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1.
Aust Occup Ther J ; 69(6): 676-688, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35871761

RESUMO

INTRODUCTION: Consumer and community involvement (CCI) encompasses the range of consumer engagement activities across the research cycle. Research advisory groups (RAGs) are a common method of CCI that may empower the consumer voice in research. However, there is limited evaluation of RAGs to guide occupational therapists considering this as a CCI strategy in research. The aim of this study was to explore the processes and outcomes of a RAG partnership for an eDelphi study. METHODS: Rapid ethnography enabled a rich, thick description of the RAG through triangulation of field notes, a monthly research team log, focus groups, and an individual interview. Data were analysed using reflexive thematic analysis. Recruitment targeted consumers, health service staff, and academics with experience in CCI to enhance the diversity of perspectives guiding the eDelphi study. The RAG met four times over 4 months. FINDINGS: Seven diverse RAG members were recruited resulting in a RAG of 12 members, including the research team that included two consumers. Reflexive thematic analysis resulted in an overarching theme: Different in so many ways, which reinforced that authentic CCI in research continues to be rare even for stakeholders with experience in CCI. There were four subthemes: Set up for success, Authentic and capable facilitation, Structures and strategies for genuine partnerships, and A ripple effect of benefits. Findings added to the limited research regarding RAGs and highlighted that a short-term RAG with 12 diverse stakeholders was an effective strategy to foster mutually beneficial and meaningful collaboration. Partnering with two consumer co-researchers in RAG planning, implementation, and evaluation was central to success. CONCLUSION: Findings demonstrated that with careful co-planning and recruitment, capable facilitation with support of a committed research team (inclusive of consumers), and empowering meeting processes and structures, a short-term RAG resulted in many benefits to participants and enhanced research outcomes.


Assuntos
Terapia Ocupacional , Humanos , Participação da Comunidade , Serviços de Saúde , Antropologia Cultural
2.
Aust Occup Ther J ; 69(5): 625-636, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35715976

RESUMO

INTRODUCTION: Australia's population is ageing, resulting in more older adults living in residential aged care facilities. Occupational therapy scope of practice in Australian residential aged care facilities is significantly influenced by the government funding instrument. As the current government funding instrument is administratively inefficient, insufficiently discriminates between residents' care needs and provides perverse incentives, a new funding model is set to be implemented. This creates an opportunity for a review of the current evidence base to support the lobbying of national associations to shape occupational therapy practice. The research question that guided this systematic mapping review was as follows: What is the current state of scholarship about occupational therapy in Australian residential aged care facilities? METHODS: A search of four databases (CINAHL, Medline, Embase and Scopus) was conducted and 1,617 papers were identified. All papers were screened through a two-phase process: (i) title and abstract review and (ii) full text review, using pre-determined inclusion and exclusion criteria to identify papers relevant to this review. A data extraction tool was designed in Microsoft Excel® and was used to extract data from the included papers. RESULTS: Twelve Australian articles were published between 1986 and 2020, most frequently authored by an occupational therapist. Included articles were classified into four groups: articles including occupational therapists as participants, articles about occupational therapy practice, articles exploring an occupational perspective of residents and articles with limited exploration of occupational therapy. CONCLUSION: This review identified that there is a dearth of Australian occupational therapy literature. This creates challenges for occupational therapists seeking evidence to guide their practice to optimise resident health and well-being and for national associations seeking to lobby for the profession. Consequently, there is a crucial need to develop the evidence base to support the profession within this practice setting and, ultimately, residents.


Assuntos
Terapia Ocupacional , Idoso , Envelhecimento , Austrália , Atenção à Saúde , Humanos
3.
Aust Occup Ther J ; 69(4): 447-455, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35439846

RESUMO

INTRODUCTION: Australian occupational therapy practice in residential aged care facilities has been largely funded using the Aged Care Funding Instrument since March 2008. Literature indicates that the funding model constrains occupational therapy practice, impacting on therapists' and residents' experiences. In preparation for the implementation of the new funding model, the Australian National Aged Care Classification, it is timely to understand current practice. Therefore, the aim of this study was to explore occupational therapy practice in residential aged care facilities under the Aged Care Funding Instrument. The objectives were (1) to understand occupational therapists' experiences of working in residential aged care facilities under the Aged Care Funding Instrument; and (2) to explore occupational therapists' perceptions of how the Aged Care Funding Instrument influences residents' occupational performance and engagement. METHODS: A phenomenological research design was employed to understand therapists' perspectives. Data were collected from seven occupational therapists using a demographic form and a semi-structured interview. Data were analysed using a modified Colaizzi's descriptive phenomenological data analysis. Ethics approval was obtained. FINDINGS: Two themes emerged from the study's findings: a restrictive practice context that disables residents; and a restrictive practice context that inhibits occupational therapists. The first theme describes how the Aged Care Funding Instrument constrains practice and incentivises the disabling of residents. The second theme describes the challenges faced by occupational therapists throughout their journey of employment under the funding model. CONCLUSION: Occupational therapists perceived that the Aged Care Funding Instrument restricts occupational therapy practice and prevents residents from living occupationally rich lives. With the introduction of the Australian National Aged Care Classification in late 2022, it is crucial that national associations and employers advocate to policymakers to ensure future practice reflects the profession's unique knowledge and skills to optimise the health and wellbeing of residents.


