Development and evaluation of an early specialised traumatic brain injury vocational rehabilitation training package

Background: In a feasibility randomised controlled trial, training was developed to equip Occupational Therapists to deliver Early Specialised Traumatic Brain Injury Vocational Rehabilitation in the English National Health Service. Methods: The package was developed by "experts" in vocational rehabilitation and traumatic brain injury and included a manual, direct instruction by six trainers and opportunity for mentorship by four therapists. Following training, therapists were interviewed regarding the effectiveness and "ease of use" of the package. Interviews were analysed using the framework approach. Results: Five trained therapists were interviewed regarding the package. Results were organised into 6 categories: (1) motivation to participate in research; (2) impact of the learning environment; (3) changing confidence levels over time; (4) growing appreciation of complexities about the intervention; (5) acceptability of the training package; (6) lessons for future implementation. Conclusions: Therapists reported acquiring knowledge necessary to implement the intervention. Data indicates that training packages require detailed descriptions of the interventions being taught for local implementation in the NHS and for future research. Training materials are valued by therapists but require time for familiarisation and reminders from mentors help put training into practice. Therapists have concerns about implementing interventions within a research context, which researchers should address

Walking as a meaningful leisure occupation: the implications for occupational therapy

Introduction: In response to growing interest in leisure in occupational therapy and the importance of understanding how occupations maintain, enhance and promote health and wellbeing, a qualitative phenomenological study was conducted to explore the experiences of walking for leisure. Method: Six healthy student participants, identified as regular walkers, were interviewed using a semi-structured format. Data were analysed following interpretative phenomenological analysis methodology. Findings: Participants expressed how and why walking was meaningful to them; the four main themes were social connectedness, wellbeing, connection to nature and achievement from a challenge. Findings suggest that occupational therapists could use walking and leisure occupations in intervention, and that there is scope for an occupational therapy perspective in health promotion. Conclusion: Determining the subjective meaning of engaging in walking as a leisure occupation has implications for occupational science and health promotion in helping to explain why people do what they do

Enabling Everyday Lives: A report into occupational therapy in social services' departments in Wales

This report, commissioned by the College of Occupational Therapists’ Welsh board in September 2006 and informed by the Community Occupational Therapy Advisory Group in Wales (COTAG), draws together evidence from a range of existing documents, reports and literature, to establish the contribution that occupational therapy can make to the Assembly’s vision for heath and wellbeing in Wales

Telecare, obtrusiveness, acceptance and use: An empirical exploration

Introduction Telecare is increasingly part of the United Kingdom (UK)’s health and social care arrangements, and therefore occupational therapists’ practice. Understanding factors which influence telecare’s acceptance and usage is important to ensure optimal outcomes, both for service users and health and social care systems. Method This paper uses data collected by a qualitative, multi-method, longitudinal research study (n = 60) to explore whether an American model of ‘obtrusiveness’ is applicable to the UK context by examining what factors influence older adults’ acceptance and use of telecare. Findings The obtrusiveness model is broadly applicable to the UK context, but there are also two further issues which affected the acceptance and use of telecare: the degree of control a service user feels they have and the information and support they receive in using their devices. Conclusion The obtrusiveness model, plus the two additions (control and information), highlight important issues which could assist professionals working with telecare, including occupational therapists, in ensuring telecare is both accepted and well used

The identification of research priorities for UK occupational therapists in work rehabilitation

Background/Aims: UK occupational therapists are recognised as having key skills in work rehabilitation, but there is limited evidence to underpin this. In order to use research resources to best effect, it is vital to identify the research priorities of occupational therapists in work rehabilitation. This study aims to gather the views of those with a special interest in the field in order to identify their research priorities. Methods: An online survey was developed and administered electronically to members (n=173) of the College of Occupational Therapists Specialist Section-Work (COTSS-Work). Respondents were asked to: i) prioritise and comment on research areas; ii) propose research questions. A final sample of 42 surveys was collected and analysed thematically Results: Responses reflected the diversity and complexity of work rehabilitation. Identifying a rank order of research priorities proved challenging as the majority (≥62%) of respondents considered all of the topic areas listed a high priority. Research into the following areas were included in the survey: interventions; outcome measurements; assessments; management and/or service delivery; planning and/or commissioning; and education. However, 'interventions' was rated highest overall. Conclusions: Occupational therapists in the UK need more evidence to justify their role in the work and health arena. Greater opportunities are required for occupational therapists in clinical practice, as well as those involved in research, to address areas in which evidence-based practice is lacking and the mechanisms to disseminate this knowledge base

