Heidi Lauckner

Patients as educators: the challenges and benefits of sharing experiences with students

Medical Education 2012: 46: 992–1000

Exploring Canadian occupational therapists' understanding of and experiences in community development.

Background. Occupational therapists are increasingly recognizing the importance of working with communities as a way to enhance health and well-being. Such work can occur through community development, a community-driven process in which communities are supported in identifying and addressing their health priorities. Purpose. This paper presents the qualitative findings of a study that explored the experiences of occupational therapists in Canada working in community development including how they understand community development and how they designed their role in this field. Methods. Occupational therapists working in community development shared their experiences and understanding of community development during 12 interviews. Results. The results of this study describe the iterative, reflexive process occupational therapists have undergone in coming to establish their role in this field. Implications. Recommendations are made regarding the preparation of future occupational therapists and for supporting those currently working in this field.

Conceptualizing Community Development: Occupational Therapy Practice at the Intersection of Health Services and Community:

Background. Despite occupational therapys theoretical commitment to community development (CD) approaches, current practice models focus on individual interventions rather than community issues. Purpose. This research examined three cases of Canadian occupational therapists working in CD to conceptualize CD from an occupational therapy perspective. Method. Data collection occurred over 12–14 days at each site and included observations, document reviews, and interviews with 14 colleagues and program participants. Constructivist grounded theory informed data analysis. Findings. A conceptual framework was developed that describes the contextual background to CD initiatives and the strategies used: nurturing community partnerships, building community capacity, influencing health services, and linking sectors. Underlying these strategies was the strategic use of self, which allowed the sharing of power and legitimacy to create opportunities for meaningful occupational engagement. Implications. The conceptual framework helps articulate CDs underlying processes and can be used to understand and guide practice.

The Dalhousie Health Mentors Program: Introducing students to collaborative patient/client-centered practice

The Dalhousie Health Mentors Program builds on a long history of interprofessional health education initiatives by introducing students in health and social care professions to chronic conditions and disabilities, patient/client-centredness, interprofessional learning, and team functioning. This large interprofessional education program (16 participating programs, 650 students) connects interprofessional student teams with Health Mentors, who are adult volunteers with chronic conditions, for a learning experience that extends over one academic year. Students explore their mentors life story and chronic condition journey, the impact the condition has had on her/his life, and her/his experience with health care in general and interprofessional collaboration in particular. All aspects of the program planning, management, implementation, and evaluation have been interprofessional in nature. Lessons have been learned regarding

The Benefits of Recreation for the Recovery and Social Inclusion of Individuals with Mental Illness: An Integrative Review

Abstract Previous research has shown the physical health benefits of physical activity for individuals with mental health challenges to their recovery, including reduced symptoms, weight reduction, and improved cardiovascular health. The focus of this previous research has excluded an exploration of the benefits of all types of recreation (including physical activity, creative pursuits, and social recreation) and the possibility of these benefits supporting broader recovery goals, including social inclusion. Through an integrative review and critical appraisal of existing literature, we outline the benefits, barriers to participation, and characteristics of successful programs of a range of community-based recreation. Results included 35 papers and indicate that physical, social and creative community recreation can contribute to the recovery and social inclusion of individuals with mental health challenges. Additionally, inclusive recreation environments set the stage for cultivating friendships if staff is properly trained on supporting camaraderie among participants and facilitating communication with groups they lead.

The QATSDD critical appraisal tool: comments and critiques

RATIONALE, AIMS AND OBJECTIVES The aim of this research note is to reflect on the effectiveness of the QATSDD tool for its intended use in critical appraisals of synthesis work such as integrative reviews. METHODS A seven-member research team undertook a critical appraisal of qualitative and quantitative studies using the QATSDD. RESULTS AND CONCLUSION We believe that the tool can spur useful dialogue among researchers and increase in-depth understanding of reviewed papers, including the strengths and limitations of the literature. To increase the clarity of the process, we suggest further definition of the language in each indicator and inclusion of explicit examples for each criterion. We would also like to see the authors outline clear parameters around the use of the tool, essentially stating that the tool should be used in synthesis work for studies of mixed methods or work that includes qualitative and quantitative research informed by a positivist paradigm. In the context of an appropriate team composition, the tool can be a useful mechanism for guiding people who are coming together to discuss the merits of studies across multiple methodologies and disciplines.

Improving quality of care in nursing homes: What works?

See related research article by Boorsma and colleagues at [www.cmaj.ca/lookup/doi/10.1503/cmaj.101498][1] and synopsis on page 1262. The research of Boorsma and colleagues,[1][2] published in this issue of CMAJ , is notable for framing its approach to intervention in a multidisciplinary chronic

Linking recreation and health with people living with chronic conditions

ABSTRACT Globally, non-communicable chronic diseases are a leading health problem. Heart disease and stroke are the primary causes of death worldwide, followed by respiratory-related diseases such as chronic obstructive lung disease. Self-management is a strategy that helps individuals learn how to live well with their health conditions. For self-management to be effective, a strong network of agencies and stakeholders who can provide necessary education and supports must be developed and sustained. Recreation and community services are well positioned to link individuals with chronic conditions with health services and create a more holistic health network. The Expanded Chronic Care Model frames this project as it draws on population health promotion principles that acknowledge the influence of social and environmental determinants of health while emphasizing the importance of creating supportive community environments for health. This paper reports on a community-based participatory research project in a rural area of Nova Scotia Canada, aimed at identifying community-based approaches to support people with chronic conditions to live well in their community. The findings include themes related to community assets, barriers to participation in recreation, and action for moving forward collaboratively. Implications for managers in the recreation and health sectors are offered.

“Removing the thorns”: the role of the arts in recovery for people with mental health challenges

Abstract Background: While the arts have long been associated with mental health, the role of self-directed arts participation in recovery has not been fully explored. Methods: We explored the question: From the perspectives of people living with mental health challenges, how does participation in and exhibiting or performing one’s art impact recovery? Six individual interviews and 19 narratives by artists with mental health challenges associated with an arts exhibit were analyzed using inductive thematic analysis. Results: The data are described by the themes providing structure and continuity, (re)creating our personal stories and building community. Novel findings include ongoing engagement in the arts as providing continuity during turbulent times. The role of the arts in advocacy on mental health was highlighted. Conclusion: While artists sometimes perceived paternalism in audience members, the arts provided a powerful means of communicating about mental illness, countering stigma and challenging dominant ways of conceptualizing mental illness.

Building sustainable fieldwork partnerships between Canada and India: Finding common goals through evaluation

ABSTRACT Initiatives in education and research have taken centre stage to address global health issues. Fieldwork learning in a global context is seen as one strategy to expose students to global health challenges and to collaborate towards viable solutions. Because of the inequities that exist globally, ethical dilemmas can be encountered throughout partnership development and require thoughtful consideration regarding the demands placed on partners in low resourced settings and issues of sustainability. A programme evaluation using the WEIGHT guidelines as a framework for critical reflection discusses the partnership development and future of one collaborative multi-stakeholder programme between Canadian occupational therapy programmes, an Indian partner and a Canadian charity. Collegiality, mentorship and an overall perspective of meeting the WEIGHT guidelines were evident from the reflections. Important considerations of programme equity as it relates to cost, communication and feedback needs, resource gaps and sponsor related issues emerged as areas of future priority.