Assuntos
Terapia Ocupacional , Idoso , Pessoal Técnico de Saúde , Austrália , Humanos , Terapeutas Ocupacionais , Pesquisa Qualitativa
4.
Health Expect ; 25(4): 1563-1579, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35472122

RESUMO

BACKGROUND: The capability of consumers and staff may be critical for authentic and effective partnerships in healthcare quality improvement (QI). Capability frameworks describe core knowledge, skills, values, attitudes, and behaviours and guide learning and development at individual and organizational levels. OBJECTIVE: To refine a capability framework for successful partnerships in healthcare QI which was coproduced from a scoping review. DESIGN: A two-round eDelphi design was used. The International Expert Panel rated the importance of framework items in supporting successful QI partnerships, and suggested improvements. They also rated implementation options and commented on the influence of context. PARTICIPANTS: Seven Research Advisory Group members were recruited to support the research team. The eDelphi panel included 53 people, with 44 (83%) and 42 (77. 8%) participating in rounds 1 and 2, respectively. They were from eight countries and had diverse backgrounds. RESULTS: The Research Advisory Group and panel endorsed the framework and summary diagram as valuable resources to support the growth of authentic and meaningful partnerships in QI across healthcare contexts, conditions, and countries. A consensus was established on content and structure. Substantial rewording included a stronger emphasis on growth, trust, respect, inclusivity, diversity, and challenging the status quo. The final capability development framework included three domains: Personal Attributes, Relationships and Communication, and Principles and Practices. The Equalizing Decision Making, Power, and Leadership capability was foundational and positioned across all domains. Ten capabilities with twenty-seven capability descriptions were also included. The Principles and Practices domain, Equalizing Decision Making, Power, and Leadership capability, and almost half (44.4%) of the capability descriptions were rated as more important for staff than consumers (p < .01). However, only the QI processes and practices capability description did not meet the inclusion threshold for consumers. Thus, the framework was applicable to staff and consumers. CONCLUSION: The refined capability development framework provides direction for planning and provision of learning and development regarding QI partnerships. PATIENT OR PUBLIC CONTRIBUTION: Two consumers were full members of the research team and are coauthors. A Research Advisory Group, inclusive of consumers, guided study execution and translation planning. More than half of the panel were consumers.


Assuntos
Atenção à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Melhoria de Qualidade , Atitude do Pessoal de Saúde , Participação da Comunidade , Comportamento Cooperativo , Atenção à Saúde/organização & administração , Atenção à Saúde/normas , Instalações de Saúde , Humanos , Liderança , Melhoria de Qualidade/organização & administração , Melhoria de Qualidade/normas , Qualidade da Assistência à Saúde/organização & administração , Qualidade da Assistência à Saúde/normas
5.
Plast Reconstr Surg ; 149(4): 913-917, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35157618

RESUMO

BACKGROUND: Collagenase injection is a relatively new, minimally invasive treatment option for Dupuytren disease. Most literature focusses on quantitative outcome measures, such as degree of residual contracture and recurrence. The patient experience of the treatment has rarely been explored. This study sought to explore patients' experiences of the treatment process, including their reasons for seeking and choosing the treatment. METHODS: A qualitative descriptive design was used to explore patients' experiences. Seven patients (aged 57 to 81 years) who had received collagenase treatment for Dupuytren disease engaged in individual, semistructured interviews. Interviews were audio recorded, transcribed verbatim, and analyzed thematically. RESULTS: Thematic analysis revealed that Dupuytren disease was an obstacle to doing things, but not a barrier. Patients "went with the flow" of treatment, often taking a passive approach to their health care decisions. Patients found the collagenase injections to be extremely painful, but worth it. They had a varied knowledge of the disease and treatment. CONCLUSIONS: Patients were pleased with the results of the collagenase treatment, even if the finger was not completely straight or there was recurrence. The quick recovery and minimal complications were positive factors; however, the injections were extremely painful and could deter patients from future treatment. This research highlighted that a number of patients had low health literacy regarding their condition, and this affected their expectations of treatment outcomes and future treatment seeking. There are opportunities for health professionals to improve health literacy for people with Dupuytren disease, possibly in a group setting.


