Item validity of the physical demands from the Dictionary of Occupational Titles for the functional capacity evaluation of clients with chronic back pain

This study assessed the item validity of 15 of the physical demands from the Dictionary of Occupational Titles (DOT), as evaluated in a new approach to functional capacity evaluation (FCE) for clients with chronic back pain, the Gibson Approach to FCE (GAPP FCE). Fifty-two occupational therapists were sent the specifications of the items in the GAPP FCE procedures and were asked to rate the items in terms of item-objective congruence, relevance and difficulty. A response rate of 59.2% was obtained. The majority of the therapists agreed that most of the items were congruent with the objectives based on the definition of the physical demands from the DOT. The items evaluating Balancing and Pushing and Pulling had the lowest item-objective congruence. The evaluation of Balancing and the Lifting, Carrying and Pushing and Pulling of loads greater than light-medium weight (10–16 kg) were not considered significantly relevant. Concerns were raised about the difficulty and safety of the evaluation of Lifting, Carrying and Pushing and Pulling with clients with chronic back pain, particularly if the therapist evaluates the manual handling of medium to heavy loads. These results may have implications for other FCEs, particularly those which are based on the DOT, or when assessing clients with chronic back pain.

A visiting occupational therapy service to indigenous children in school: Results of a pilot project

The need for additional support for Indigenous children at school is well documented. Occupational therapists are well positioned to form part of this support. However, many occupational therapists report that Indigenous families do not access their services and when they do, the occupational therapist feels uncertain about how best to meet their needs. This article documents a pilot project which delivered occupational therapy services within several schools and preschools in Brisbane which had significant numbers of Indigenous students. The project was evaluated using a qualitative methodology and included focus groups and interviews with teachers and parents. The results indicated that in general the service provided valuable support to students, teachers and parents. In particular, providing the service within the school context was seen as critical to its success. Suggestions for improvements in future support services are also provided.

A framework for systematically improving occupational therapy expert opinions on work capacity

Aim: To present an evidence-based framework to improve the quality of occupational therapy expert opinions on work capacity for litigation, compensation and insurance purposes. Methods: Grounded theory methodology was used to collect and analyse data from a sample of 31 participants, comprising 19 occupational therapists, 6 medical specialists and 6 lawyers. A focused semistructured interview was completed with each participant. In addition, 20 participants verified the key findings. Results: The framework is contextualised within a medicolegal system requiring increasing expertise. The framework consists of (i) broad professional development strategies and principles, and (ii) specific strategies and principles for improving opinions through reporting and assessment practices. Conclusions: The synthesis of the participants' recommendations provides systematic guidelines for improving occupational therapy expert opinion on work capacity.

The role of occupational therapy for individuals living with sickle cell disease

The purpose of the research study was to determine the role occupational therapy plays in the management of sickle cell disease (SCD). A descriptive survey was administered to 39 persons living with or caring for persons living with SCD. This survey was administered at two sickle cell foundations and one hospital. ^ The research study determined that none of the 10.3% of the sample who had rehabilitative therapy received occupational therapy. Furthermore, at least 50% of persons surveyed agreed that SCD affected their activities of daily living; at least 38.5% agreed that work and productive activities were hampered; and at least 18% agreed that play/leisure activities were affected. No one within the sample received gene therapy. ^ It was concluded that occupational therapy is relevant for persons who are disabled by SCD. It is recommended that occupational therapists realize the importance of treating patients with SCD from a more holistic perspective. ^

Historical perspectives of occupational therapy and mental health

Occupational therapy emerged as a health profession in Australia at a time when thousands of people with mental illness lived behind high walls, devoid of normal routines and activities. Detailed analysis of texts of practice, images and stories are used in this study to illustrate the dynamic link between practice environments and the knowledge of occupational therapy that aimed to confront the problems of institutional living. Occupational therapists implemented craft-based practice within psychiatric institutions of the 1940s and 1950s. Through two decades, occupational therapists aligned their practice with medical paradigms before returning to occupation as a core of practice knowledge. Following closure of institutions during the 1990s, occupational therapists were challenged by relocation to community-based, multidisciplinary environments. Occupation again emerged as the central concept of community living. The study concludes that occupational therapy has a quiet, yet consistent role within the changing environment of mental health practice. Gender, social views and practice environments are significant influences on the evolution of occupation as a core of practice.