Occupational Therapy for South Asian Older Adults in the United Kingdom: Cross-Cultural Issues

Introduction There is limited understanding of the cultural needs of diverse Black and Minority Ethnic populations such as South Asian older adults, which may be perpetuating occupational injustices and health inequalities faced by these groups. Although cultural considerations are intrinsic to person-centred occupational therapy and increasingly relevant to the changing landscape of health and social care, the profession is criticised for its western-centric focus. This study aimed to gain understanding of the current cross-cultural issues in supporting South Asian older adults in the UK, as perceived by occupational therapists. Method A constructivist qualitative design supported by thematic analysis was used, involving seven occupational therapists in the United Kingdom who participated in semi-structured interviews via Skype/telephone. Findings Cross-cultural issues were illustrated through the following themes: ‘when the barriers go down’ – cultural mismatch in individualist vs. collectivist worldviews; ‘invasion of the family home’ – cultural inappropriateness of standard interventions; and ‘I go into every assessment assuming nothing’ – recognition of and response to challenges. Conclusion This study provides insight into cross-cultural issues in occupational therapy for South Asian older adults, revealing a gap between theory and practice in integrating cultural humility. It highlights the need for a more inclusive, person-centred approach to support culturally diverse populations

Sustaining people with dementia or mild cognitive impairment in employment: A systematic review of qualitative evidence

Introduction The World Health Organization estimates that 10% of the 35.6 million people worldwide with dementia are aged under 65 years. In an ageing workforce this has implications for employers, employees, and statutory and third sector services. Limited research has been conducted into this emerging global issue. Method This systematic review, employing the methodology of the Joanna Briggs Institute, aimed to identify and synthesise the best available qualitative evidence regarding the needs, experiences and perspectives of people with early onset dementia or mild cognitive impairment who were either in employment or wished to gain employment. Results Of 69 studies identified, eight met the inclusion criteria. From these, four themes emerged: disease progression and recognition; the emotional impact of change; the employer's management of the worker; and changes to the worker role. Conclusion There are health benefits to the individual with dementia or mild cognitive impairment of continuing to engage in meaningful occupation. Retirement policy changes have resulted in an ageing workforce with concurrent risk factors for dementia. A lack of understanding of reasonable adjustments and sheltered employment opportunities was evident from the literature. This review highlights the potential for occupational therapists to engage this client group in vocational rehabilitation

Interprofessional learning in practice: The student experience

Interprofessional learning and the development of teamworking skills are recognised as essential for patient care and are also a government priority for undergraduate education. Sixteen occupational therapy students worked on an interprofessional training ward as part of their practice placement and three of them participated in an evaluation using the nominal group technique. Despite this small number, the evaluation identifies the value of this learning experience in giving the students an opportunity to appreciate the importance of interpersonal skills; to learn about other team members’ roles; and to experience the challenges of working on a busy rehabilitation ward for older people

Being well, being musical: Music composition as a resource and occupation for older people

Introduction: Participatory music making for older people has tended to focus on singing and performance. In a community music project undertaken by Manchester Camerata (a chamber orchestra), Blacon Community Trust and a small group of older adults, participants were given the opportunity to compose individual pieces of music interactively with professional musicians. This paper reports the findings of the research project. Method: An arts-based research method was adopted and incorporated action research and interpretive interactionism to articulate the experiences and perceptions of participants. Participants and Manchester Camerata musicians also worked together to represent the thematic findings of the research in a group composition. Findings: The findings demonstrate that individual and group music composition contributed to a sense of wellbeing through control over musical materials, opportunities for creativity and identity making, validation of life experience and social engagement with other participants and professional musicians. Conclusion; The results emphasised occupation as essential to health and wellbeing in the later stages of life. The findings also highlight the particularly innovative aspects of this research: (i) the use of music composition as a viable arts-in-health occupation for older people and (ii) the arts-based research method of group composition. (PsycINFO Database Record (c) 2016 APA, all rights reserved