Assuntos
Contratura de Dupuytren , Idoso , Idoso de 80 Anos ou mais , Colagenases/uso terapêutico , Contratura de Dupuytren/tratamento farmacológico , Contratura de Dupuytren/cirurgia , Seguimentos , Humanos , Injeções Intralesionais , Colagenase Microbiana/uso terapêutico , Pessoa de Meia-Idade , Resultado do Tratamento
6.
Brain Inj ; 36(2): 239-250, 2022 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-35125057

RESUMO

BACKGROUND: Return to independent driving is an important goal following acquired brain injury which may be explored through driving rehabilitation. Whilst on-road driving remediation often form the basis for rehabilitation, the efficacy of such intervention is uncertain. AIMS: To describe current evidence regarding the use of on-road driving remediation to facilitate return to independent driving following acquired brain injury and define gaps in research. METHODS: CINAHL, Embase, MEDLINE (OVID), PsycInfo and Scopus were the primary information sources searched 8th and 29th January 2020 using the Joanna Briggs Institute protocol for scoping review. RESULTS: Searching identified 904 studies, after 442 duplicates were eliminated, 462 studies screened. Title and abstract screening revealed 447 irrelevant studies with 13 full-text studies assessed for eligibility. Six studies [cohort studies (n=4) and case report (n=2)] were selected for data extraction. c. CONCLUSIONS: Emerging evidence indicates a level of support for the use of on-road driving remediation as a rehabilitation tool following acquired brain injury. Further research is required to define which goals are suited to on-road remediation as a return to driving intervention and explore the capacity of participants to sustain any gains made through on-road driving remediation at follow-up.


Assuntos
Condução de Veículo , Lesões Encefálicas , Lesões Encefálicas/reabilitação , Estudos de Coortes , Humanos
7.
Scand J Occup Ther ; 29(5): 353-362, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34455894

RESUMO

BACKGROUND: Describing how occupation is used in practice can be challenging for occupational therapists. Occupation-centred, occupation-based, and occupation-focussed terminology are frequently used interchangeably and ambiguously to describe practice. However, ambiguous language creates confusion and inadequately demonstrates the value of occupation. AIMS/OBJECTIVES: This scoping review aimed to identify how occupation-centred, occupation-based, and occupation-focussed terminology are defined and represented in occupational therapy literature. MATERIALS AND METHODS: A five-step scoping review included papers published between 2014 and 2019 from four databases. Extracted data were summarised to outline how the terms were being used within the literature. RESULTS: Initial searching yielded 819 articles and 35 papers met inclusion/exclusion criteria. Within current literature, occupation-focussed and occupation-based terminology were inconsistently described. A limited number of articles used occupation-centred and occupation-focussed terminology to describe practice, whilst occupation-based was more prominent. Occupation-based terminology was represented in numerous ways to describe assessments, practice tools, interventions, research, and theory. Discrepancies between the description and implementation of occupation-based practice were most prominent within interventions. CONCLUSION AND SIGNIFICANCE: Findings demonstrated that occupation-based and occupation-focussed terminology were used interchangeably and inconsistently in literature. It is timely to consider how this is problematic for our professional identity and perceptions of occupation in practice.


Assuntos
Terapeutas Ocupacionais , Terapia Ocupacional , Humanos , Ocupações , Identificação Social
8.
Scand J Occup Ther ; 29(3): 175-197, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34617493

RESUMO

INTRODUCTION: A strong professional identity helps occupational therapists maintain professional values and thrive when facing work-related challenges and opportunities including generic, blurred or emerging roles, funding pressures and a push for outcome evidence. A scoping review will build understanding of professional identity and how to maintain it in such circumstances. OBJECTIVES: To scope what is currently understood of professional identity in occupational therapy and factors which influence ability to maintain this and adapt in challenging work environments. METHODS: Using Arksey and O'Malley's scoping review framework three databases were searched using the terms 'occupational therap*' and 'professional identity'. Data extraction and thematic analysis highlighted the extent and nature of current literature and mapped key concepts. RESULTS: 89 papers were included. Professional identity was revealed as a multidimensional construction. Four themes emerged: developing a shared ontology, embracing the culture, enacting occupational therapy, and believing in occupational therapy. Factors which influenced development and maintenance of professional identity included occupation-centred practice, ontological reflexivity, linking theory to practice and professional socialization. CONCLUSIONS AND SIGNIFICANCE: The enhanced understanding of professional identity and factors which preserve or enhance it can help the profession identify how to position itself to remain resilient and adaptive in an ever-changing environment.


