Brent Braveman

Occupational Identity: Exploring the Narratives of Three Men Living with AIDS

Abstract The relationship between occupation and identity has received increased attention in recent years. This article explores the usefulness of the construct of occupational identity as measured by the Occupational Performance History Interview (OPHI‐II) in understanding the evolving narratives of three men living with AIDS who participated in a vocational rehabilitation program. The narratives of the three men are described and the impact of AIDS and an attempt to return to work on each individuals occupational identity is discussed. Narrative slopes are presented for each of the three men. Directions for future research are suggested.

Developing and Maintaining Community Partnerships Within “A Scholarship of Practice”

SUMMARY This article describes the application of a model developed and adopted by the occupational therapy faculty at the University of Illinois at Chicago to utilize partnerships with community-based organizations to meet a tripartite mission of education, research, and service delivery. The model (A Scholarship of Practice) was developed and adopted in response to contextual influences occurring at multiple levels. These influences are identified and the actions taken by the faculty are described. “A Scholarship of Practice” is briefly described and the principles that have guided development and maintenance of successful partnerships with community-based organizations are discussed. Finally, the outcomes and benefits of partnering with community-based organizations are identified.

Development of a Community-Based Return to Work Program for People with AIDS

SUMMARY This article overviews the needs assessment and program development process conducted by an occupational therapist in partnership with a community-based agency. The resulting work rehabilitation program for persons living with HIV/AIDS and based on the Model of Human Occupation is utilized as a case example to illustrate the process. The needs assessment of the target population, the processes of organizational and environmental assessment and the resulting program design and program evaluation are discussed.

A Factor Analytic Study of the Model of Human Occupation Screening Tool of Hypothesized Variables

The Model of Human Occupation (Kielhofner, 2008) postulates that occupational participation is influenced by volition, habituation, three skill areas, and the environment. The Model of Human Occupation Screening Tool (MOHOST) (Parkinson, Forsyth, & Kielhofner, 2004) was developed to provide a broad assessment of the factors that influence a clients occupational participation. The purpose of this study was to ask whether there was evidence that the items of the MOHOST meaningfully cluster into these theoretical sub-constructs. Nine occupational therapists used the MOHOST with 166 clients in the US and the UK, and a series of confirmatory factor analyses (CFA) were conducted. The six-dimensional model fit better than the one-dimensional model, and the standardized coefficients also indicated that the items were well designed and captured each factor. The results of this study confirmed the hypothesis that the MOHOST contains six factors and provides further evidence of the validity of the MOHOST.

Narrative slope as a predictor of work and other occupational participation

This study aims to determine the utility of the narrative slope in predicting the vocational/productive outcomes of participants. For 65 participants living in supportive facilities for adults with HIV/AIDS in the United States, narrative slopes, based on the Occupational Performance History Interview II, were constructed and classified as progressive, stable, or regressive. Information regarding participants’ productive activities was collected at discharge from intervention programming, and at 3-month intervals, up to 9 months. Data were analyzed to examine the relationship between narrative slope and engagement in employment and other productive activity post-intervention. Demographic variables were also analyzed. None of the demographic factors significantly correlated to outcomes. It was found that a more positive narrative slope was predictive of a higher likelihood of being employed or engaged in other productive activity.

Therapists' and Clients' Perceptions of the Occupational Performance History Interview

SUMMARY The Occupational Performance History Interview-Second Version (OPHI-II) is a semi-structured interview that gathers life history information. The interview data is used to score three rating scales and complete a narrative slope. Previous research has primarily examined the validity of the scales. This qualitative study sought to understand from the perspectives of therapists and clients how they experienced the interview process and narrative slope of the OPHI-II. Clients and therapists agreed that the OPHI-II interview built rapport, generated insights into the clients life experiences, and was helpful in planning goals and services and both groups generally found the narrative slope valuable. Both therapists and clients indicated the importance of tailoring the interview process and the narrative slope to each clients unique perspective and needs. Study findings both support the usefulness of the OPHI-II and provide suggestions for how it can be used most effectively.

Managed care: Survival skills for the future

The last two decades have been a time of dramatic and consistent change in the way health care is delivered. The use of managed care strategies by health care providers impacts occupational therapy practitioners directly, yet they are often ill-prepared to respond to changes constructively. With adequate preparation, occupational therapy practitioners may not only respond to organizational change, but play a major role in helping to shape their organizations future. This article presents and defines the major managed care strategies being utilized by health care providers and their impacts on occupational therapy practitioners. The skills and strategies occupational therapy practitioners can use to effectively respond are presented and discussed. Suggested methods for gaining these skills are included. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworth.com].