Mothering occupations: A review identifying mothering occupations.

INTRODUCTION: This review aimed to retrieve and collate a list of culturally relevant mothering occupations in the New Zealand context with mothers positioned as experts of their experience. Mothering occupations influence wellbeing and this study aimed to better inform on the daily occupations mothers participate in that contribute to feelings of maternal confidence. METHODS: Two main sources were used to identify mothering occupations: A systematic search of mothering literature, and participant additions. The first step involved mothering literature being searched, collated and condensed. The second step involved presenting the compiled list of mothering occupations to a panel of mothers for review and to invite additions. Mothers were asked to consider the occupations they participate in that evoke feelings of confidence and mastery in their mothering. Fifteen mothers with infants 12 to 18 months old were recruited, eight contributed to the mothering occupations list. RESULTS: A list of 203 items was collated then condensed based on the inclusion criteria for the participant group, and was tracked in a table. The list was reduced to 36 items. Eight participants added to the mothering occupations list, bringing the total number of items to 47. Mothers indicated through their contributions to the list that some types of mothering occupations are more relevant to them when considering feelings of maternal confidence and mastery. The mothers of this study indicated that connecting with their infant, their culture and nature are of high value to them. CONCLUSION: Developing a list of culturally relevant and relatable mothering occupations is a significant undertaking, highlighting the subjective experiences of mothers. Mothering occupations are vast and influenced by context. Mothers valuing some types of occupation more in relation to maternal confidence indicates a role for occupational therapy with this population to support with engagement and participation in occupations that promote wellbeing.

The use of simulation in occupational therapy education: A scoping review.

INTRODUCTION: Simulated learning experiences are a common feature of many health professions' pre-registration curricula. However, the use of simulation within occupational therapy is still largely undefined. This scoping review seeks to identify and summarise the available evidence exploring the use of simulation within occupational therapy pre-registration education. METHODS: A search was conducted in four databases for articles published between 2009 and 2020 to identify international literature relevant to the use of simulation within occupational therapy education. Articles were evaluated using the appropriate Critical Appraisal Skills Programme (CASP) tool and key features and benefits of current simulation education were identified using thematic analysis. RESULTS: A total of 32 papers were included within the review. Four themes were identified and explored: simulation methods, authenticity, global approaches to simulation, and relationship to practice education. CONCLUSION: Simulation is taking place in many different forms within occupational therapy internationally. It is positively received by students and may provide an effective replacement for practice education if focussed on professional standards and competencies. Further research into the potential effectiveness of simulation in relation to practice learning is indicated.

The experiences of mothers of children with autism spectrum disorder: Managing family routines and mothers' health and wellbeing.

BACKGROUND/AIM: Families of children with autism spectrum disorder (ASD) use family routines to provide predictability and structure to support occupational engagement of their family members. Mothers assume the major role to orchestrate occupations in constructing family routines, which may impact their health and wellbeing. However, the experiences of mothers in managing family routines and their health and wellbeing have not been the main focus in previous research. Thus, this study explored the experiences of mothers of children with ASD in managing family routines and their perceptions of the impact of family routines on their health and wellbeing. METHODS: An interpretive phenomenological approach was used. Twenty mothers of children with ASD, aged between 28 and 56 years, participated in semi-structured interviews. Data were transcribed verbatim and each transcript was analysed. RESULTS: Five themes that summarise mothers' perceptions towards health and wellbeing when managing family routines emerged: (i) Keeping on track keeping healthy; (ii) My life is busy, because I do everything for everyone else; (iii) Keeping on track all the time is tiring or frustrating; (iv) Looking after my family by looking after myself; and (v) I am not perfect and it is OK. CONCLUSION: This study highlighted the substantial efforts required in constructing family routines that may be at the cost of mothers' health and wellbeing. However, mothers may be able to cope with everyday demands in managing family routines by changing their perspectives. By integrating 'me-time' activities in family routines, mothers may be able to support their own health and wellbeing. Mothers' values and needs are reflected in family routines; hence, thorough understanding of family routines may be a key to support mothers' occupational engagement.

The impact of a Role Emerging Placement while a student occupational therapist, on subsequent qualified employability, practice and career path.