Assuntos
Terapia Ocupacional , Humanos , Terapeutas Ocupacionais , Terapia Ocupacional/métodos , Ocupações , Identificação Social , Local de Trabalho
9.
Aust Occup Ther J ; 69(1): 25-37, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34490901

RESUMO

INTRODUCTION: Occupation-centred practice is key to aligning with the contemporary paradigm. Benefits of this approach for clients and the profession are well documented, yet how to identify occupation-centred practice is not yet understood. Therefore, this study aimed to uncover the characteristics of occupation-centred practice and how they can be identified in practice. METHODS: A three round Delphi survey was conducted to gain consensus on the defining characteristics of occupation-centred practice. Purposive, convenience, and snowball sampling were used to distribute three survey rounds to occupational therapists internationally. Content analysis was used to create characteristics, descriptions, and examples of occupation-centred practice. Percentage agreement between occupational therapists were calculated to determine consensus. RESULTS: Responses were received from 100 participants in round one, 89 in round two, and 70 in round three. Round one generated 12 characteristics that were refined and finalised into four defining characteristics, one of which had three subcharacteristics. The four characteristics are as follows: guided by theory and philosophy grounded in occupation, language and documentation promotes occupation among stakeholders, understanding and incorporating the person's context, and occupation as core to practice, which includes occupation in goal setting, assessment, and intervention. Descriptions and examples were generated for each characteristic. CONCLUSION: This study presents valuable information for occupational therapists wanting to practise in an occupation-centred manner. The characteristics, descriptions, and examples provide a foundation upon which occupational therapists can understand and identify occupation-centred practice. Examples provided were highly influenced by factors including practice settings and preferred terminology. Future research will explore the creation of a tool for occupational therapists to evaluate their own practice against the characteristics to demonstrate areas of strength and for development.


Assuntos
Terapia Ocupacional , Técnica Delfos , Humanos , Terapeutas Ocupacionais , Ocupações , Inquéritos e Questionários
10.
BMJ Qual Saf ; 31(2): 134-146, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34253682

RESUMO

BACKGROUND: Internationally, patient and public involvement (PPI) is core policy for health service quality improvement (QI). However, authentic QI partnerships are not commonplace. A lack of patient and staff capability to deliver successful partnerships may be a barrier to meaningful QI collaboration. OBJECTIVES: The research questions for this scoping review were: What is known regarding the capabilities required for healthcare staff and patients to effectively partner in QI at the service level?; and What is known regarding the best practice learning and development strategies required to build and support those capabilities? METHODS: A six-stage scoping review was completed. Five electronic databases were searched for publications from January 2010 to February 2020. The database searches incorporated relevant terms for the following concepts: capabilities for PPI in healthcare QI; and best practice learning and development strategies to support those capabilities. Data were analysed using descriptive statistics and qualitative content analysis. RESULTS: Forty-nine papers were included. Very little peer-reviewed literature focused explicitly on capabilities for QI partnerships and thus implicit paper content was analysed. A Capability framework for successful partnerships in healthcare quality improvement was developed. It includes knowledge, skills and attitudes across three capability domains: Personal Attributes; Relationships and Communication; and Philosophies, Models and Practices, and incorporates 10 capabilities. Sharing power and leadership was discussed in many papers as fundamental and was positioned across all of the domains. Most papers discussed staff and patients' co-learning (n=28, 57.14%). Workshops or shorter structured training sessions (n=36, 73.47%), and face-to-face learning (n=34, 69.38%) were frequently reported. CONCLUSION: The framework developed here could guide individualised development or learning plans for patient partners and staff, or could assist organisations to review learning topics and approaches such as training content, mentoring guidelines or community of practice agendas. Future directions include refining and evaluating the framework. Development approaches such as self-reflection, communities of practice, and remote learning need to be expanded and evaluated.


