A Q-method approach to perceptions of professional reasoning in occupational therapy undergraduates.

BACKGROUND: Professional reasoning provides a firm basis for the development of teaching and assessment strategies to support the acquisition of skills by healthcare students. Nevertheless, occupational therapy educators should use diverse methods of learning assessment to examine student learning outcomes more fully with an evaluation that supports the overall complexity of the process, particularly learners' subjective experience. The aim of this article is to identify the range of perspectives among occupational therapy undergraduates regarding terms or concepts that are key for improving their professional reasoning. METHODS: Q-methodology was used to address the aim of the study. A concourse relating to a series of ideas, phrases, terminology, and concepts associated with various studies on professional reasoning in occupational therapy, specifically on students in this field, was generated. The terms that had the clearest evidence, the most relevance or the greatest number of citations in the literature were collected (n = 37). The P-set was assembled by non-probabilistic sampling for convenience. It comprised undergraduate university students in occupational therapy. Factor analysis was conducted using Ken-Q Analysis v.1.0.6, reducing the number of Q-sets to smaller groups of factors representing a common perspective. RESULTS: Through statistical analysis of the Q-sorts of 37 occupational therapy students, 8 default factors were identified. The four factors in accordance with the selection criteria were rotated by varimax rotation to identify variables that could be grouped together. Each viewpoint was interpreted, discussed and liked to different aspects of professional reasoning in occupational therapy. CONCLUSIONS: The observed perceptions were linked to the various aspects of professional reasoning that have been widely discussed in the occupational therapy literature. For most of the students, there was a strong correspondence between the narrative, interactive and conditional aspects of the various components.

Occupational engagement of people living with a life-limiting illness: Occupational therapists' perceptions.

BACKGROUND/AIM: Occupational therapists working in palliative care aim to enable clients living with a life-limiting illness to continue participating in meaningful activities for as long as possible. However, little is published about the occupations people living with a life-limiting illness wish to engage in, and how occupational therapists can best enable occupational engagement. Therefore, this study aimed to gain an in-depth understanding of occupational therapists' perceptions on clients' occupational engagement post-diagnosis of a life-limiting condition. METHODS: Occupational therapists working in Australia with people with a life-limiting illness were recruited to participate in a national online survey over the period of a month. Recruitment used a purposive, snowball sampling technique, resulting in 144 survey responses. Data were analysed using modified grounded theory methods. RESULTS: Findings revealed two interrelated categories and four subcategories. The first category, focusing on life is concerned with therapists' perceptions of how clients continue to focus on living post diagnosis and encompasses two subcategories: (i) prioritised engagement and (ii) altered engagement. The second category, preparing for death, centres on therapists' perceptions of what clients do to practically prepare for death and find closure as their illness progresses, and is comprised of the two subcategories: (i) practical preparation for death and (ii) "facilitating closure". CONCLUSION: Therapists perceived that meaningful occupational engagement changes over time as occupational performance levels decrease and clients prepare for death.

Experiences with continuous quality improvement work based on the Occupational Therapy Intervention Process Model.

BACKGROUND: Sustainability is an important issue in implementation processes in health care, and more knowledge is needed to facilitate improvement work in occupational therapy practice. AIM: The aim of this study was to explore how occupational therapists experienced continuous quality improvement work based on the Occupational Therapy Intervention Process Model after 17 years. METHOD: Two focus group interviews were conducted with a total of 12 occupational therapists. The data were analysed using qualitative content analysis. RESULTS: The analysis resulted in three themes with related subthemes describing the occupational therapists' experiences of their model-based long-term improvement work. The themes were labelled as follows: 'sharing a safe and well-known professional reasoning', 'reaching normality and empowerment' and 'questioning and reshaping the too safe and too well-known normality'. The model functioned as a sustainable framework both for ordinary clinical practice and for continuous improvement work. CONCLUSION: By using the model, the occupational therapists had established a safe and well-known professional reasoning in which continual quality improvement work had become sustainable.

Home safety evaluation - getting it right.

PURPOSE: Comprehensive and efficient home safety assessments are needed to provide quality interventions for community living. This study explores early career and experienced home evaluator perspectives on content and usability of HESTIA, a home safety assessment app. METHOD: Four early career and five experienced practitioners rated the HESTIA app using the uMARS usability evaluation and then participated in focus groups. Data were analysed using a key concept analytic approach. RESULTS: Results include "how to do" home safety evaluations and how prompts and training help practitioners "get it right." Early practitioner participants viewed the step-wise processes of the app as necessary whereas the experienced evaluators relied on own knowledge and experiences. CONCLUSIONS: Gobet and Chassy's TempT theory provides insight into the development of expertise in practice for rehabilitation professionals. The procedural complexities of assessment and ethical responsibility to provide competent, quality service to clients with disabilities are integrated into discussion of the development of professional intuition and ethical practice as guided by HESTIA.IMPLICATIONS FOR REHABILITATIONHome safety evaluations and home modifications are essential in helping persons with disabilities to live at home.Mobile applications such as HESTIA can serve as beneficial supports in facilitating effective decision making processes for rehabilitation practitioners conducting home safety evaluations.Technology driven assessments through mobile applications (apps) can help improve proper decision making and client outcomes, as well as aid in the development of intuition in students and early-career practitioners.Decision making support systems can help practitioners uphold their ethical responsibility to provide competent and quality rehabilitative services.

