E. Sharon Brintnell

Disruption of Life Roles Following InjuryImpact on Women's Social Networks.

Clients with orthopedic and soft-tissue injuries (n = 53) who were settling insurance claims or currently in litigation were assessed using the Values Scales, Salience Inventory, measures of perceived exertion, physical capacity, and functional ability, and a structured interview, the Life Satisfaction Questionnaire. Participation in major life roles was compromised following injury. Role value scores for working and home/family roles also changed, but commitment to these roles did not. Women in this sample (n = 27) experienced disruptions in their social networks that were likely related to the compromise or loss of their working role.

Old themes, new directions--occupational therapy in the 21st century.

The paper begins with a brief look at direction for the future of occupational therapy as expressed in occupational therapy literature over the past six decades. The major contribution in the areas of practice, research and education, professional organization and therapy/knowledge base are highlighted. It then considers current social issues in Canadian society which have a bearing on occupational therapy and implications for its future development; population trends, health status and hospitalization, universal access to health and social services, unemployment, client expectations, multiculturism medical ethics, family breakdown and child abuse. It looks at the occupational therapy profession in relation to these social issues and concludes with a summary of implications for occupational therapy and predictions for its future into the 21st century based on the analysis of these trends.

Changing to an Outcome-focused Program Improves Return to Work Outcomes

Objectives: The purposes of this study were to: (1) evaluate the effectiveness of changing a Return to Work (RTW) program’s focus to one that was “outcome-focused”, and (2) to determine which factors collected in the facility’s database were most predictive of RTW. Methods: A total of 13,428 client files were extracted from Millard Health’s database which included data on two cohorts of subjects: those in the program before and after the change in focus had been made. This was to determine whether significant improvements in outcomes were achieved. Variables that were hypothesized to be predictive of RTW were selected based on previous published literature. Analyses included ANOVA’s, logistic regression analysis and Pearson correlation. Results: Statistically significant improvements in RTW, total temporary disability claims, client satisfaction, efficiency of services and scores on the Perceived Disability Index (PDI), Short Form-36 (SF-36) and Visual Analogue Scale (VAS) for perceived pain were found. Variables that were predictive of RTW included: more efficient services, completion of a worksite visit, having the worker participate in the visit, availability of modified duties from the employer, fewer absences from the program and better scores on the PDI, SF-36 and VAS. The most predictive variable of RTW was sores on the PDI indicating lower levels of perceived disability. Conclusions: Changing to an outcome-focused program improved various outcomes in this RTW program. Several factors predict the outcome of RTW and these should be considered in treatment planning.

The expression of depression among Javanese patients with major depressive disorder: A concept mapping study

In this study, we explored the presentation of clinical depression in Java, Indonesia. Interviews were conducted with 20 Javanese patients (male and female) with major depressive disorder from both lower and higher socioeconomic levels. The recruited participants came from provincial and private mental health hospitals in the cities of Solo, Yogykarta (Jogja), Jakarta, and Malang on the island of Java, Indonesia. Concept mapping methodology using multidimensional scaling and hierarchical cluster analysis was used to identify underlying themes in the expression of depressive phenomena in this Indonesian population. The results identified themes that grouped into six clusters: interpersonal relationships, hopelessness, physical/somatic, poverty of thought, discourage, and defeat. Findings give support to the view that culture influences the expression of Indonesian depressive phenomenology, which nevertheless has some common roots with Western clinical pictures of the disorder. Cultural influences may mask symptoms of the disorder to clinicians. Diagnostic and assessment tools must be carefully selected to ensure they address culturally specific expressions of depression.

Muriel Driver Memorial Lecture 1985: Career Planning in Occupational Therapy. I want up, not out.

As the Canadian health care delivery system expands to increase the scope of community based services as well as the range of services offered in acute and long terrn facilities, it also opens the job market for occupational therapists. The service industries, including health, currently make up twothirds of the Canadian work force. It is predicted that 7507o of the new jobs created between now and the year 2000 will be in the service sector (CCRW Newsletter, 1985). There has always been non-traditional career opportunities for the innovative, creative thinkers in our field (Madill, Brintnell, Stewin and Fitzsimmons, 1983; Goldenberg and Quinn, 1985), but the majority of us have looked for advances within a health care institution, an environment with well-established hierarchies. It is an industry which has a history of attempting to keep females impotent in the system. Those wishing to play roles different to their stereotypes vvere considered deviant or pathological, a failure for not obeying group rules (Torres, 1981). Occupational therapists should heed these words as we need to continue to professionally assert ourselves and our service contributions. For as a female minority group, with primary credentials at the baccalaureate level, we are vulnerable. To take advantage of career opportunities in senior administration in health care or

Position Paper on Occupational Therapist's Role in Work Related Therapy

In summary, occupational therapists use work related assessment and interventions to assist clients experiencing physical, psychological, cognitive and/or sociocultural disabilities to determine their competitive employment potential and to maximize their work performance. Clients with work histories (transient or consistent), as well as those with non-existent work histories, are all suitable candidates. For some clients, more formal educational training will be required for re-entry into the workforce. For others the use of previously developed work skills and habits can be transferred to new or related occupations. Although successful work vocational outcomes require the contribution of a number of health and education professionals, the occupational therapists have a unique contribution and role to play in work-related therapy and vocational rehabilitation.