Assuntos
Atenção à Saúde , Melhoria de Qualidade , Instalações de Saúde , Humanos , Liderança , Qualidade da Assistência à Saúde
11.
Scand J Occup Ther ; 28(3): 188-200, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31774692

RESUMO

BACKGROUND: In a globalised world, with injustices and inequities, occupational therapists have a moral and ethical obligation to use their knowledge and skills to work at a collective level with groups, communities, and populations rather than focus solely on individualistic approaches. OBJECTIVES: To review the literature exploring the question: What do occupational therapists do in their everyday practice that could be characterised as having a collectivist orientation? METHOD: A scoping review with searches on Web of Science, Scopus and CINAHL databases with the keywords 'occupational therapy' AND collectiv*. RESULTS: 161 articles were found and after screening of abstracts and/or full text, 19 were included. Articles were published in English (13) and Portuguese (6), in 12 different journals and one book, from 1988 to 2018. They were categorised as focussing on: social welfare - collectivism (n = 2); collective occupations (n = 11); and collective oriented practices (n = 6). CONCLUSION: A clear definition of collectivist approaches in occupational therapy practice was not found. What was evident, however, was a focus on experiential accounts of working with groups of people and the methods and processes utilised. It is argued that occupational therapy needs to further develop knowledge and practices aimed at injustices grounded in a collectivist epistemology.


Assuntos
Atitude do Pessoal de Saúde , Direitos Humanos , Terapeutas Ocupacionais/psicologia , Terapia Ocupacional/métodos , Terapia Ocupacional/organização & administração , Terapia Ocupacional/psicologia , Seguridade Social/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Scand J Occup Ther ; 28(1): 26-40, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786968

RESUMO

Background: Occupational adaptation is a key occupational therapy concept, yet lacks clarity and consensus, impacting on its application in practice, theory and research. Concept analysis is a rigorous methodology which enables identification of unique features, gaps in knowledge, and the need for further concept refinement.Aim: This study aimed to determine the conceptual maturity of occupational adaptation, and identify steps needed to understand and use occupational adaptation.Methods: Four databases were searched using the term 'occupational adaptation' and a principle-based concept analysis was conducted from epistemological, pragmatic, linguistic, and logical perspectives. A mapping of the concept's evolution and analysis of the maturity of its structural features also occurred.Results: Seven hundred and fourty-eight papers were identified, which reduced to 161 after abstract and full-text review. A diverse range of applications and two primary theoretical frames of reference were identified. The definition, attributes, preconditions, outcomes, and boundaries of the concept lacked maturity, limiting clinical utility.Conclusions and significance: Occupational adaptation is a concept applied across many practice and research contexts, yet the concept is not fully mature. Concept refinement is required before further applied research is conducted. A shared understanding of occupational adaptation through refinement and research may consolidate its importance and future utility.


Assuntos
Adaptação Psicológica/classificação , Terapia Ocupacional/psicologia , Ocupações/estatística & dados numéricos , Terminologia como Assunto , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Scand J Occup Ther ; 28(3): 213-224, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32356478

RESUMO

BACKGROUND: Occupational therapists have sought to reconnect with the foundations of the profession for many years, and a key focus has been the place of occupation in practice. Existing literature suggests that therapists working in acute settings experience difficulties practicing in ways that centralise occupation. AIM/OBJECTIVE: This scoping review aimed to explore the existing literature on contemporary occupational therapy philosophy and practice in acute hospital settings. METHODS: A five step scoping review process was implemented. Four electronic databases were searched using a combination of search terms. Searching reference lists of papers was also completed. Results were summarised using numeric and thematic analysis. RESULTS: Twenty four publications were included. Four themes were identified; attitudes towards occupation-based practice, benefits of occupation-based approaches, challenges implementing occupation-based practice, and strategies to overcome challenges. CONCLUSION AND SIGNIFICANCE: Findings highlighted therapists value occupation as an important aspect of practice, however they experience many environmental and personal challenges in acute settings. Strategies to overcome these challenges related to individual's changing their practice to be more occupation-focussed and changes within the practice context including adapting environments, documentation and intervention protocols to focus on occupation. These strategies may support therapists to align practice with their professional values.


Assuntos
Pessoal Técnico de Saúde/psicologia , Hospitais/estatística & dados numéricos , Terapeutas Ocupacionais/psicologia , Terapia Ocupacional/organização & administração , Terapia Ocupacional/psicologia , Filosofia Médica , Papel Profissional/psicologia , Adulto , Pessoal Técnico de Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapeutas Ocupacionais/estatística & dados numéricos , Terapia Ocupacional/estatística & dados numéricos
14.
Aust Occup Ther J ; 68(2): 180-192, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33047341