BACKGROUND: Although Role Emerging Placements (REP) are now a common feature in pre-registration occupational therapy curricula, there is a need to expand the understanding of the impact of this experience on employability, practice and career path of qualified occupational therapists. METHOD: A case finding online survey was used to create a purposive sample for Thematic Analysis of semi-structured interviews with practising occupational therapists from one UK Masters' level pre-registration occupational therapy program. RESULTS: The case finding survey (n = 19) led to recruitment of six participants to be interviewed. The qualitative findings reflected the impact of a REP experience on occupational therapists' employability, practice and career path. The complementary features of the more traditional placement and the role emergent type of placement were considered as being useful and beneficial to qualified practice regardless of setting. However, the REP additionally, had an internal and outward impact. Internally, the therapist gains a passion for occupation-focussed practice and builds confidence to promote both self and the profession. Outwardly, the therapist can offer extra skills in qualified practice, particularly in innovative service development and delivery, thereby offering added value for employability. CONCLUSION: A REP experience as an occupational therapy student, can develop additional skills for qualified professional practice than traditional practice placements alone. The impact of such a placement matches with the 'Generation Y' traits of young adults who are now starting to emerge into training and the work place, translates well into a variety of working environments and lasts into career development. The placement model of occupation-focussed project development and the less apprentice style learning of a REP may be influential, and could be a suitable model within traditional placements.

The first year experience of occupational therapy students at an Australian regional university: Promoting student retention and developing a regional and remote workforce.

OBJECTIVE: Student retention at regional universities is important in addressing regional and remote workforce shortages. Students attending regional universities are more likely to work in regional areas. First year experience at university plays a key role in student retention. This study aimed to explore factors influencing the first year experience of occupational therapy students at a regional Australian university. DESIGN: Surveys were administered to 58 second year occupational therapy students in the first week of second year. Data were analysed using descriptive statistics, inferential statistics (Pearson χ2 ; Spearman rho) and summarising descriptive responses. SETTING: An Australian regional university. PARTICIPANTS: Second year undergraduate occupational therapy students. MAIN OUTCOME MEASURES: Factors influencing students' decisions to study and continue studying occupational therapy; factors enhancing first year experience of university. RESULTS: Fifty-four students completed the survey (93.1%). A quarter (25.9%) of students considered leaving the course during the first year. The primary influence for continuing was the teaching and learning experience. Most valued supports were orientation week (36.7%) and the first year coordinator (36.7%). CONCLUSION: The importance of the first year experience in retaining occupational therapy students is highlighted. Engagement with other students and staff and academic support are important factors in facilitating student retention. It is important to understand the unique factors influencing students' decisions, particularly those from regional and remote areas, to enter and continue in tertiary education to assist in implementing supports and strategies to improve student retention.

Establishing a community of practice for Occupational Therapy curriculum development: the value of a two-way process.

INTRODUCTION: A novel application of the concept of a community of practice was adopted in the development of a revised curriculum for undergraduate occupational therapy education in July 2012. University Academic staff and invited practice scholars met together, half yearly for day long meetings to develop and review a new curriculum. The formation of this community of practice allowed for open discourse and feedback to integrate theory and practice. METHOD: A qualitative study utilised two focus groups, one for academic staff and one for practice scholars, at the end of the third meeting. The focus groups were facilitated by an external researcher, recorded and transcribed verbatim. Thematic analysis elicited five major themes. FINDINGS: Participants reported a sense of community and commitment to the curriculum process. Five themes emerged from the focus groups: (i) a sense of community; (ii) a two-way process with mutual benefits; (iii) benefits to the curriculum and to student learning; (iv) future opportunities including resilience of graduates, and potential research collaborations; and (v) the structure and process of engaging in the community of practice. CONCLUSION: The commitment of time, planning and resources required to establish and participate in collaborative curriculum development with practice scholars is shown to be a valuable investment for occupational therapy academics, expert practice scholars and ultimately for student learning. Further studies of student and graduate outcomes from the curriculum are warranted. Potential future outcomes of this process include resilience in graduates and collaborative research with practice scholars.

Attributes of excellence in practice educators: the perspectives of Australian occupational therapy students.

