Internalizing Client-Centredness in Occupational Therapy Students

Background: Pre-licensure interprofessional education prepares students for collaborative client-centred practice. However, most interprofessional educational efforts are aimed at developing the collaborative component of practice. The purpose of this article is to share the findings of a study that explored occupational therapy students’ client-centred development, in order to inform other pre-licensure educators about integrating client-centredness into uni- and interprofessional education contexts.Methods and Findings: Twenty-nine participants were recruited from each of three stages assumed to be representative of occupational therapy client-centred development in each of the two years of the educational program and during the first year of practice. Semi-structured focus groups were used to capture the participants’ experiences. The core emergent theme, internalizing client-centredness, included three main processes: identifying occupational therapy as a client-centred profession, engaging in the push and pull of client-centredness, and defining self as a client-centred practitioner.Conclusions: Educators of pre-licensure health care students should deliberately focus on client-centredness in their uni- and interprofessional education curricula; the authors offer examples of curricular opportunities focused on internalizing client-centredness. Enabling health care students to internalize client-centredness may be an important aspect of developing practitioners who are prepared to enact interprofessional collaboration for client-centred practice

A framework of strategies for client-centred practice

Implementing strategies to overcome barriers to client-centred practice is a challenge encountered by many occupational therapists in their daily practice. The Client-centred Strategies Framework is proposed as a tool to assist occupational therapists to consider barriers and implement strategies from a variety of perspectives. Description. The framework consists of five categories: personal reflection, client-centred processes, practice settings, community organizing, and coalition advocacy and political action. Within each category are a number of actions that can be taken to facilitate client-centred practice. This paper describes the framework with elaboration of each of the five categories. A case example is used to illustrate how a therapist can use the framework to address client-centred practice issues. Practice Implications. This framework will assist therapists and students to problem-solve ways to enhance the use of client-centred processes within their own practice environments

JourneyCam: Exploring Experiences of Accessibility and Mobility among Powered Wheelchair Users through Video and Data

Recent HCI research has investigated how digital technologies might enable citizens to identify and express matters of civic concern. We extend this work by describing JourneyCam, a smartphone-based system that enables powered wheelchair users to capture video and sensor data about their experiences of mobility. Thirteen participants used JourneyCam to document journeys, after which the data they collected was used to support discussions around their experiences. Our findings highlight how the system facilitated the articulation of complex embodied experiences, and how the collected data might have particular value in surfacing these experiences to help inform urban design and policymaking. Participants valued the ways in which JourneyCam’s moving image and sensor data made hard-to-express sensations apparent, as well as how it enabled them to surface previously unrecognised issues. We conclude by highlighting future opportunities for how such tools might enable citizens to inform and influence civic governance

Exploring fathers’ experiences of caring for a child with complex care needs through ethnography and arts-based methodologies

Abstract Background Although the number of children living with complex care needs (CCN) is increasing worldwide, there is limited data on the experience of fathers caring for children with CCN. This paper reports on findings specific to fathers’ experiences of caring for their child with CCN and highlights recommendations provided for parents of children with CCN, service providers, and policymakers. The findings emerged from a larger study designed to examine how Canadian families of children with CCN participate in society. Methods We used the qualitative research approach of ethnography and arts-based methodologies (ecomaps and photovoice) as well as purposive and snowball sampling techniques. Four parents were engaged as advisors and twenty-nine fathers participated in interviews (all were married or in a relationship; age range of 28 to 55 years). In line with an ethnographic approach, data analysis involved several iterative steps including comparing data from the first, second, and third set of interviews and refining themes. Results One overarching theme, striving to be there for the child with CCN, was identified. Five supporting themes further exemplified how fathers strived to be there for their child: 1) contributing to the parental team through various roles; 2) building accessibility through adaptation; 3) engaging in activities with the child; 4) expressing admiration and pride in their children; and 5) meaning making. Recommendations for parents included making and nurturing connections and asking for help while recommendations for healthcare and social service providers included communicating authentically with families and listening to parents. Fathers also indicated that leadership and funding for programs of families of children with CCN should be priorities for policymakers. Conclusions In addition to documenting fathers’ active involvement in their child’s care and development, our findings provide new insights into how fathers make participation in everyday life accessible and inclusive for their children. Study findings also point to 1) priority areas for policymakers (e.g., accessible physical environments); 2) factors that are critical for fostering collaborative care teams with fathers; and 3) the need for complex care teams in the adult health care system. Implications for those providing psychosocial support for these families are noted as well as knowledge gaps worthy of future exploration such as the role of diversity or intersectionality in fathering children with CCN

