Margaret Nicol

College of Occupational Therapists: Research and Development Strategy

The role of research in occupational therapy has been widely debated over the last two years within the profession. The outcome has been the production, by the Research and Development Committee, of the Research and Development Strategy for the College of Occupational Therapists. The strategy addresses how the College of Occupational Therapists can help to support occupational therapists as research consumers, as participants in research and as proactive researchers.

Systematic review: Evidence of the value of continuing professional development to enhance recruitment and retention of occupational therapists in mental health.

Occupational therapy in mental health is changing as a result of service developments. The College of Occupational Therapists reported these changes and their impact for occupational therapists in the Mental Health Project (Craik et al 1998b). This report suggested that there were problems in recruitment and retention in the field of mental health. Background reading for this article highlighted that a variety of factors is influential for an occupational therapist to enter, remain in or leave a post. One factor identified to assist recruitment and retention was the influence of continuing professional development. A comprehensive literature search was carried out to identify the evidence regarding the influence of continuing professional development in enhancing recruitment and retention. A protocol was developed to search for published research and evaluations specific to state-registered occupational therapists from a range of clinical specialties. Thirteen articles were cited and these are systematically reviewed with key findings documented. The review identified that there was little evidence for the influence of continuing professional development on staff recruitment and retention and that no study had set out to explore the relationship between the two in isolation. What evidence was available suggests that recruitment and retention are influenced by a combination of personal and professional factors. In concluding, the findings outline the implications for research and practice.

FACTORS THAT CONSTITUTE A GOOD COGNITIVE BEHAVIOURAL TREATMENT MANUAL: A DELPHI STUDY

Cognitive behavioural treatment manuals have increased in frequency, purpose and impact over the last 40 years. Despite numerous papers on the topic, few empirical studies regarding the constitution of treatment manuals have been conducted. A Delphi study examining the factors that constitute a good cognitive behavioural treatment manual is presented. This study generated a consensus of opinion of factors that therapists and researchers should consider when developing and appraising treatment manuals for cognitive behavioural interventions. Limitations of the study and the potential relevance of the research are discussed.

Subtle Realism and Occupational Therapy: an Alternative Approach to Knowledge Generation and Evaluation

Occupational therapists are increasingly engaging in research. As this occurs, important and challenging questions are being asked about the most appropriate research approaches to use. Strongly held perspectives of what best constitutes evidence often conflict with influential hierarchies of research. The British Journal of Occupational Therapy has, in recent years, published a variety of papers and letters that have presented and defended effectively the differing perspectives of research approaches. Each of these has presented challenges to occupational therapy research. This opinion piece supports a combinist approach to research. It presents and defends such an approach from a subtle realist perspective.

A Systematic Review of the Evidence for the Value of Functional Assessment of Older People with Dementia

There exists concern within the occupational therapy profession to demonstrate the efficacy of treatment through evidence-based practice (Bannigan 1997, Lloyd-Smith 1997, Taylor 1997). This is in keeping with other health care professionals who, equally, are addressing this issue (Muir Gray 1997). The clinical experience of the authors of this article suggests that occupational therapists are in a significant and powerful position when making decisions about the ability of someone with dementia to return to his or her own home. It is often the observations from a predischarge home assessment that are the determining factors for the discharge decision. A systematic review of the current available evidence was carried out. This review highlighted that there was remarkably little evidence from the current occupational therapy literature in relation to people with dementia either to support or to refute the home assessment visit as the optimum method of assessing their ability to return home. The review demonstrated the need to undertake further evaluation and research into this key occupational therapy activity.

Book Review: Occupational Therapy: Perspectives and ProcessesOCCUPATIONAL THERAPY: PERSPECTIVES AND PROCESSES. HagedornRosemary, 1st ed. Churchill Livingstone1995. 327 pp. £16.00. ISBN 0 443 04978 5.

and these need to be addressed before objectives are set. An evaluation of the research methodology was undertaken but is too lengthy to include here, except for a summary. A quasi-experimental design is limiting because of the lack of control and threats to internal validity. However, some were minimised with foresight and others can be improved with hindsight. The advantages of external validity are encouraging. Despite some of the issues neglected in the study, conclusions are still possible on the benefits of preoperative education, in terms of preparation, length of hospitalisation and financial savings for the implementing organisation.

Book Review: Willard & Spackman's Occupational TherapyWILLARD & SPACKMAN'S OCCUPATIONAL THERAPY. HopkinsHL, SmithHD. 6th ed.JB Lippincott Company1983. £30.00. ISBN 0 397 54361 1.

The foot complications are due to a variety of causes predisposing factors such as vascular disease, neuropathy and decreased resistance to infection and precipitating factors such as physical injury. This concept of predisposing and precipitating factors is stressed, for while the vascular disease and neuropathy generally cannot be reversed (although their development may be delayed) the precipitating factors may be regarded as being preventable. This preventative approach is strongly emphasised by Mr Faris throughout the book and will be of particular interest to occupational therapists.