RESUMO

INTRODUCTION: Consumer engagement in research is becoming an ethical, political, and moral imperative. The aim of this scoping review was to provide a snapshot of the current status of the emerging area of consumer engagement in occupational therapy health-related research, as published in the Australian Occupational Therapy Journal. METHODS: A scoping review was conducted of all health-related original research published in the Australian Occupational Therapy Journal for 5½ years, plus Early View, as at June 2019. Eligible papers were examined for consumer engagement content which included any active choice or control by consumers, beyond being a research participant. A recognised six stage methodology was used with quantitative and qualitative data analysed. Two consumers collaborated in interpreting the data including finalising themes, leading theme naming, developing key discussion points, and producing recommendations. RESULTS: Of the 123 eligible papers, 48 (39.02%) included consumer engagement. However, only two incorporated consumer engagement across all research phases-preparation, execution and translation. A total of 103 consumer engagement activities were charted and categorised across all papers. There were limited instances of consumer collaboration (14/103, 13.59%) or consumer-led research processes (15/103, 14.56%) reported. Four themes emerged: Parity in research partnerships; It's important to know the Who, What, When, How and So What of consumer involvement; Consumer engagement must be a two-way process-not a dead end street; and Meeting the challenge-being diverse and inclusive. CONCLUSION: Comprehensive consumer-researcher partnerships may not be common-place in health-related occupational therapy research in the Australian Occupational Therapy Journal. This paper is a call to action. Occupational therapists must embrace consumer research partnerships as a demonstration of the key philosophies of enabling and empowering consumers and communities. Collaboration with two consumers in finalising data analysis, results interpretation and reporting added a diverse and valuable perspective.


Assuntos
Terapia Ocupacional , Austrália , Participação da Comunidade , Humanos
15.
Aust Occup Ther J ; 67(4): 373-395, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32281131

RESUMO

INTRODUCTION: The number of occupational therapy degree programs in Australia has increased substantially over the last decade. During this time, Australian academics have produced a significant amount of scholarship focussed on entry-level education; however, the landscape of this scholarship has not been examined. The aim of this study was to review the literature on the scholarship of entry-level Australian occupational therapy education programs, specifically the topics explored and methods employed. METHODS: An extensive search of nine databases produced 1,002 papers related to occupational therapy education. Two researchers screened each paper using inclusion and exclusion criteria. Seventy-six articles, published between 2000 and September 2019, were included. Data were extracted using a coding tool, and entered into NVivo, where data were analysed using queries and tallies of the characteristics of the articles. RESULTS: Sixty-eight articles were research and eight were other peer reviewed literature. Articles primarily focussed on student characteristics and perceptions. Quantitative research designs were predominant with surveys the most frequently used method. There were few articles that addressed the topic of teaching methods and approaches, and of these none addressed occupation-centred teaching. No articles addressed the learning environment. Four articles reported on an educational intervention that targeted participation, and attitudes/perceptions or knowledge/skills of students and/or academics. These findings inform understanding about what has been completed so far in the scholarship; and what topic focus and research designs could address gaps in existing knowledge. CONCLUSIONS: This review elucidated topics that have been well researched (student focus), as well as gaps in the scholarship (teaching methods and approaches including occupation-centred teaching, and the learning environment). It showed that quantitative designs were predominant, with qualitative approaches less frequently adopted. The results of this review could assist academics and researchers to focus their scholarship on topics that require further investigation and diversify research methods.


Assuntos
Educação Profissionalizante/organização & administração , Bolsas de Estudo/organização & administração , Terapia Ocupacional/educação , Preceptoria/organização & administração , Austrália , Currículo , Educação Profissionalizante/economia , Bolsas de Estudo/economia , Humanos , Terapia Ocupacional/economia
16.
Cad. Bras. Ter. Ocup ; 28(1): 330-342, jan.-mar. 2020.
Artigo em Inglês | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1132763

RESUMO

Abstract Over the past decades, the profession of occupational therapy has increased its focus on the wellbeing of society as a whole in response to growing inequality. In addition, guidelines for occupational therapy student education have also been revised to ensure that occupational therapists graduate with an appreciation of and ability to work with diverse populations of people in multiple contexts, beyond a biomedical focus on health and impairment. As a result, occupational therapy educators have been challenged to create curricula that meet the profession's social responsibility by preparing students to practice with communities and populations in a contextualised way. To contribute to this discussion and foster dialogue about what this may look like in occupational therapy programs, we present examples of curricula from three courses in two undergraduate occupational therapy programs in Australia and Brazil: "Understanding the Context of Occupation" and "Occupation, Health and Participation - Communities and Populations", at Griffith University, Australia; and the course "Social Occupational Therapy", at the Federal University of Sao Carlos, Brazil. The courses include topics such as: working in micro to macro contexts, working with communities and populations, collective occupation, politics and advocacy, social justice, occupational justice, social security and others. With differences across the programs, based on their geographical and institutional contexts, as well as their socio-historical and cultural contexts, the examples provide some ideas for educators about preparing students to work in a contextualised way with communities and populations.