AIM: Occupational therapists frequently undertake the role of practice educator contributing to the development of the future workforce, however, little is known about how they effectively perform this role. This study aimed to elucidate students' perspectives on what makes an excellent practice educator. METHOD: Documentation for 124 Practice Excellence Commendations nominations by Queensland occupational therapy students for Queensland Occupational Therapy Fieldwork Collaborative awards between 2008 and 2011 were analysed. These were based on students' experiences on long block placements (five weeks or more) in their later years of undergraduate or masters' entry study. Written nominations addressing five selection criteria were de-identified and responses to each of these compiled. One independent coder and the two lead authors read the transcripts, identified coding categories and reached consensus regarding emerging themes using standard content and thematic analysis techniques. RESULTS: Providing the 'just right' challenge was the overarching theme that symbolised excellence in practice education from students' perspectives. Three themes emerged that enabled practice educators to provide student support needed to balance the challenges of learning on placement; (i) valuing a reciprocal relationship; (ii) facilitating learning opportunities and experiences; and (iii) encouraging autonomy and independence. CONCLUSION: Findings provided insights into student perceptions about how excellent practice educators facilitated their learning while on placement. These insights can be used to inform practice educators who wish to enhance their supervision skills. Future research should focus on how the attributes of practice educators positively influence student learning outcomes.

Allied Health Professions Accreditation Standards for Work Integrated Learning: A Document Analysis.

A key role of allied health (AH) professional regulatory and professional bodies is to ensure that AH education programs provide work-integrated learning (WIL) opportunities for students. The requirements are outlined via the respective profession's educational accreditation standards. Although a significant component of the AH professional degrees, researchers have not explored how standards specific to WIL are developed, nor how WIL might be conceptualised through the standards. This study explored how WIL is conceptualised through comparing the WIL education standards across Australian AH professions. Using a non-experimental explanatory mixed-methods research design, a document analysis of Australian education program accreditation standards (and associated documents) for 15 AH professions was undertaken. Data analysis included inductive textual and thematic analyses to compare AH professionals' conceptualisation of WIL. This study found a high degree of variation in how AH professions describe WIL. While there was a common requirement for students to demonstrate competency in WIL, requirements for WIL quantity, assessment and supervision varied. Four key themes were identified regarding the contribution of WIL to curriculum and student learning: (1) the relationship between WIL and the program curriculum; (2) WIL as a learning process; (3) learning from diverse WIL contexts; and (4) developing competence through WIL. Overall, the diversity in the standards reflected differing understandings of what WIL is. Thus, in the absence of frameworks for designing accreditation standards, the risk is that some AH professions will continue to perpetuate the myth that the primary purpose of WIL is to provide a bridge between theory and practice.

An exploration of subjective wellbeing among people experiencing homelessness: a strengths-based approach.

Negative perceptions of homelessness contribute to deficit models of practice, false notions of homogeneity, and marginalization. Wellbeing is a state of satisfaction with material, social, and human aspects of life and can be measured both objectively and subjectively. The study explored the meaning and experience of wellbeing in the everyday lives of 20 homeless participants through fieldwork and interviews. This study revealed that health contributed little to their overall perception of wellbeing. Keeping safe, being positive and feeling good, connecting with others, and the ability to participate in "normal" life were the key contributors of subjective wellbeing. The authors demonstrate that social exclusion experienced in homelessness has a negative effect on subjective wellbeing. Services that provide opportunities to experience social inclusion and develop community and cultural connections will improve the wellbeing of homeless persons.

New graduate occupational therapists feelings of preparedness for practice in Australia and Aotearoa/New Zealand.

AIM: The development of competent future allied health professionals through academic programmes, professional support and practical education is continually evolving. The aim of this study was to explore the feelings of newly graduated occupational therapists in Australia and Aotearoa/New Zealand regarding their education and work preparedness. METHODS: Newly graduated occupational therapists from Australia (n = 178) and Aotearoa/New Zealand (n = 53) who had completed their occupational therapy studies in 2007 were recruited. Participants completed an online survey which explored their preparedness for work; based on professional competencies. RESULTS: Most newly graduated occupational therapists felt somewhat prepared for practice. However, only 17.1% of Australian new graduates, and even fewer (8.5%) of Aotearoa/New Zealand new graduates felt very well prepared. Participants felt more prepared for the competencies required for 'managing inwards' (including interpersonal skills) and less prepared for those required for 'managing outwards' (including evidence-based practice). CONCLUSIONS: This study provides the first international comparison into the feelings of competence and preparedness for practice of new graduates of occupational therapy from Australia and Aotearoa/New Zealand. Given the importance of competencies, such as evidence-based practice to the progress of the profession, there is a need to further explore methods to increase feelings of preparedness in these areas.

