Mary Tremblay

Going Back to Civvy Street: A historical account of the impact of the Everest and Jennings wheelchair for Canadian World War II veterans with spinal cord injury

In February 1945, the Canadian government agreed to provide the Everest and Jennings folding, self-propelled wheelchair to all World War II veterans with spinal cord injury. These wheelchairs replaced wooden and wicker invalid wheelchairs that were usually assigned to hospital wards rather than to individuals. Veterans with spinal cord injury were among the first group of Canadians to use these wheelchairs to participate in community life. By 1947, Canadian veterans had demonstrated that it was possible to return to education, employment and leisure activities using a wheelchair. Drawing on oral history interviews and archival research, this paper provides an account of the introduction of folding, self-propelled wheelchairs into Canada following World War II. It discusses the impact of these wheelchairs on the life experiences of veterans, and outlines the strategies used by these early pioneers to live and work in communities that had neither expected nor planned for individuals using wheelchairs.

Problem-based learning in occupational therapy: why do health professionals choose to tutor?

For over 20 years the occupational therapy programmes offered by McMaster University and Mohawk College, Hamilton, Ontario have used small-group, problem-based learning tutorials as a major component of their curriculum. These programmes were among the first occupational therapy programmes in the world to use a problem-based tutorial format. The inclusion as tutors of both full-time faculty and clinicians, from all clinical practice areas, was central to the design of the problem-based learning courses. A survey of all tutors from the last 20 years collected information about why health professionals are motivated to tutor and what they see as challenges to maintaining this educational role. Three primary themes emerged from the data: being an educator; being a learner and present and future challenges to continuing with the tutoring role. Within the educator theme there was a secondary theme of professional duty or obligation. In addition, the participants identified suggestions for enhanced support and continuing education for tutors. This article summarizes the findings of the survey.

Advocacy in Occupational Therapy: Exploring Clinicians' Reasons and Experiences of Advocacy

Background. Occupational therapy literature encourages therapists to advocate, yet any member of the team could advocate with/for people with disabilities. There is a need to determine why occupational therapists provide these services and how they learn to advocate. Purpose. The objective of this article is to understand the meaning of advocacy for occupational therapists by exploring their reasons for advocating. Methods. Interpretive phenomenology and the social model of disability were used to interview 13 occupational therapists about their advocacy experiences. Data analysis was completed using a Gadamerian-based approach. Findings. Occupational therapists advocate for a number of reasons; some relate to themselves, some relate to clients, and others relate to both. Learning about advocacy may be understood as taking place on a continuum of time. Implications. The occupational therapists unique reason for advocating is to facilitate the clients occupational performance. A new definition of advocacy is presented based on study findings.

AGING WITH A PREEXISTING DISABILITY: DEVELOPING A BIBLIOGRAPHY AND CURRICULUM GUIDE FOR HEALTH AND SOCIAL SCIENCE EDUCATORS

One of the most exciting and challenging aspects of aging in Canada is the increasing numbers of individuals with preexisting disabilities surviving into old age. Many of these individuals are among the first generation of people with disabilities to survive and experience aging with a disability. As a response to this challenge, a multidisciplinary, interuniversity group of faculty in Ontario prepared a computerized bibliographic database and curriculum guide on aging with a preexisting disability. One aspect of the project was a survey of health and social science educators in Ontario. This article presents a summary of the faculty survey results, describes the current bibliography and database, and provides an overview of the four learning units designed to accompany the bibliography.

The Once and Future Programme: Educational Innovation in Occupational Therapy

During the late 1960s and early 1970s while the Canadian Association of Occupational Therapists was wrestling with issues of educational standards, Mohawk College in Hamilton, Ontario was developing two diploma programmes in occupational therapy and physiotherapy with input from McMaster University Faculty of Health Sciences. This article reviews the development of the Mohawk College Diploma Programme in Occupational Therapy and focuses on several unique features of the curriculum which proved to be the strengths of the programme. These features, problem-based small group learning, strong partnerships with the clinical community and non-traditional fieldwork placements, formed a strong base for the subsequent development of the degree completion programme at McMaster and the new second degree undergraduate (BHSc.OT.) programme in Occupational Therapy. The reference to “The Once and Future Programme” emphasizes the fact that the new undergraduate programme in Occupational Therapy at McMaster University has successfully built upon the strengths of the earlier Mohawk College Diploma Programme.

The implications of chronic pain models for rehabilitation of distal radius fracture

Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned helplessness and cognitive-behavioural models of chronic pain in assessing the psychosocial risk profile of patients following DRF. We have also integrated key findings derived from studies addressing personal and life-style factors in assessing this risk profile. This framework is proposed as a basis to categorize patients as higher or lower psychosocial risk for developing chronic pain and disability following DRF. We outline a model depicting the RACE approach (Reducing pain, Activating, Cognitive reshaping, Empowering) towards the management of patients following DRF. The model suggests that patients with minimal psychosocial risk factors are managed based on their injury profile and those with higher psychosocial risk are treated with the risk-based RACE approach. Using a biopsychosocial RACE approach to prognosis and treatment, hand therapy intervention can be customized for patients recovering from DRF. In future, researchers can conduct clinical trials to compare the RACE-based treatment approach to routine hand therapy in mitigating the risk of chronic pain and disability in patients with elevated risk profile for adverse outcomes following DRF.

Occupational Responses to Mid‐life and Aging in Women with Disabilities

Abstract Our understanding of occupational responses across the life course is in its infancy. The occupational responses of women in mid‐life and aging have received little attention. The focus of this paper is on the occupational responses to mid‐and later life of a particularly neglected group of women: those with disabilities. For women in the general population, mid and later life are characterized by a host of intrinsic changes (physical and psychological) along with extrinsic or environmental changes (children leaving home, divorce, socio‐cultural expectations, aging parents). These changes have the potential to impact occupational behaviour. Women with disabilities have spent a lifetime orchestrating themselves and their environments to enable meaningful and satisfying occupational engagement. There is a need to understand how they adapt with age and to identify the resources and barriers to their continued occupational participation through mid and later life. Using focus groups and telephone interviews of 29 women with spinal cord injury (age range 35–70, mean age 50 years), this study reports on four aspects of the womens experiences: personal mid‐life factors and triggers to occupational change, adaptive occupational responses, implications of the occupational adaptations, and critical resources for occupational adaptation in mid‐life. The findings suggest that the women are dealing simultaneously with issues of the disability, mid‐life, and later life. As a result they feel they have little in common with other groups of women. Age‐related changes mean they have to relinquish valued roles and occupations, they feel isolated and misunderstood, and they share profound fears of future losses in personal control and occupational engagement.