What is Professionalism in Occupational Therapy? A Concept Analysis: Qu'est-ce que le professionnalisme en ergothérapie? Analyse de ce concept.

BACKGROUND.: Professionalism has been given different definitions over time. These are, commonly theoretical and difficult to operationalize. PURPOSE.: This study aimed to provide an operational definition of the concept of professionalism in occupational therapy. METHOD.: Based on a concept analysis design, a meta-narrative review was conducted to extract information from 30 occupational therapy manuscripts. FINDINGS.: Professionalism is a complex competence defined by the manifestation of distinct attitudes and behaviours that support excellence in the occupational therapy practice. In addition, professionalism is forged and evolves according to personal and environmental characteristics. The manifestation of professionalism can lead to positive consequences for occupational therapists, clients, and the discipline, notably contributing to a positive and strong professional identity. Moreover, professionalism is also subject to cultural influences, which leads to variations in its development, manifestations, and consequences. IMPLICATIONS.: This study offers a contemporary operational definition of professionalism and levers to promote its development and maintenance.

A tool to enhance occupational therapy reasoning from ICF perspective: The Hasselt Occupational Performance Profile (H-OPP).

BACKGROUND: In order to enhance occupational therapy reasoning in clinical practice, different elements such as client-centred approach, evidence-based care and interdisciplinary work should be taken into account, but is a challenge. AIM: To describe the development of the digital Hasselt Occupational Performance Profile (H-OPP©) that enhances occupational therapy reasoning from ICF perspective. METHOD: A participative qualitative design was used to create the H-OPP© in an iterative way in which occupational therapy lectures, ICF experts, students and occupational therapists in the field were involved. RESULTS: After linking occupational therapy terminology to the ICF, different stages of the H-OPP were identified and elaborated with main features: generating an occupational performance profile based on inventarization of problems and possibilities, formulating an occupational performance diagnosis and enabling to create an intervention plan. In all stages, both the perspectives of the client and the occupational therapist were taken into account. To increase practical use, the tool was further elaborated and digitalized. CONCLUSION: The H-OPP© is a digital coach that guides and facilitates professional reasoning in (novice) occupational therapists. It augments involvement of the client system. Furthermore, it enhances interdisciplinary communication and evidence-based care.

MEMÓRIA DE BAIRRO COMO PROJETO DE VIDA COLETIVA A PARTIR DA ABORDAGEM DE TERAPIA OCUPACIONAL DE ENSINAGEM EM DESENVOLVIMENTO LOCAL PARTICIPATIVO / Neighborhood memory as a collective life project from the occupational therapy approach of "ensinagem" in participatory local development / La memoria de barrio como proyecto de vida colectiva desde el enfoque de la terapia ocupacional de "ensinagem" en el desarrollo local participativo

Objetivo: Trata-se de uma imagem de capa que aborda o raciocínio profissional, sustentado pela abordagem de terapia ocupacional de ensinagem em desenvolvimento local participativo, durante a construção de um projeto de vida coletiva, relacionado à memória de um bairro de assentamento rural e luta pela moradia, no ano de 2014. Descrição da imagem: As imagens colaboram esteticamente para identificar os procedimentos da abordagem, que servem como pistas para orientar a prática de terapeutas ocupacionais atenta às questões territoriais-comunitárias.(AU)

Aim: This is a cover image that addresses the professional reasoning supported by the occupational therapy of "ensinagem" in participatory local development approach during the construction of a collective life project related to the memory of a rural settlement neighborhood and the struggle for housing, in the year of 2014. Image description: The images collaborate aesthetically to identify the procedures of the approach that serve as clues to guide the practice of occupational therapists who are aware of territorial-community issues.(AU)

Objetivo: Esta es una imagen de portada que aborda el razonamiento profesional sustentado por el enfoque de la terapia ocupacional de "ensinagem" en el desarrollo local participativo durante la construcción de un proyecto de vida colectiva relacionado con la memoria de un barrio de asentamiento rural y la lucha por la vivienda, en el año de 2014. Descripción de la imagen: Las imágenes colaboran esteticamente para identificar los procedimientos del enfoque que sirven de pistas para orientar la práctica de terapeutas ocupacionales conscientes de la problemática territorial-comunitaria.(AU)

Occupation-centred, occupation-based, occupation-focused: same, same or different? Previously published in Scandinavian Journal of Occupational Therapy 2013; 20: 162-173.

BACKGROUND: Since the beginning of the occupational therapy profession, engagement in occupation has been valued as the primary therapeutic agent as well as the goal of intervention. While there are few today who would not support this idea, occupational therapists continue to struggle with implementing their beliefs through "what we do" and "how we do it". Contributing to this problem is their failure to use terminology in a manner that clearly defines what and how occupational therapists do what they do in occupational therapy research, education, and practice. METHODS: The author will, therefore, first discuss some key occupational therapy terms and propose that they represent an occupation-related taxonomy that can be used to more clearly define and describe for occupational therapists and others what they do and how they do what they do as occupational therapists. Then, with a goal of fostering critical self-reflection among occupational scientists and occupational therapy researchers, educators, and practitioners, the author will go through the stages of the occupational therapy process outlined in the Occupational Therapy Intervention Process Model (OTIPM) and demonstrate how a more precise use of this occupation-related taxonomy can facilitate maximizing the power of occupation in practice.