Is length of experience an appropriate criterion to identify level of expertise?

Clinical experience plays an important role in the development of expertise, particularly when coupled with reflection on practice. There is debate, however, regarding the amount of clinical experience that is required to become an expert. Various lengths of practice have been suggested as suitable for determining expertise, ranging from five years to 15 years. This study aimed to investigate the association between length of experience and therapists’ level of expertise in the field of cerebral palsy with upper limb hypertonicity using an empirical procedure named Cochrane–Weiss–Shanteau (CWS). The methodology involved re-analysis of quantitative data collected in two previous studies. In Study 1, 18 experienced occupational therapists made hypothetical clinical decisions related to 110 case vignettes, while in Study 2, 29 therapists considered 60 case vignettes drawn randomly from those used in Study 1. A CWS index was calculated for each participant's case decisions. Then, in each study, Spearman's rho was calculated to identify the correlations between the duration of experience and level of expertise. There was no significant association between these two variables in both studies. These analyses corroborated previous findings of no association between length of experience and judgemental performance. Therefore, length of experience may not be an appropriate criterion for determining level of expertise in relation to cerebral palsy practice.

Transitioning to practice across the professions : some lessons from the teaching profession

Across the professions, there is strong interest in the transition between graduation and early stages of professional practice. Our initial literature search revealed that this period of transition is significant to professions that include nursing, vets, midwives, financial planners, lawyers, occupational therapists, doctors as well as our particular area of interest - teachers. This importance is easy to understand for in these applied fields new graduates need to be competent in applying and synthesizing their theoretical content knowledge on a daily basis, often with limited supervision and mentoring (Goetz, Tombs & Hampton, 2005). As such, this transition period is of critical importance to the individual and their feelings of competence and early profession learning. An added layer for graduates in these professions during this transition/probation period is that they are also expected to have well-developed 'soft skills' such as communication, problem solving, and teamwork (Oblinger & Verville, 1998; Rao & Sylvester, 2000) in order to be effective in their roles.

The association between leisure motivation and recovery: A pilot study

Background and aims: Recovery from mental illness may be facilitated by participation in activities that provide meaning and purpose in the lives of consumers. Leisure participation can be a major source of enjoyment as well as mental and physical well-being. Methods and results: This study examined the association between consumers’ motivation to engage in leisure and their self-reported perception of recovery in a sample of 44 Clubhouse members. The Leisure Motivation Scale and the Recovery Assessment Scale were used to measure the association between leisure motivation and recovery. The results indicated a statistically significant association between leisure motivation and recovery. Conclusion: These findings have implications for service delivery within mental health settings, as occupational therapists may be able to design leisure-based programs more effectively if they can understand the needs and motives for participation. More emphasis should be placed on supporting consumers to re-integrate and be socially included within the community through leisure-based initiatives.

A Sexual Health Programme Implemented in a Psychiatric Inpatient Unit

Research has shown that people with a mental illness are an at-risk group for sexually transmitted infections. A programme for preventing risk behaviours for sexually transmitted infections among people with psychiatric disorder was designed and implemented by mental health occupational therapists. This programme used an interactive didactic approach to provide education and awareness of sexual health issues to acute psychiatric inpatients. Twenty-four participants completed a sexual health questionnaire, which was designed for this study, both before and after attending the programme. They had a higher than expected knowledge of sexually transmitted infections and safe sex practices at pre-test. The education programme resulted in a statistically significant but modest increase in sexual health knowledge. These findings indicate that there are benefits in providing sexual health education to clients with a mental illness. Further programme development should be directed towards sexual health decision-making and behaviour change.

