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1 – 10 of 57At present, there is no reference to Attention Autism (AA) as a framework and therapeutic tool with autistic children in occupational therapy (OT) literature. By way of…
Abstract
Purpose
At present, there is no reference to Attention Autism (AA) as a framework and therapeutic tool with autistic children in occupational therapy (OT) literature. By way of introducing AA as a potential intervention to the OT community, this study aims to investigate the extent to which participation in a two-day AA training could contribute to increasing confidence and inspire changes in practice for Irish occupational therapists (OTs) supporting autistic children.
Design/methodology/approach
A pilot study design with mixed qualitative and quantitative methods was used to evaluate the impact of a two-day AA training on six OTs. The OTs support autistic children throughout Ireland across public, private and voluntary sectors. They completed brief, non-standardised questionnaires 2 weeks before the training (Time 1) and again 12 weeks post (Time 2) training session. At Time 2, additional exploratory questions were answered by OTs regarding their use of AA in practice.
Findings
This explorative study’s quantitative findings presented percentage change increases within three areas of confidence for all OTs. These include establishing attention, motivating and developing functional skill goals with autistic children. One of the participants did not score any change in confidence in a fourth area, building rapport, however, the five other participants scored percentage change increases. Qualitative data provided by participants showed that they were implementing AA in practice since attending the training. Five of the participants reported positive experiences of using AA and one participant reported the programme was not suitable for her caseload because of their level of understanding and need.
Research limitations/implications
This was a small, exploratory, practice-based study. As this is the first study exploring this area of practice for OTs, to the best of the authors’ knowledge, there were no standardised methods of assessment available, therefore a self-designed survey was used by the author which had a limited number of open-ended questions and four Likert scale questions. This study was also limited in that there was one main researcher who also delivered the two-day AA training. The sample data set was small which resulted in the limitation of the choice of methods used to analyse the quantitative data. Percentage changes were used as the only available and reliable method for a small data set.
Originality/value
Findings of this study, despite their preliminary nature, indicate that AA training may be a useful professional development consideration for OTs who provide a service for autistic children. Further AA research in OT is required including larger and more rigorous studies. An alternative training option of The Curiosity Programme may be considered for OTs supporting children who may not yet be ready to participate in AA.
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Sharon Davenport and Ann Underhill
This study aims to explore which outcome measures are used by occupational therapy staff in adult social care settings in the UK, and the factors affecting use of outcome measures.
Abstract
Purpose
This study aims to explore which outcome measures are used by occupational therapy staff in adult social care settings in the UK, and the factors affecting use of outcome measures.
Design/methodology/approach
A quantitative descriptive research design was used, using a cross-sectional study to explore occupational therapy staff views on the use of outcome measures. A 38-question survey was developed on Microsoft Forms. Recruitment occurred online over a three-week period in 2021 via the social media platform “Twitter”. Results were analysed using Excel using descriptive statistics and qualitative results used thematic analysis.
Findings
Participants (n = 20) used a range of outcome measures (13) in adult social care settings in the previous 12 months. Standardised measures were used by half the sample in the previous 12 months. The Therapy Outcome Measure and Barthel Index were in most use. The breadth of adult social care practice and practical factors such as caseload and lack of a meaningful tool were found to be barriers to outcome measure use. Facilitators included service improvement, accountability, use of audit and professional occupational therapy leadership.
Research limitations/implications
The overall use of outcome measures can be considered low in this setting, with manager support seen to be key to the use of outcome measures. Further research is needed to investigate nationwide use.
Practical implications
Training, time and manager support are key to use of standardised tests and outcome measures in the adult social care settings. The use of occupational performance measures should be considered to demonstrate unique professional impact.
Originality/value
This contemporary study reveals use of outcome measures within occupational therapy adult social care services in the UK, which is an under researched and under published area.
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Elina Aaltio and Sirpa Kannasoja
While studies on service users’ participation and their perceptions on the quality of services exist, agreement between family members’ and practitioners’ assessments of the…
Abstract
Purpose
While studies on service users’ participation and their perceptions on the quality of services exist, agreement between family members’ and practitioners’ assessments of the family’s situation has received less interest. The purpose of this paper is to investigate agreement and its effect on outcomes by comparing the viewpoints of three groups of informants (children, mothers and practitioners) in the context of statutory child protection in two study groups – one applying a systemic approach (SPM) and a service-as-usual control group (SAU).
Design/methodology/approach
A quasi-experimental repeated-measures study design was applied. Outcome data comprised 112 cases (SPM cases n = 56 and SAU cases n = 56) at three sites. Data was collected from all participants at baseline and six months later.
Findings
First, practitioners’ analyses of a child’s need for protection did not meet family members’ expressed need for help. Second, child–mother agreement on the need for service intervention at T1 predicted a decrease in practitioner-assessed abuse or neglect from T1 to T2. In this sample, no differences were found between the two groups.
