Ingrid Provident

The Benefits of and Challenges to the Use of Occupation in Hand Therapy

ABSTRACT This mixed methods survey examines the perceptions of occupational therapists working in hand therapy in the United States regarding the benefits of and barriers to occupation-based hand therapy. Electronic questionnaires containing open- and closed-ended questions were answered by 105 occupational therapists working in hand therapy and analyzed using descriptive statistics and qualitatively according to themes. Participants reported that occupation-based interventions benefit clients by facilitating functional activity, meaningful therapeutic experiences, and holistic approach to treatment. Reported barriers to occupation-based interventions include logistic issues, reimbursement issues, the limitations imposed by the clients medical condition or the treatment protocol, and credibility of occupation-based interventions. Overcoming the challenges to occupation-based practice in hand therapy requires research in the efficiacy of occupation-based hand therapy and education of the public as well as health professionals and occupational therapists working in hand therapy.

School-based pediatric physical therapists' perspectives on evidence-based practice.

Purpose: This study described the current knowledge, beliefs, attitudes, and practices of a group of school-based pediatric physical therapists regarding evidence-based practice (EBP). Methods: Five practitioners participated in this project. Each was interviewed individually and in a group and completed a quantitative survey. Results: All of the participants had a positive attitude toward EBP and believed that it should be an important element of clinical practice. Knowledge and practice were more variable, with several individuals reporting a lack of confidence in this area and an inability to routinely implement EBP. Conclusions: These participants were more likely to rely on colleagues, interaction with their supervisor, and professional experience to aid in decision making than research evidence. Pediatric physical therapists face numerous challenges accessing, analyzing, and applying research evidence. It is critical for the profession to identify optimal ways to support practitioners in this aspect of clinical practice.

A phenomenology of occupation-based hand therapy

BACKGROUND/AIM The existing tension between holistic, occupation focused approaches and the medical model in occupational therapy is most evident in the area of hand therapy. Occupation-based hand therapy has been proposed as a means to alleviate this tension. However, there is a lack of research on occupation-based hand therapy. Clearly describing and defining what constitutes occupation-based hand therapy can facilitate efficacy research and help promote occupation-based practice in keeping with the philosophy of the profession. METHODS The qualitative approach of phenomenology as described by Moustakas was used. Participants who were occupational therapists with more than 5 years of experience who self -identified as occupation-based practitioners were recruited to the point of saturation using criterion and chain sampling for a final total of 10 participants. Data were collected through audio recorded telephone interviews and electronic mail. The data were reduced and distilled into a description of the experience of providing occupation-based hand therapy. RESULTS Participants described the experience of providing occupation-based hand therapy around the concepts of influences, psychosocial benefits, procedural elements of practice and challenges. CONCLUSION Findings of this study can assist occupational therapists to develop a more occupation-based intervention program through focusing on occupation-based theory, being intentional, using occupation-focused interventions and building an occupation focused context. Findings can also inform future research into the efficacy of occupation-based hand therapy, appropriate timing for balancing occupation with tissue protection, and the effects of therapist experience on their ability to use an occupation-based approach in hand therapy.

An Experiential Learning Lab Embedded in a Didactic Course: Outcomes from a Pediatric Intervention Course

ABSTRACT This paper examines the outcomes of an experiential learning lab embedded in a didactic course. Program evaluation results were derived from student surveys and reflective journaling. The outcomes indicate that students valued the opportunity for experiential learning citing the primary benefits as the opportunity to, apply and manipulate knowledge, build clinical reasoning skills, and develop the professional skills to engage in and effectively manage an intervention session.