The Large Allen Cognitive Level Screen as an indicator for medication adherence among adults accessing community mental health services

Background: Medication remains the cornerstone treatment for mental illness. Cognition is one of the strongest predictors of non-adherence. The aim of this preliminary investigation was to examine the association between the Large Allen Cognitive Level Screen (LACLS) and medication adherence among a small sample of mental health service users to determine whether the LACLS has potential as a screening tool for capacity to manage medication regimens. Method: Demographic and clinical information was collected from a small sample of people who had recently accessed community mental health services. Participants then completed the LACLS and the Medication Adherence Rating Scale (MARS) at a single time point. The strength of association between the LACLS and MARS was examined using Spearman rank-order correlation. Results: A strong positive correlation between the LACLS and medication adherence (r = 0.71, p = 0.01) was evident. No participants reported the use of medication aids despite evidence of impaired cognitive functioning. Conclusion: This investigation has provided the first empirical evidence indicating that the LACLS may have utility as a screening instrument for capacity to manage medication adherence among this population. While promising, this finding should be interpreted with caveats given its preliminary nature.

Attracting and retaining specialist teachers and non-teaching professionals in Queensland secondary schools : a report to the Queensland Department of Education and Training

This report provides the Queensland Department of Education and Training (DET) with independent evidence based data to enable the identification of barriers and enablers to effective attraction and retention of suitably qualified people to specialist teaching and non‐teaching roles in Queensland secondary schools. The scope of this report is to consider the strategic imperatives, trends, and drivers as they apply to the recruitment and retention of specialised teachers and non‐teaching professionals. The research was specifically designed to inform DET on innovative and novel strategies to recruit and retain staff within Education Queensland in areas specifically identified as at risk of experiencing shortages in the near future. Those areas considered to be at risk of experiencing shortages included: • Teaching principals • Specialist teachers in mathematics, science, industrial technology and design, and special education • Non‐teaching professional roles, such as speech pathologists, occupational therapists, physiotherapists and registered nurses providing services in schools to students with special needs.

A contribuição da Metodologia de Projeto em Design no processo de desenvolvimento de recursos de Tecnologia Assistiva

O presente trabalho apresenta o processo utilizado por terapeutas ocupacionais no desenvolvimento de objetos de Tecnologia Assistiva. São apresentadas definições e teorias relacionadas ao desenvolvimento de produtos de Tecnologia Assistiva a qual trata de um grupo de produtos desenvolvidos para pessoas com deficiência. São apresentados: o design de produtos voltados para inclusão, modelos de ações voltados às pessoas com deficiência, princípios para o desenvolvimento de produtos para pessoas com deficiência, o mercado brasileiro e o perfil do público-alvo, e os métodos e técnicas de desenvolvimento de Tecnologia Assistiva. Sendo o terapeuta ocupacional um profissional que no processo de reabilitação desenvolve produtos de Tecnologia Assistiva, explicita-se o seu papel no desenvolvimento desses produtos. Tendo o Ergodesign como base metodológica para o desenvolvimento de produtos de Tecnologia Assistiva, apresentam-se questões pertinentes à essa teoria dentro da ergonomia e do design. Expõem-se os resultados da pesquisa de campo realizada com terapeutas ocupacionais que produzem produtos de Tecnologia Assistiva, com terapeutas ocupacionais que encaminham para outro profissional realizar a produção, com professores de disciplinas de Tecnologia Assistiva dos cursos de Terapia Ocupacional da cidade do Rio de Janeiro e com usuários desses produtos. A partir da pesquisa bibliográfica e dos resultados obtidos na pesquisa de campo, este trabalho tem como objetivo principal contribuir, através de uma proposta metodológica, para a formação do terapeuta ocupacional no processo de desenvolvimento de objetos para pessoas com deficiência