Reverse integration in wheelchair basketball: stakeholders’ understanding in elite and recreational sporting communities

Wheelchair basketball (WCBB) often includes reverse integration (RI), defined as the inclusion of athletes without impairment in a sport traditionally aimed at athletes with an impairment. This study explored how RI in WCBB was understood by internal stakeholders. Data were gathered from athletes, coaches, and administrators at an Australian club competition and at a Canadian elite training center. Analysis of semistructured interviews with 29 participants led to the identification of eight themes. Collectively, the findings showed that RI was embedded within WCBB, RI was considered to be a way to advance the growth and improve the quality of WCBB as well as a way to increase awareness of WCBB and disability. There were some concerns that RI may not be equitable, as WCBB is a “disability sport.” Stakeholders’ perspectives on RI could provide useful information for sport policymakers, managers, administrators, sports organizations, and athletes interested in further developing WCBB

Patterns of community participation across the seasons: A year-long case study of three Canadian wheelchair users

<p><b>Purpose:</b> The aim of this study was to explore the patterns of wheelchair users’ community participation across a one-year period, including periods with substantial differences in weather conditions. We sought to develop a detailed understanding of the patterns of, and influences on, wheelchair use and participation within wheelchair users’ own communities.</p> <p><b>Method:</b> We conducted an instrumental case study of three purposefully selected individuals who use a wheelchair. Participants’ wheelchairs were instrumented with a GPS data logger and data were collected for one week per month across a year. A prompted recall interview was conducted with participants each month, in order to gain an understanding of the influences on their community participation patterns.</p> <p><b>Results:</b> For each participant, the percent of trips taken at various trip distance ranges and the mean trips/days and overall distance traveled at or above 0 °C and below 0 °C are reported. Three distinct patterns were identified in response to variations in weather conditions: (1) season and transportation options are linked: winter limits community participation; (2) winter conditions are surmountable: with the right supports year-round participation is maintained; and (3) pre-planning is the key: winter conditions affects ease, choices and options but not overall participation.</p> <p><b>Conclusions:</b> While winter weather conditions created community participation challenges, individuals responded differently based on their unique circumstances. The findings highlight the importance of policy that addresses the dynamic nature of weather and the needs of people with disabilities as specific individuals.Implications for rehabilitation</p><p>Wheelchair users experience both similar and unique challenges regarding seasonal weather conditions that influence their community participation patterns.</p><p>While some individual wheelchair users effectively maintain their community participation patterns across the year, they employ their own specific strategies in response to winter weather challenges.</p><p>Ready access to vehicular transportation that is accessible regardless of weather condition is a key factor in promoting community participation across the year for wheelchair users.</p><p>Accessible community environments can become inaccessible with the addition of winter weather conditions and thus the changing nature of community participation across the seasons should be considered.</p><p></p> <p>Wheelchair users experience both similar and unique challenges regarding seasonal weather conditions that influence their community participation patterns.</p> <p>While some individual wheelchair users effectively maintain their community participation patterns across the year, they employ their own specific strategies in response to winter weather challenges.</p> <p>Ready access to vehicular transportation that is accessible regardless of weather condition is a key factor in promoting community participation across the year for wheelchair users.</p> <p>Accessible community environments can become inaccessible with the addition of winter weather conditions and thus the changing nature of community participation across the seasons should be considered.</p