Neural Plastic Effects of Working Memory Training Influenced by Self-perceived Stress in Stroke: A Case Illustration

This case study examined the effects of auditory working memory (WM) training on neuroplastic changes in stroke survivors and how such effects might be influenced by self-perceived stress. Two participants with a history of stroke participated in the study. One of them had a higher level of self-perceived stress. Both participants underwent a course of auditory WM training and completed baseline and post-training assessments such as self-perceived stress, performance satisfaction questionnaires, behavioral task performance, and functional magnetic resonance imaging. They were trained on a computerized auditory WM task (n-back) 5 days a week for 6 weeks, for a total of 20 h. Participant 1 had high levels of perceived stress, both pre- and post-training, and showed improvement on the satisfaction aspect of functional engagement only. Participant 2 had lower levels of perceived stress and demonstrated improvements on all performance tasks. Neuroimaging results showed evidence of improved neural efficiency on the trained task for participant 2. The results shed light on the need to evaluate psychological influences, e.g., stress, when studying the neuroplastic changes in people with stroke. However, the case design approach and other factors that might have positively influenced outcomes mean that these results must be interpreted with a great deal of caution. Future studies using a larger sample are recommended to verify the findings.

Elements for developing community-based interventions for adults with fetal alcohol spectrum disorder: A scoping review:

Introduction Current literature about interventions for adults with fetal alcohol spectrum disorder (FASD) is limited, which is a concern, due to the high prevalence of FASD. FASD creates lifelong physical, mental, cognitive and behavioral deficits, which impacts many aspects of daily living. Community-based interventions are necessary to better support adults with FASD and provide them with the opportunity to achieve success in their daily lives and social participation. This scoping review aimed to identify elements for developing successful community-based interventions for these individuals. Method A search was conducted in the MEDLINE, PsycINFO, CINAHL, and EMBASE databases and supplementary gray literature was resourced. Articles were selected based on inclusion–exclusion criteria, and a thematic analysis was completed to identify and present relevant findings. Results Seven articles met selection criteria and were included in this review. Six emerging themes were identified: inclusion of a functional context, individualized support, education for service providers, structure and routine, utilizing a strengths-based approach, and environmental adaptations. These themes were used to present the findings related to the elements necessary for developing interventions for adults with FASD. Conclusion The results indicate that the identified elements may be necessary to develop successful interventions, especially community-based interventions, for adults with FASD.

Educational Standards and Entry Level Considerations

Quality assurance is usually associated with the provision of service. It can equally be applied to the process of preparing the service provider. From this latter viewpoint, the Canadian Association of Occupational Therapists (C.A.O.T.) has been involved in developing quality assurance measures. To assure competence requires that the knowledge, skills and attributes, along with the content of the professions domain, be adequately described and that potential members, primarily new graduates, are able to demonstrate these competencies to a specified level. Professions concerned with the delivery of health care are constantly striving to meet these requirements (Laduca, Taylor, & Hill, 1984; Hinojosa, 1985). To be competent ultimately means that the individual can function safely, efficiently and effectively in practice.

Trends in Lower Limb Splinting by Canadian Occupational and Physical Therapists

This article highlights the results of a survey which examined the distribution of lower limb splinting practices in selected occupational and physical therapy departments located in the same hospital, in January, 1977. The responses yielded information on 72 (84%) of the 86 hospitals surveyed. The compiled data, therefore, provided a good indication of the distribution of the splinting practices for the two groups in question and represented a comprehensive collection of lower extremity splinting techniques by these professions. The survey indicated that: Both the occupational and physical therapy departments were involved in lower limb splinting; the former group, however, was more than twice as active as the latter. Occupational therapists were using low temperature thermoplastics almost exclusively, whereas physical therapists preferred plaster of paris. Many new techniques have been developed but few have been documented in occupational and physical therapy journals. The implications of the study are that occupational therapists should make a greater effort to share current and newly-developed techniques through publications and should strive to maximize the quality and performance of their splints.