Outcome measures in assertive outreach : one team\u27s journey towards a system of implementation

The article describes a team\u27s efforts to develop a workable system of outcome measures as a means of supporting good practice and fostering meaningful therapeutic relationships with clients. The team identified their reasons for using outcome measures. Then, they considered what they wanted to measure. The Health of the Nation Outcome Scale was identified as the only compulsory outcome measure. Throughout the process, team members often expressed the need for the system to be workable.<br /

Does universal design education impact on the attitudes of architecture students towards people with a disability?

The impact of the built environment on the participation and engagement of all people in the community is now widely recognized. The principles of universal design originated from the field of industrial design and architecture, as a design foundation for more useable products and environments. The aim of this study was to investigate the attitudes of architecture students towards people with a disability, comparing those who received inter-professional universal design education with those who had not. A sample of 147 Australian undergraduate architecture students (response rate 39.7%) completed the Interaction with Disabled Persons Scale (IDP). Quantitative descriptive analysis of their scores was undertaken, along with inductive analysis (Mann-Whitney U tests and ANCOVA). Architecture students who had previously participated in inter-professional universal design education had significantly less negative attitudes on two items of the IDP &ndash; &lsquo;I wonder how I would feel if I had this disability&rsquo; and &lsquo;I am grateful that I do not have such a burden&rsquo;. They also expressed significantly less fear towards people with a disability, as measured by that factor on the IDP. This study suggests education around universal design may promote more positive attitudes towards people with a disability for architecture students, but further research is required to gain a comprehensive understanding of this topic. This study also raises the issue of the need for the development of more contemporary attitudinal scales in relation to disability and impairment

Clinical Leadership and Management Perceptions of Inpatients with Obesity: An Interpretative Phenomenological Analysis

While obesity is recognized as a key global public health issue, there has been no research to date on the perceptions of care for people with this condition held by individuals in positions of organizational power. The aim of this study was therefore to describe the perceptions and experiences of clinical leaders and managers of providing care to inpatients with obesity at a metropolitan public health service. This study applied an interpretative phenomenological analysis (IPA) approach to qualitative research, conducting interviews with 17 participants. Their perceptions of care for inpatients with obesity encompassed both their personal understanding as an individual, and their observations about the organizational, patient and carer perspectives. Three overall themes were identified: (1) the problem of inpatients with obesity, (2) inpatients with obesity as sources of risk and (3) personal and professional perceptions of inpatients with obesity. While clinical leaders and managers were aware of the potential impact of stigma and weight bias on care given to this cohort, elements of implicit bias, stereotyping, &ldquo;othering&rdquo; and ambivalence were frequently present in the data. Ongoing efforts to improve care for patients with obesity must therefore include efforts to address perceptions and attitudes at all organisational levels of the workforce

Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness

Background: The term &lsquo;life limiting conditions&rsquo; refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition. Methods: A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for 2 years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. Results: One hundred three occupational therapists responded (n&thinsp;=&thinsp;55 pre, n&thinsp;=&thinsp;48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. Conclusions: The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group

Inclusive pedagogy in Australian universities: a review of current policies and professional development activities

This article reports on activities undertaken by Australian universities to support academic staff to provide inclusive teaching. The findings of two lines of inquiry are reported - a desktop audit of the presence of inclusive teaching or universal design for learning (UDL) in publically available policies and procedures documents, and a survey of the methods adopted to build staff capacity to provide inclusive teaching and learning. Just over a third (34.21%) of Australian universities referred to inclusive teaching or UDL in their policies and procedures. A wide range of current practices in professional development for inclusive teaching was reported, with the most frequent being one-off workshops focussing on accommodating specific groups of students. Improved institutional support through policies, procedures and professional development would enable Australian higher education teachers to provide quality inclusive teaching to all students

