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Article

Sissel Horghagen, Tore Bonsaksen, Unni Sveen, Anne Stine Dolva and Cathrine Arntzen

Reforms in the health-care system may impact how health-care professionals perceive and enact their roles. This study aims to examine the way in which occupational

Abstract

Purpose

Reforms in the health-care system may impact how health-care professionals perceive and enact their roles. This study aims to examine the way in which occupational therapists experience and describe their roles in municipalities after the implementation of a health reform (the Coordination Act) in Norway.

Design/methodology/approach

This qualitative study was designed within the perspectives of social constructivism. Data was collected through focus group interviews with 10 community-working occupational therapists. A thematic framework analysis was used to examine the participants’ experiences.

Findings

The following four themes emerged: external factors that framed and shaped the occupational therapists’ roles in municipalities; the strengths and dilemmas of the generalist; the problematic generic position and the strengths; and dilemmas of the specialist.

Originality/value

The study suggests that occupational therapy practitioners should identify new opportunities and adapt to health reform changes. They also need to renegotiate their roles as the health reforms require more specialized competences. Greater emphasis must be placed on the core knowledge and competences of occupational therapists to strengthen their professional identity in the municipalities.

Details

Irish Journal of Occupational Therapy, vol. 48 no. 2
Type: Research Article
ISSN: 2398-8819

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Book part

Michelle Veyvoda, Thomas J. Van Cleave and Laurette Olson

This chapter draws from the authors’ experiences with service-learning pedagogy in allied health training programs, and illustrates ways in which community-engaged…

Abstract

This chapter draws from the authors’ experiences with service-learning pedagogy in allied health training programs, and illustrates ways in which community-engaged teaching and learning can prepare students to become ethical healthcare practitioners. The authors infuse examples from their own courses throughout the chapter, mostly from the clinical fields of speech-language pathology, audiology, and occupational therapy. However, the chapter is applicable and generalizable to faculty from a wide scope of allied health training programs. The chapter introduces considerations for establishing campus–community partnerships in an ethical manner, as well as ways to foster student self-reflection and critical thinking through an ethical lens. Principles from the codes of ethics of various allied health professions are incorporated throughout the chapter along with examples of how each can be applied in community-based clinical experiences. Through a review of relevant literature, analysis of professional codes of ethics, case-based examples, and a step-by-step guide to course development, this chapter provides readers with a mechanism to ground their courses in professional ethics in a way that is relatable and relevant to students.

Details

Civil Society and Social Responsibility in Higher Education: International Perspectives on Curriculum and Teaching Development
Type: Book
ISBN: 978-1-83909-464-4

Keywords

Content available
Article

Laura Moloney and Daniela Rohde

Physical activity is associated with both physical and mental health benefits for people with psychosis. However, mental health services have been criticised for failing…

Abstract

Purpose

Physical activity is associated with both physical and mental health benefits for people with psychosis. However, mental health services have been criticised for failing to adequately promote physical activities. Occupational Therapy, with its focus on meaningful everyday occupations, is well placed to incorporate physical activity interventions. The purpose of this study was to explore the experiences of men with psychosis participating in an Irish community-based football programme.

Design/methodology/approach

Six men with psychosis participated in qualitative interviews. The interviews were audio-recorded and transcribed verbatim. Interview data were analysed thematically.

Findings

Participants identified many benefits of engaging in the programme. Football became a valued part of weekly routines and fostered re-engagement with previously valued roles. Participants identified improvements in social confidence and motor and process skills, as well as a positive impact on their mental and physical health.

Originality/value

This study highlights the value and meaning of participation in football for men with psychosis, as well as demonstrating the longer-term feasibility of football as a therapeutic medium in Occupational Therapy mental health service provision. Findings could help to promote the routine use of sports interventions to mental health services.

Details

Irish Journal of Occupational Therapy, vol. 45 no. 2
Type: Research Article
ISSN: 2398-8819

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Article

Anne Graham, Celia Harbottle and David King

The purpose of this paper is to examine a model of effective forensic practice with positive interventions for men with learning disabilities who have committed serious…

Abstract

Purpose

The purpose of this paper is to examine a model of effective forensic practice with positive interventions for men with learning disabilities who have committed serious sexual offences. It outlines the theoretical and philosophical frameworks which have informed the model of care and support in a community-based setting and the evidence base for the efficacy of the approach.

Design/methodology/approach

This approach to a community-based forensic learning disability service is informed by systemic practice and underpinned by models of human occupation (Keilhofner, 2008) which informs occupational therapy and total attachment (Harbottle et al., 2014). This is a whole systems model for developing compassionate and participatory practice based on attachment theory and approaches to professional parenting drawn from foster care settings and prevention frameworks for adult safeguarding. It uses Klinean Thinking Environments (1999) to give practical communication to the model.

Findings

The attachment model which underpins both the support for staff and the framework for scaffolding the care and support provided for service users is building calm, consistent and respectful relationships. This enables workers and service users to feel accepted through the availability of support; to feel a sense of belonging and inclusion in which skills and confidence can flourish helping all to feel more effective. This is evidenced by the stability of the service user group and the staff team.