Resumo Nas últimas décadas, a área de terapia ocupacional ampliou seu enfoque em dimensões sociais em resposta ao crescente patamar de desigualdade. Além disso, as diretrizes para a formação de terapeutas ocupacionais também foram revisadas para garantir que os profissionais se graduem com uma sensibilidade e capacidade de trabalhar com populações diversas e em múltiplos contextos, para além de um foco biomédico em saúde e deficiência. Como resultado, os educadores em terapia ocupacional têm sido desafiados a criar currículos que abordem a responsabilidade social, preparando os alunos para atuarem com comunidades e populações de forma contextualizada. Para contribuir com essa discussão e dialogar sobre como poderiam ser programas em terapia ocupacional, apresentamos exemplos de currículos de três cursos em dois programas de terapia ocupacional, um na Austrália e um no Brasil, são eles: "Entendendo o contexto da ocupação" e "Ocupação, saúde e participação - comunidades e populações", na Griffith University, Austrália; e o curso "Terapia Ocupacional Social", da Universidade Federal de São Carlos, Brasil. Os cursos incluem tópicos como: trabalhar do micro ao macro contextos, trabalhar com comunidades e populações, ocupação coletiva, política e defesa de direitos, justiça social, justiça ocupacional, seguridade social e outros. Com diferenças entre o programas, com base em seus contextos geográficos e institucionais, bem como em seus contextos sócio-históricos e culturais, os exemplos fornecem algumas ideias para educadores sobre como preparar os alunos para trabalhar de maneira contextualizada com comunidades e populações.

17.
Aust Occup Ther J ; 67(2): 100-109, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31840290

RESUMO

INTRODUCTION: Collaboration, choice and power-sharing are cornerstones of practice as occupational therapists support individuals to re-establish an occupational identity and reintegrate into the community following stroke. Yet evidence of unmet client needs suggests client-centred care is not optimal, and little is known of client perspectives of client-centred practice. A deeper understanding of the client experience of therapeutic relationships during adjustment following stroke, will help facilitate client-centred practice. This paper reports on a study exploring the research question: how do stroke survivors perceive their relationship with their health care team as they adjust to life following stroke? METHODS: In this constructivist grounded theory study, in-depth interviews were conducted with six adult stroke survivors from South-East Queensland, Australia. Transcribed interviews were analysed using a constant comparative approach, identifying emerging concepts and patterns, to construct a theoretical understanding of the experience and meaning of adjustment and reintegration back into the community, with a specific focus on perceptions of therapeutic relationships and client-centred practice. RESULTS: Participant perspectives of client-centred care during their rehabilitation following stroke were revealed and implications of this for their recovery identified. Themes of being understood; out of the driver's seat; knowing what's going on; and what I need when I need it emerged. Participants described not being: involved in decision making, provided with information, or receiving services aligned to their needs. Periods of frustration, loss of hope and fluctuating motivation were also common. CONCLUSION: Findings shed further light on previously reported health service and discharge experiences. The insight gained into individual experiences of client-centred care following stroke suggest ways therapists can understand and address each client's adjustment experience and the impact this has on their needs, goal-setting, motivation, and confidence. Client-centred care must be grounded in client reality.


Assuntos
Terapia Ocupacional/psicologia , Participação do Paciente/psicologia , Reabilitação do Acidente Vascular Cerebral/psicologia , Sobreviventes/psicologia , Feminino , Teoria Fundamentada , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Assistência Centrada no Paciente/métodos , Pacientes/psicologia , Queensland
18.
Disabil Rehabil ; 42(13): 1880-1885, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-30672347

