treatment efficacy through access to the research literature.

Publication practices of English language occupational therapy journals

The aim of this study was to determine the characteristics and publication practices of English language occupational therapy journals. An adapted version of the Survey of Editors Regarding Publishing Practices was posted to the editors of English language occupational therapy journals (n = 14) in September 2001. The response rate was 92.9% (n = 13). Journals were published on average 4.77 times per year and comprised 89% text and 10% advertising. The preferred average length of manuscripts was 20 pages using American Psychological Association format. The average acceptance rate of unsolicited manuscripts was 46.6%. All the journals were peer-reviewed publications and 80% were research oriented. The most frequently cited reasons for rejection of manuscripts were methodology problems, poorly developed idea, poorly written and data interpretation problems. The professional focus of published manuscripts was on research and the clinical foci were on paediatrics, gerontology and physical medicine. The study concludes that there are a variety of publishing opportunities available to occupational therapists. It is essential that prospective authors consult the journal guidelines for authors, including the types of manuscript accepted.

Profile of paediatric occupational therapy practice in Australia

Background: The purpose of the present study was to describe a profile of Australian paediatric occupational therapy practice in terms of theories, assessments and interventions used with the most frequently seen client groups. Methods: An ex post facto survey design was utilised. A purpose-designed survey was mailed to 600 occupational therapists identified by OT Australia as working in paediatrics. Results: The response rate was 55% (n = 330). Respondents in the sample worked chiefly with children with developmental delays, learning disabilities, neurological impairments, and infants/toddlers. Theoretical models used by paediatric clinicians that were common to the most frequently seen client groups focused on sensory integration/multisensory approaches, occupational performance, and client-centred practice. Assessment tools most frequently used were the Test of Visual Motor Integration, Sensory Profile, Bruininks-Oseretsky Test of Motor Proficiency, Handwriting Speed Test, and Motor-Free Visual Perception Test. The most often used treatment methods across the four most frequently seen client groups were parent/caregiver education, sensory integration/stimulation techniques, and managing activities of daily living. Conclusions: Paediatric occupational therapists appeared to draw on a range of theoretical models. With the exception of the Sensory Profile, the assessment and treatment methods most frequently used are not congruent with the most commonly used theoretical models. It is critical that the assessment and treatment methods used are conceptually consistent with the theoretical models that guide practice. Occupational therapists need to examine the evidence and determine whether their clinical practice is grounded in the best contemporary theoretical models, assessments and interventions.