In-the-moment experiences of mothers of children with autism spectrum disorder: a comparison by household status and region of residence.

PURPOSE: This study compared the in-the-moment experiences among mothers of children with Autism Spectrum Disorders (ASD) by their household status (i.e., single versus coupled) and region of residence (i.e., regional versus major city area). METHODS: An experience sampling method was employed to collect data, and a total of 40 mothers used an iOS device to record activity types and in-the-moment experiences for one week during school term. Mann-Whitney U test and multilevel analysis were conducted to compare the experiences of these mothers. RESULTS: The analyses found the following results: 1) mothers spent most time in childcare and least time in self-care activities; 2) coupled mothers were more likely to feel supported; 3) coupled mothers were less likely to feel supported in domestic tasks; 4) mothers from major city were more likely to feel challenged in self-care activities; and 5) mothers from major city were more likely to feel supported in productivity tasks. CONCLUSION: Limited but significant differences between single and coupled mothers, as well as mothers from regional and major city areas, were found. Future research direction and service provisions were suggested.Implications for rehabilitationThis study shows that all mothers spent the most time on childcare and the least amount of time on self-care activities.In-the-moment experiences between single and coupled mothers, as well as mothers from major cities and mothers from regional areas, differ somewhat; however, this study builds evidence to support that these mothers' experiences are similar.The result of the study indicates that single mothers require extra support as they carry similar levels of responsibilities as coupled mothers, but without the support of a partner.Promoting a sense of control may assist all mothers to fully engage in parenting activities.

Drinking sucrose enhances quinpirole-induced yawning in rats.

Food and drugs can activate brain dopamine systems and sensitivity to the effects of drugs acting on those systems is influenced by amount and content of food consumed. This study examined the effects of drinking sucrose on behavioral effects of the direct-acting dopamine receptor agonist quinpirole. Male Sprague-Dawley rats (n=6/group) had free access to water or 10% sucrose and quinpirole dose-response curves (yawning and hypothermia) were generated weekly for 8 weeks. Subsequently, all rats drank water for 8 weeks with quinpirole dose-response curves determined on weeks 9, 10, and 16. In rats drinking sucrose, the ascending (D3 receptor-mediated), but not descending (D2 receptor-mediated), limb of the yawning dose-response curve shifted leftward. The D3 receptor-selective antagonist PG01037 shifted the ascending limb of the dose-response curve to the right in all rats. When rats that previously drank sucrose drank water, their sensitivity to quinpirole did not return to normal. Quinpirole-induced hypothermia was not different between groups. These data show that drinking sucrose increases sensitivity to a dopamine D3, but not D2, receptor-mediated effect and that this change is long lasting. Dopamine receptors mediate the effects of many drugs and the actions of those drugs are likely impacted by dietary factors.

Reflecting on our effectiveness: Occupational therapy interventions with Indigenous clients.

BACKGROUND: The health and social inequity experienced by the Indigenous population of Australia has resulted in the establishment of a national priority to close the gap in health outcomes. The occupational therapy profession is being urged to ensure the cultural appropriateness of practice interventions for Indigenous people. Although the importance of practice modification has been recognised by the occupational therapy profession, minimal research has been conducted in relation to older Aboriginal and Torres Strait Islander populations. METHOD: The aim of this study was to explore occupational therapists' views of their effectiveness when practising with Indigenous clients. The qualitative study utilises in-depth interviews with occupational therapists working in a regional centre of North Queensland to explore their views of effectiveness when modifying interventions for Indigenous clients. RESULTS: Inductive thematic analysis of the descriptive data generated four themes. The first theme provides insights into participants' views of effectiveness when providing interventions to Indigenous clients. The remaining themes identify specific modification as (i) awareness of culture and respect for the individual, (ii) developing different expectations and (iii) ensuring equality of outcomes. CONCLUSION: The study supports the importance of modifying practice to provide culturally safe occupational therapy to Indigenous clients. The importance of adopting a client-centred approach in modifying interventions is also highlighted. Self-reflection by the therapist regarding their occupational therapy practice with Indigenous clients is strongly suggested. In response, a self-reflection tool has been developed from the findings of the study.