Dynamic and diverse ways of knowing in mental health occupational therapy

This study focused on evidence based practice in mental health occupational therapy. It investigated the theoretical, evidentiary and practical knowledge that occupational therapists use to support consumers and understand the relationship between occupation and health

Evidence based guidelines to improve engagement and participation for people experiencing depression

Background:Depression can have a strongly negative impact on a person&rsquo;s ability to engage with and participate in activities of daily living. Clinicians currently seeking guidance on best practice in this area currently need to access and critique a wide range of evidence from a number of disciplines. While some clinical practice guidelines are available, this form of evidence presentation presents several barriers to implementation.Procedures:This article proposes a new procedure for developing guidance for clinicians, known as evidence based guidelines. The purpose of the guidelines presented here is to provide guidance on appropriate assessment and intervention strategies with people experiencing depression, who wish to improve their engagement and participation in daily activities. They were constructed using a multiple methods procedure, with five phases.Results:Evidence based guidelines for the general population, older adults and people with co-morbid physical conditions are presented at the conclusion of this article.Conclusion:The procedure described here produces evidence based guidelines with built in measures to promote implementation into practice. The resulting guidelines for depression will enable clinicians from all disciplines to engage in best practice, and assist people with depression participate more fully in their lives

Promoting participation through the universal design of built environments: making it happen

Environmental design is a determinant of social inclusion and people&rsquo;s participation in life roles. Design that does not cater for a diverse range of ages, abilities and cultures restricts people&rsquo;s access to, and use of, domestic or public premises. Universal design is an approach that acknowledges diversity of populations and encourages designers to create objects and places that are usable by the greatest majority of users. Although there are potential benefits to the widest application of universal design within society, such application is not mandatory within Australia. This paper presents findings from an Australian qualitative study that explored universal design as a means of facilitating greater environmental access for all. The views of experts working within the field of architecture and environmental access were explored regarding factors that restrict or facilitate application of universal design to the design of built environments. Study findings revealed a number of themes relating to factors that may restrain, &lsquo;what&rsquo;s holding us back?&rsquo; and factors that may facilitate application of universal design, &lsquo;making it happen&rsquo;. These findings have direct relevance to those involved in the planning and design of built environments, policy developers and educators

Readiness for interprofessional learning : a cross-faculty comparison between architecture and occupational therapy students

Health and wellbeing includes a need for built environments to accommodate and be inclusive of the broadest range of people and a corresponding need to ensure graduates are ready to engage in this field of interprofessional and inter-industry practise. All too often, interprofessional education in higher education is neglected with a tendency towards educational silos, particularly at a cross-faculty level. This paper reports on an initiative that embedded universal design practice education into the curricula of first year architecture and third year occupational therapy students and evaluated the impact on students&rsquo; readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) was given to students at the beginning and end of the semester during which students participated in a variety of online and face-to-face curriculum initiatives. Results showed that at the beginning of semester, occupational therapy students were significantly more positive about interprofessional learning than their architecture counterparts. Post-results showed that this trend continued but that occupational therapy students became less positive on some items after the interprofessional learning experience. This study provides insights into the interprofessional learning experiences of a group of students who have not previously been studied within the available literature

Connections, Communication and Collaboration in Healthcare’s Complex Adaptive Systems Comment on “Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation”

Abstract A more sophisticated understanding of the unpredictable, disorderly and unstable aspects of healthcare organisations is developing in the knowledge translation (KT) literature. In an article published in this journal, Kitson et al introduced a new model for KT in healthcare based on complexity theory. The Knowledge Translation Complexity Network Model (KTCNM) provides a fresh perspective by making the complexity inherent in complex systems overt. The model encourages a whole system view and focuses on the interdependent relationships between actions, interactions and actors. Taking a systems approach assists our understanding of the connections, communication and collaboration necessary to promote knowledge mobilisation and facilitate the adoption of change. With further development, this could enable the targeting of more effective strategies across the various stakeholders and levels of service, fostering redesign and innovation