Originality/value
This study highlights the importance of making explicit the viewpoints of children, parents and practitioners in casework and research to improve understanding of how their perspectives differ over the course of the process and how possible initial disagreements affect outcomes.
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Chenzhang Bao and Indranil Bardhan
The purpose of this study is to evaluate the determinants of health outcomes of dialysis patients, while specifically focusing on the role of dialysis process measures and…
Abstract
Purpose
The purpose of this study is to evaluate the determinants of health outcomes of dialysis patients, while specifically focusing on the role of dialysis process measures and dialysis practice characteristics. The dialysis industry is facing a major transition from a volume-based health care system to a value-based cost-efficient care model, in the USA. Under the bundled Prospective Payment System, the treatment-based payment model is subject to meeting quality thresholds as defined by clinical process measures including dialysis adequacy and anemia management. Few studies have focused on studying these two processes and their association with the quality of patient health outcomes.
Design/methodology/approach
In this study, the authors focus on identifying the determinants of patient health outcomes among freestanding dialysis clinics, using a large cross-sectional data set of 4,571 dialysis clinics in the USA. The authors use econometric analyses to estimate the association between dialysis facility characteristics and practice patterns and their association with dialysis process measures and hospitalization risk.
Findings
The authors find that reusing dialyzers and increasing the number of dialysis stations is associated with higher levels of clinical quality. This research indicates that deploying more nurses on-site allows patients to avail adequate dialysis, while increasing the supply of physicians can hurt anemia control process. In addition, the authors report that offering peritoneal dialysis and late night shifts are not beneficial practices in terms of their impact on the hospitalization risk.
Research limitations/implications
While early studies of dialysis care mainly focused on the associations between practice patterns and patient outcomes, this research reveals the underlying mechanisms of these relationships by exploring the mediation effects of clinical dialysis processes on patient outcomes. The results indicate that dialysis process measures mediate the impact of the operational characteristics of dialysis centers on patient hospitalization rates.
Practical implications
This study offers several managerial insights for owners and operators of dialysis clinics with respect to the association between managerial and clinical practices that they deploy within dialysis clinics and their impact on clinical quality measures as well as hospitalization risk of patients. Managers can draw on this study to optimize staffing levels in their dialysis clinics, and implement innovative clinical practices.
Social implications
Considering the growth in healthcare expenditures in developing and developed countries, and specifically for costly diagnoses such as dialyses, this study offers several insights related to the inter-relationships between dialysis practice patterns and their clinical quality measures.
Originality/value
This study makes several major contributions. First, the authors address the extant gap in the literature on the relationships between dialysis facility and practice characteristics and clinical outcomes, while specifically highlighting the role of clinical process measures as antecedents of patient hospitalization ratio, a key metric used to measure performance of dialysis clinics. Second, this study sheds light on the underlying mechanisms that serve as enablers of the dialysis adequacy and anemia management. To the best of the authors’ knowledge, this is the first study to explore these relationships in the dialysis industry. The authors’ approach provides a new direction for future studies to explore the pathways that may impact clinical quality measures in the delivery of dialysis services.
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Carla Nouwen, Isolde Driesen, Lisbeth Verharen and Tine Van Regenmortel
The growing number of people with multiple problems in different areas of life means that cross-domain interprofessional collaboration is becoming increasingly important. This…
Abstract
Purpose
The growing number of people with multiple problems in different areas of life means that cross-domain interprofessional collaboration is becoming increasingly important. This study aims to focus on interprofessional collaboration between professionals from social work and financial and employment service organizations in The Netherlands. This type of cross-domain collaboration is still mostly superficial, and limited empirical knowledge is available about its beneficial factors.
Design/methodology/approach
The interprofessional collaboration model of Mulvale et al. (2016) was used as theoretical background for the research methodology and to reflect on the findings of our study. Data was collected through a qualitative study among professionals (N = 18) from social work and financial and employment service organizations in three different Dutch municipalities.
Findings
Similar team-level collaboration mechanisms of Mulvale et al.’s (2016) model were seen within this study. Joint client meetings were very beneficial for the interprofessional collaboration. Further beneficial factors include the decision-making process, team vision, client as an equal member, open communication and the appointment of a coordinator.
Research limitations/implications
Further special attention is needed to determine how best to allocate co-ordinating tasks, and how organizational and policy contexts affect the functioning of interprofessional collaborative teams.
Originality/value
This study offers an empirical view on a cross-domain collaboration between social work and financial and employment service organizations, by using Mulvale et al.’s (2016) model. In addition, this study also offers special attention to the role of the client in interprofessional collaborative teams.
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Mitch Blair, Heather Gage, Ekelechi MacPepple, Pierre-André Michaud, Carol Hilliard, Anne Clancy, Eleanor Hollywood, Maria Brenner, Amina Al-Yassin and Catharina Nitsche
Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of…
Abstract
Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.
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Petra Pekkanen and Timo Pirttilä
The aim of this study is to empirically explore and analyze the concrete tasks of output measurement and the inherent challenges related to these tasks in a traditional and…
Abstract
Purpose
The aim of this study is to empirically explore and analyze the concrete tasks of output measurement and the inherent challenges related to these tasks in a traditional and autonomous professional public work setting – the judicial system.