RESUMO

Purpose: Studies highlighting the time spent in self-isolating and inactive activities during stroke rehabilitation have led to the introduction of group programs and environmental enrichment to improve activity levels. A less explored perspective is to understand how the introduced changes align with the occupational needs of the stroke survivors. Therefore, the aim of this study was to explore stroke survivors experiences of engagement in occupations during stroke rehabilitation.Methods: A descriptive phenomenological approach with semi-structured interviews explored stroke survivors experiences.Results: Eight participants (five male and three female, mean age 72 years) described their experiences with two themes emerging: (1) "I'm here for that reason:" which highlighted therapy as an occupation which participants wanted to perform and (2) "Celebration of quiet moments:" exploring the value of rest and recreation.Conclusion: This study provides a preliminary understanding of how stroke survivors experience occupational engagement during rehabilitation. There was an apparent shift in priorities with therapy considered the most important occupation and a strong need expressed for rest and relaxation to be factored into people's days. It appears the increasing activity levels may not always align with people's occupations and that due consideration of this malalignment may further enhance engagement and outcomes.Implications for rehabilitationDuring hospital-based stroke rehabilitation, stroke survivors prioritized the occupations of therapy, rest, and recreation.People with stroke are motivated to participate when the activities within and outside of, therapy align with their pre-stroke life and occupations.A daily stroke rehabilitation program should be balanced with opportunities for rest to support recovery time from therapy and possible consolidation of learning.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Idoso , Feminino , Hospitais , Humanos , Masculino , Ocupações , Pesquisa Qualitativa , Sobreviventes
19.
BMC Med Educ ; 19(1): 308, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409410

RESUMO

BACKGROUND: Professional identity is critical to the safe and effective clinical practice of all health professions. University programs play an important role in the formation of professional identity of students, and so it essential to understand professional identity at this stage of students' development. However, the majority of research into professional identity has been conducted using the qualitative paradigm so further quantitative analysis through the use of psychometrically-sound professional identity measures is required. This study aimed to identify professional identity measures used with university students enrolled in health programs and synthesise the evidence of their psychometric properties. METHODS: The systematic review was conducted in two phases. Phase 1 involved searching five online databases for studies that used professional identity measures with student health professionals. These studies were assessed against a priori criteria for inclusion and a list of measures was identified. Phase 2 involved searching the same databases for psychometric evidence of the measures identified in Phase 1. The psychometric properties of each measure were compared against the Consensus-based standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Data were narratively synthesised, and comparisons were made between measures. RESULTS: Phase 1 identified eight professional identity measures. Phase 2 identified a total of 15 studies that evaluated the psychometric properties of at least one of the professional identity measures. There was a paucity of psychometric evidence for the measures. The revised Nurses' Professional Values Scale and Macleod Clark Professional Identity Scale had the greatest volume of psychometric evidence. None of the measures fulfilled all criteria in the COSMIN checklist. CONCLUSION: There is a paucity of evidence underpinning the psychometric of professional identity measures. Evidence which uses these measures should be interpreted with caution. Further research is warranted to ensure that the results of quantitative professional identity studies are valid and reliable.


Assuntos
Educação de Graduação em Medicina , Papel Profissional , Identificação Social , Estudantes de Medicina , Humanos , Liderança , Papel Profissional/psicologia , Psicometria
20.
Aust Occup Ther J ; 65(6): 533-543, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30132914

RESUMO

BACKGROUND/AIM: Primary contact models of care are an emerging area of occupational therapy practice that aim to respond to the changing health-care landscape. There is a dearth of literature exploring an occupational perspective in primary contact roles, and literature in the broader scope of hand therapy has recognised that occupational therapists' practice often aligns with the biomedical worldview. Therefore, this study aimed to explore the practice of occupational therapists within Primary Contact Occupational Therapy Hand (PCOTH) Clinics from an occupational perspective. METHOD: This ethnographic study gathered in-depth data through observations of primary contact hand therapy sessions, review of progress notes and interviews with occupational therapists. Qualitative data analysis was conducted using a three-stage process first at the item level, then pattern level and finally at the structural level. The research team collaboratively discussed all codes and then themes. RESULTS: The push of the biomedical culture and the pull of an occupational perspective was conceptualised as an overarching theme shaping occupational therapists' practice in the primary contact clinics. Five themes emerged: bottom-up approach to an occupational perspective, an occupational perspective via informal discussion, occupational therapists' expectations of patients, occupational perspective on autopilot and blurred professional identity. CONCLUSION: Occupational therapists working in primary contact roles were pushed by the biomedical culture of the setting. Despite this, there was still a pull towards an occupational perspective. This research provides an initial exploration of primary contact clinics, and highlighted the added bonus of an occupational perspective. The findings present a timely opportunity for occupational therapists to critically reflect on practice in PCOTH clinics.


Assuntos
Atitude do Pessoal de Saúde , Mãos , Terapeutas Ocupacionais/psicologia , Terapia Ocupacional/organização & administração , Atenção Primária à Saúde/organização & administração , Antropologia Cultural , Grupos Focais , Humanos , Planejamento de Assistência ao Paciente , Participação do Paciente , Papel Profissional , Queensland , Identificação Social
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