Evidence-based ergonomics education: Promoting risk factor awareness among office computer workers

BACKGROUND Work-related musculoskeletal disorders (WMSDs) related to computer work have become a serious public health concern. Literature revealed a positive association between computer use and WMSDs. OBJECTIVE The purpose of this evidence-based pilot project was to provide a series of evidence-based educational sessions on ergonomics to office computer workers to enhance the awareness of risk factors of WMSDs. METHODS Seventeen office computer workers who work for the National Board of Certification in Occupational Therapy volunteered for this project. Each participant completed a baseline and post-intervention ergonomics questionnaire and attended six educational sessions. The Rapid Office Strain Assessment and an ergonomics questionnaire were used for data collection. RESULTS The post-intervention data revealed that 89% of participants were able to identify a greater number of risk factors and answer more questions correctly in knowledge tests of the ergonomics questionnaire. Pre- and post-intervention comparisons showed changes in work posture and behaviors (taking rest breaks, participating in exercise, adjusting workstation) of participants. CONCLUSIONS The findings have implications for injury prevention in office settings and suggest that ergonomics education may yield positive knowledge and behavioral changes among computer workers.

Community Dwelling Elderly Women and Meal Preparation

ABSTRACT Maintaining instrumental activities of daily living independence is an important component of successful aging in place. Meal preparation is an essential occupation and aspect of self-identity for many women. The aim of this study was to learn which meal preparation occupations are perceived to have high activity demands, the source of these activity demands, and the coping strategies developed to mitigate the press of these activity demands. Eight community dwelling American women, 73 years old or more, participated in this study. Using the Canadian Occupational Performance Measure, each woman identified meal preparation occupations that were important to her but which she felt were performed unsatisfactorily. The author completed an activity analysis based on the Person-Environment-Occupation Model to validate each participants identified source of high activity demands. The results suggest that the activity demands are not solely due to a decline in functional capacity but also due to environmental barriers.

Educating for Community-Based Practice: A Collaborative Strategy

SUMMARY This paper describes creative instruction strategies that prepare students for community-based practice. These educational innovations are designed to prepare graduates to understand occupation-based service delivery in community settings, to develop community-built programs that are responsive to community needs, and to understand how to both secure funding for and market occupational therapy services in the community. The process and products of collaboration between instructors in an administration and a community-based practice course are described. Outcome data from students and community partners are presented. Strategies for successful community partnerships and recommendations for continued development of these educational approaches are presented based on these data.

Muscular dystrophy summer camp: a case study of a non-traditional level I fieldwork using a collaborative supervision model.

OBJECTIVE A shortage of traditional medical fieldwork placements has been reported in the United States. Alternative settings are being sought to meet the Accreditation Standards for Level I fieldwork. This study was designed to examine and report the outcomes of an alternative pediatric camp setting, using a group model of supervision to fulfill the requirements for Level I fieldwork. PARTICIPANTS Thirty-seven students from two Pennsylvania OT schools. METHODS Two cohorts of students were studied over a two year period using multiple methods of retrospective review and data collection. RESULTS Students supervised in a group model experienced positive outcomes, including opportunities to deliver client centered care, and understanding the role of caregiving for children with disabilities. CONCLUSION The use of a collaborative model of fieldwork education at a camp setting has resulted in a viable approach for the successful attainment of Level I fieldwork objectives for multiple students under a single supervisor.

Strengthening School-Based Occupational Therapy through Peer Mentoring.

ABSTRACT This article evaluates a peer mentoring experience for school-based practitioners and its effect on collaborative consultation practices. Best practice and public school policy promote the use of collaborative consultation services but school-based practitioners report significant barriers in achieving effective collaborative consultation practice. Contract therapists were recruited from three (geographic district) schools to participate in a 6-week peer mentoring experience, using technology and self-determined goals to improve competency. Pre- and post-project mixed methods measurements demonstrate that the experience improved perceived competency in eight areas, and that peer support, goal implementation, and the organized time frame supported new collaborative practices by participants.

Changing occupational therapists’ knowledge of their role in secondary transition planning

ABSTRACT Students with disabilities need to effectively transition to adult occupations after secondary school. Occupational therapists are uniquely qualified to support this transition to adulthood; however, school-based occupational therapists report a lack of understanding of their role in transition planning (Kardos & White, 2005; Mankey, 2011). The purpose of this mixed-method study was to explore the effectiveness of a six-module e-training intervention designed to teach school-based occupational therapists about their role in secondary transition planning. Participants completed pre/post tests and provided qualitative information via online discussion. Results suggest that online training modules are an effective continuing education intervention to improve occupational therapists’ knowledge of secondary transition.