Design/methodology/approach
The analysis of the tasks is based on a categorization of general performance measurement motives (control-motivate-learn) and main stakeholder levels (society-organization-professionals). The analysis is exploratory and conducted as an empirical content analysis on materials and reports produced in two performance improvement projects conducted in European justice organizations.
Findings
The identified main tasks in the different categories are related to managing resources, controlling performance deviations, and encouraging improvement and development of performance. Based on the results, key improvement areas connected to output measurement in professional public organizations are connected to the improvement of objectivity and fairness in budgeting and work allocation practices, improvement of output measures' versatility and informativeness to highlight motivational and learning purposes, improvement of professional self-management in setting output targets and producing outputs, as well as improvement of organizational learning from the output measurement.
Practical implications
The paper presents empirically founded practical examples of challenges and improvement opportunities related to the tasks of output measurement in professional public organization.
Originality/value
This paper fulfils an identified need to study how general performance management motives realize as concrete tasks of output measurement in justice organizations.
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Charlotte Sullivan, Helen Lynch and Amanda Kirby
As occupational therapists embrace evidence-informed and occupation-centred practice, the use of standardised visual perceptual tests remains a strong feature of typical…
Abstract
Purpose
As occupational therapists embrace evidence-informed and occupation-centred practice, the use of standardised visual perceptual tests remains a strong feature of typical paediatric practice. Yet, the research evidence for the use of such tools is inconclusive at best. This study compared the results of the Test of Visual Perceptual Skills (TVPS) with a checklist of reported functional difficulties in 30 children attending occupational therapy. The purpose of this paper was to determine the usefulness of visual perceptual testing in relation to occupation-centred practice.
Design/methodology/approach
A descriptive correlational study design was used. Participants were 30 primary school-age children who were on a paediatric occupational therapy caseload. An additional 30 typically developing children participated in the development of the checklist.
Findings
Correlations were found between reported functional visual skill difficulties and two subtests of the TVPS (visual memory and visual discrimination). No correlation was found between the reported functional difficulties and any of the other five subtests of the TVPS or the total score.
Originality/value
Results highlight the weak relationship that existed in this study between standardised measures of visual perception, as measured by the TVPS, and functional difficulties. Therapists are cautioned to explore both the evidence base for continued use of standardised visual perceptual measures to inform occupation-centred practice and the need to embrace a more comprehensive person-centred approach to visual perceptual assessment.
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Deirdre Manning, Mairead Campbell and Frances Horgan
This paper aims to understand the clinical practice of physiotherapists and occupational therapists in the Republic of Ireland in the assessment and treatment of spasticity in…
Abstract
Purpose
This paper aims to understand the clinical practice of physiotherapists and occupational therapists in the Republic of Ireland in the assessment and treatment of spasticity in adults, to inform and improve spasticity management practice. This study also aims to describe therapists’ knowledge, confidence and perceived barriers in the management of spasticity.
Design/methodology/approach
A cross sectional survey design study was completed, and respondents were recruited through an online survey.
Findings
In total, 92 respondents from a wide range of clinical settings revealed there is considerable variation in services available nationally for adults presenting with spasticity. There were significant inconsistencies across all areas of practice. The majority of respondents (94%) did provide intervention to patients with spasticity, yet three quarters did not have access to a specialist spasticity clinic, and the majority (82%) did not feel they were providing sufficient treatment intensity for spasticity.
Originality/value
These findings provide a unique insight into the assessment and treatment practices of Irish physiotherapists and occupational therapists. These results demonstrate the need for further upskilling and specialist high-quality spasticity services nationally.
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Alexandra Frank and Dalena Dillman Taylor
Post-COVID-19, public K–12 schools are still facing the consequences of the years of interrupted learning. Schools serving minoritized students are particularly at risk for facing…
Abstract
Purpose
Post-COVID-19, public K–12 schools are still facing the consequences of the years of interrupted learning. Schools serving minoritized students are particularly at risk for facing challenges with academics, behavior and student social emotional health. The university counseling programs are in positions to build capacity in urban schools while also supporting counselors-in-training through service-learning opportunities.
Design/methodology/approach
The following conceptual manuscript demonstrates how counselor education counseling programs and public schools can harness the capacity-building benefits of university–school partnerships. While prevalent in fields like special education, counselor educators have yet to heed the hall to participate in mutually beneficial partnership programs.
Findings
Using the multi-tiered systems of support (MTSS) and the components of the university–school partnerships, counselor educators and school stakeholders can work together to support student mental health, school staff well-being and counselor-in-training competence.
Originality/value
The benefits and opportunities within the university–school partnerships are well documented. However, few researchers have described a model to support partnerships between the university counseling programs and urban elementary schools. We provide a best practice model using the principles of university–school partnerships and a school’s existing MTSS framework.
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