Occupational therapy at the 'cultural interface': Lessons from research with Aboriginal and Torres Strait Islander Australians.

BACKGROUND: In 2008, the Council of Australian Governments announced its goals to improve Indigenous life expectancy, health, education and employment: 'Closing the Gap' (Commonwealth of Australia, 2008). Internationally, occupational therapists seek to promote social justice and human rights through occupation. Despite this effort, Australian occupational therapists have largely remained silent in response to the national agenda of closing the gap in Indigenous health. METHODS: This article identifies the challenges of research and practice at the 'cultural interface', the juncture where Western knowledge meets the Indigenous knowledge of our clients. The article draws on the first author's research experience with Indigenous peoples. Through a process of reflection on the challenges highlighted by research at the cultural interface, this article identifies a range of professional processes used to negotiate differing and conflicting perspectives. RESULTS: By comparing the research context with occupational therapy practice, the author identifies some of the actions and supports that can be used by occupational therapists to provide culturally appropriate and negotiated interventions with Indigenous people. CONCLUSIONS: Although a number of individual occupational therapists work with Indigenous communities and individuals to improve the services offered, it is suggested that the occupational therapy profession needs to work together towards closing the gap. The development of special interest groups, professional networks and a National Position Statement on Indigenous Health would provide the background to developing guidelines for practice with Indigenous clients.

Homeless adults engagement in art: first steps towards identity, recovery and social inclusion.

BACKGROUND: The Australian policy on homelessness identifies participation in structured activities as the first step towards social inclusion and increasing the likelihood of permanently leaving a homeless lifestyle. Art interventions increase interpersonal function and social participation and provide a means of expression and transformation with people who are homeless. AIM: This study explores the value of an art programme provided by a non-government agency for homeless adults. METHOD: Qualitative methods including participant observation and purposive interviews were analysed inductively and thematically to gain an understanding of the participants' experience of art and its value. Interviews with stakeholders provided additional information and triangulation of the data. RESULTS: The study demonstrates that art occupations provide a starting point for participation in community and a positive experience that encourages the construction of new identities, routines and roles. Furthermore, art provides an alternative from the problems associated with homelessness, mental health and substance abuse and allows for public recognition and social inclusion. CONCLUSIONS: Health professionals should work towards the social inclusion of homeless people through providing occupational opportunities for participation in safe settings as a first step to community engagement.

Closing the gap: Supporting occupational therapists to partner effectively with First Australians.

BACKGROUND/AIM: Occupational therapists need to be able to work competently with all clients, including First Australians. Currently, there are no national standards for occupational therapists working with First Australian clients. This article presents current issues in practice and education with First Australians and makes recommendations for the future. METHODS: A survey of 41 occupational therapists working with, or interested in First Australian health issues was conducted at a workshop held at the Australian National Occupational Therapy Conference in 2008. Results of the workshop group discussions were also collated. RESULTS: Several themes emerged from both survey data and discussions. A substantial proportion of participants rated their confidence and competence to work with First Australians as low to moderate. Higher levels of perceived confidence and competence were associated with current experience in the field. Discussions centred around six major themes: building relationships, service provision and design, education and training of occupational therapists, increasing First Australian representation within occupational therapy, professional issues and political issues. These themes were further collapsed into areas of action, which could be taken by individuals, managers, researchers and professional bodies to improve practice with First Australians. CONCLUSIONS: Occupational therapists will benefit from coordinated efforts, on individual and systemic levels, to work more effectively, and in partnership with, First Australians. Such developments should include guidelines for practice, education and research; professional development and networking opportunities; and improved collaboration, especially with First Australian partners, on a national level.

Increasing the occupational therapy mental health workforce through innovative practice education: a pilot project.

