Scholarship of Practice in the Care of People with Dementia: Creating the Future Through Collaborative Efforts.

A scholarship of practice approach sets the stage for collaborative partnerships across academic and clinical practice settings that result in positive gains for all stakeholders. These gains include an enhanced ability to generate and apply relevant evidence in practice, disseminate knowledge and innovation, and ensure best practice is relevant to and effective for, people receiving services and their caregivers. This paper discusses national and international examples of collaborative, research-based practice initiatives that have implemented a scholarship of practice approach. The exemplars described here are framed within the Model of Human Occupation, which addresses the importance of volition, habits, roles, environment, and performance capacities in facilitating engagement in occupation for people with dementia. Research that focuses on how therapists adopt and use evidence in practice, as well as the opportunities and challenges for supporting therapists and their use of theory and evidence are discussed.

The Individual Practice Development Theory: an individually focused practice development theory that helps target practice development resources.

BACKGROUND: Research indicates that multifaceted practice development (PD) interventions are more effective than single strategies. However, models of education in health care need to consider cost-effectiveness. OBJECTIVES: This paper presents a research-based, PD theory called the Individual Practice Development Theory. It argues that programmes that use the Individual Practice Development Theory to tailor PD support to the learning needs of practitioners will result in more engagement in PD and will target PD resources efficiently. METHODS: The in-depth qualitative, multi-method realistic evaluation was of a multifaceted, organization-wide PD programme in one National Health Service Mental Health and Learning Disabilities Trust. Semi-structured interviews, practice observation and documentation audit were used to gather data from occupational therapists. FINDINGS: Results indicated that environmental contexts, particularly the support of the immediate team, and the participant's personal circumstances affected PD behaviour change. Six mechanisms acted as catalysts. These were: Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Knowledge Know-how and Channelling Time. Four stages of PD characterized as: 'In the Hangar', 'On the Runway', 'Take-off' and 'In the Air' were identified. The research also illustrated the interconnectivity between outcome levels, contextual circumstances and activating mechanisms. DISCUSSION: The findings suggested that PD interventions need to be more individually tailored to achieve optimum learning outcomes. The identification of four discernable stages permits rapid understanding of PD support needs in order to focus PD support. CONCLUSION: With a systematic and individualized approach to PD in health care, more target PD supports can be put in place.

Impact of using the Model of Human Occupation: a survey of occupational therapy mental health practitioners' perceptions.

AIM: While little is known about how occupational therapists perceive the use of occupation-focused theory in their practice, evidence indicates that it has been called for in the profession. To date, the Model of Human Occupation (MOHO) is the most widely used model internationally. The aim of this study is to document practitioners' perceptions of how using MOHO impacted on their practice. METHODS: A descriptive study using an Internet-based survey study design was conducted with 429 therapists in six National Health Service (NHS) trusts in the UK. RESULTS: Of the 429 therapists, 262 completed the survey, for a response rate of 61.07%. Most were female (85.5%) with a varying range of years of experience. Most worked in community and/or inpatient mental health settings; 92.1% responded that they use MOHO as their primary model. Therapists reported using MOHO moderately to greatly improve their assessment, goal setting, and conduct of relevant interventions as well as professional identity as an OT in their mental health occupational therapy practice. CONCLUSION/IMPLICATIONS: This study examined therapists' perceived impact of using an occupation-focused model in mental health practice. The findings of this study provided promising results. Findings suggest that the utilization of MOHO increases service for clients and professional stature and identity for therapists.

Program Redesign Based on the Model of Human Occupation: Inpatient Services for People Experiencing Acute Mental Illness in the UK.

This paper discusses the current context of the UK mental health service system and the resulting need for program change within acute-care inpatient hospitals. The primary focus is to illustrate through practice example what can be done to support the delivery of client treatment packages by using the concepts described by the Model of Human Occupation (MOHO). The paper concentrates on explaining how MOHO has helped to guide program redesign and develop an Occupational Therapy Care Pathway to support occupation-focused services. The example given is of a hospital service in Gloucestershire, England, which provides inpatient care for people experiencing acute mental illness.

Achieving evidence-based practice: a process of continuing education through practitioner-academic partnership.

SUMMARY Occupational therapy is required to deliver and generate evidence-based practice. As currently articulated, evidence-based practice requires particular skills and takes time and is rarely realized. This paper illustrates a collaborative approach to building an evidence based training program within a practice context. The aim of the training program was to enable therapists in a large mental health setting to engage in evidence-based practice. Specifically, the partnership between the United Kingdom Centre for Outcomes Research and Education (UK CORE) and Gloucestershire Partnership NHS Trust (GPT) will be described. This article describes the GPT/UKCORE partnership, the process of building an evidence-based practice training program, the final structure of the evidence-based practice training program, and the evaluation of the evidence-based practice training program.