AIM: This paper describes the evaluation of a pilot trial of two innovative placement models in the area of mental health, namely role emerging and collaborative supervision. The Queensland Occupational Therapy Fieldwork Collaborative conducted this trial in response to workforce shortages in mental health. METHOD: Six occupational therapy students and eight practice educators were surveyed pre- and post-placements regarding implementation of these innovative models. RESULTS: Students participating in these placements reported that they were highly likely to work in mental health upon graduation, and practice educators were positive about undertaking innovative placements in future. An overview of the placement sites, trials, outcomes and limitations of this pilot trial is provided. CONCLUSION: Though limited by its small sample size, this pilot trial has demonstrated the potential of innovative placement models to provide valuable student learning experiences in mental health. The profession needs to develop expertise in the use of innovative placement models if students are to be adequately prepared to work with the mental health issues of the Australian community now and in the future.

Comparing and measuring the practice-based performance and competence of occupational therapy students between traditional and role emerging placements: a retrospective cohort study / Comparação entre o desempenho e competência de estudantes de terapia ocupacional em estágios tradicionais e não-tradicionais: um estudo retrospectivo

Abstract Introduction Increasingly occupational therapy programmes have complemented traditional practice placements with Role Emerging Placements (REPs) in settings with no existing occupational therapy provision. Previous research has predominantly explored the student experience of such placements with largely favorable findings. However, there is a lack of understanding regarding the professional practice-based skills students develop within REPs. Objective To measure and compare students' competencies for occupational therapy practice developed within Role Emerging Placements (REP) to those in 'traditional' practice placements. Method A retrospective cohort study design was used to analyze data extracted from the Competency Based Fieldwork Evaluation for Occupational Therapists (CBFE-OT) of MSc pre-registration occupational therapy UK students (n=181). Descriptive and inferential statistical analysis measured and compared student fieldwork competency scores between four placements, one of which was a Role Emerging Placement (REP). Results Students scored significantly higher in 'Communication' and 'Professional Interactions' compared to all other practice competencies but scored significantly less well in 'Clinical Reasoning' and 'Practice Knowledge' regardless of placement model. However, in a REP, students scored significantly higher in 'Performance Management' compared to traditional placements (z=-2.222 p=0.026). Conclusion Students can develop similar skills of competence to practise in a REP as traditional placements and may better develop leadership and time management skills. These additional skills may advantage students in developing their careers and scoping the profession.

Resumo Introdução Os cursos de graduação em terapia ocupacional têm crescentemente complementado os campos de prática tradicional dos estágios com modelos alternativos, nos quais não existem serviços de terapia ocupacional. Pesquisas anteriores exploraram predominantemente a experiência do aluno em tais estágios, com resultados amplamente favoráveis. No entanto, há uma lacuna de conhecimento sobre as habilidades profissionais que tais alunos desenvolvem a partir deste modelo alternativo de estágio. Objetivo Medir e comparar as competências dos alunos para a prática de terapia ocupacional, desenvolvida em modelos de estágios alternativos onde não existem serviços de terapia ocupacional, com os estágios tradicionais. Método Trata-se de um estudo retrospectivo no qual se analisou dados extraídos da avaliação "Competency Based Fieldwork Evaluation for Occupational Therapists (CBFE-OT)", utilizada para avaliar o desempenho de 181 alunos de terapia ocupacional de um curso de mestrado em uma universidade pública do Reino Unido. A análise estatística descritiva e inferencial mediu e comparou as pontuações de competência dos alunos em quatro estágios, em que um era o modelo alternativo, onde não havia oferta de serviços de terapia ocupacional. Resultados Os alunos obtiveram pontuações significativamente mais altas em 'Comunicação' e 'Interações profissionais', em comparação com todas as outras competências práticas, mas pontuaram significativamente menor em 'Raciocínio clínico' e 'Conhecimento prático', independentemente do modelo de estágio. No entanto, nos modelos de estágios alternativos, os alunos obtiveram pontuações significativamente mais altas em 'Gestão de desempenho' em comparação com os campos de estágio tradicionais (z = -2,222 p = 0,026). Conclusão Os alunos podem desenvolver habilidades de competência semelhantes para a prática a partir de modelos alternativos de estágio quando comparados com os estágios tradicionais, com melhor desenvolvimento nas habilidades de liderança e gerenciamento de tempo, favorável ao estágio alternativo. Essas habilidades adicionais podem beneficiar os alunos no desenvolvimento de suas carreiras e no escopo da profissão.