Research limitations/implications

The model of whole system care and support care outlined in this paper can help to provide a therapeutic environment in which men who have committed sexual offences can develop effective skills within a safe, supportive and effectively managed setting. This is on-going research but there is evidence of service users and staff in this model of practice, feeling scaffolded, able to enjoy and achieve progress and personal development.

Practical implications

This model appears to promote stable, sustained, supportive relationships. Placement breakdown has been minimal indicating that the disruption rate is low and therefore therapeutic interventions are likely to take place and be effective. This is a hopeful and positive approach which enables individuals to flourish in a safe environment.

Social implications

The social implications of this model are positive for creating a stable workforce in an industry plagued with rapid turn over of staff to the detriment of the quality of life for service users. It creates stability and confidence for the residents allowing them to begin to relax and thereafter achieve more positive relationships.

Originality/value

This paper examines the application of theoretical frameworks drawn from other disciplines and fuses them into a therapeutic approach to support this service user group. It is a model that can have great portability to other settings but it is its application in forensic services that is new and which is growing its evidence base for its effectiveness.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 7 no. 4
Type: Research Article
ISSN: 2050-8824

Keywords

Content available
Article

Aisling Helen Stack, Orla Duggan and Tadhg Stapleton

The assessment of fitness to drive after stroke is an emerging area of occupational therapy practice in Ireland. Despite this, little is known about occupational

Abstract

Purpose

The assessment of fitness to drive after stroke is an emerging area of occupational therapy practice in Ireland. Despite this, little is known about occupational therapists’ evaluation practices, and there are no internationally agreed clinical guidelines to inform best practice. The purpose of this paper is to investigate occupational therapy evaluation practices for fitness to drive after stroke in Ireland.

Design/methodology/approach

This is a cross-sectional study design targeting occupational therapists working with people after stroke using an online survey. Summary and descriptive statistics were used to analyse the returned surveys.

Findings

In total, 47 occupational therapists participated. Off-road driving assessment was completed by 68 per cent of respondents. Functional assessment and non-driving-specific assessments were most widely used and perceived to be the most useful in informing the off-road assessment. A total of 89 per cent referred clients for on-road assessments; however, some referred without first completing an off-road assessment. The therapists who completed formal post graduate education/training in driving assessment reported greater confidence and competence in their skills and ability to assess fitness to drive. A vast majority of participants agreed that clinical guidelines regarding best practice in this area would be beneficial.

Research limitations/implications

A majority of occupational therapists are assessing fitness to drive after stroke in Ireland with non-driving-specific assessments and functional observations; however, there are many gaps and wide variations between services. Education/training in evaluating fitness to drive after stroke is recommended. The development of clinical guidelines to inform practice would facilitate a consistent approach nationally.

Originality/value

This is the first study completed in Ireland to investigate occupational therapy evaluation practices for fitness to drive after stroke.

Details

Irish Journal of Occupational Therapy, vol. 46 no. 2
Type: Research Article
ISSN: 2398-8819

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Article

Catherine Roberts, Jason Davies and Richard G. Maggs

The restrictive nature of low secure mental health settings and the issues associated with risk management and safe practice raise numerous challenges which need to be…

Abstract

Purpose

The restrictive nature of low secure mental health settings and the issues associated with risk management and safe practice raise numerous challenges which need to be overcome for individuals to engage in community-based programmes. The paper aims to discuss these issues.

Design/methodology/approach

Two community-based schemes are described. The first uses the natural environment as a medium in which to deliver opportunities to develop vocational skills. The second provides exercise-based activity to promote healthier living. This paper aims to explore the acceptability, feasibility and sustainability of the projects along with the views and achievements of participants.

Findings

Both schemes were well-attended with positive views from participants and others. Planned positive risk taking enabled individuals to participate in a safe and structured way. Initial evaluation of the projects suggest that they were viewed as acceptable by the service and valued by participants. Participation led to some individuals engaging in new opportunities for vocational and leisure activities.

Practical implications

Fostering access to community-based occupational opportunities for those in low secure mental health services can be achieved safely and with numerous apparent benefits. Research is now needed to determine further the nature and extent of the gains made through such activity.

Originality/value

This is the first known study of its kind utilising inter-agency collaboration to address the needs of those residing in a low secure mental health facility. Within the forensic mental health population, the standards of care recommend a comprehensive, recovery-focused approach aimed at building resilience and preventing relapse, with the need for thorough intervention for physical health needs. This study supports these recommendations by providing opportunities for planned positive risk taking, opportunities for social inclusion, skills development, increased access to physical exercise to address overall wellbeing.

Details

Journal of Forensic Practice, vol. 17 no. 3
Type: Research Article
ISSN: 2050-8794

Keywords

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Article

Tantut Susanto, Iis Rahmawati and Wantiyah

Occupational health promotion programmes targeting the Indonesian agricultural farmers (AFs) are limited. This action research aimed to involve the AFs in the research and…

Abstract

Purpose

Occupational health promotion programmes targeting the Indonesian agricultural farmers (AFs) are limited. This action research aimed to involve the AFs in the research and development of community-based occupational health promotion (COHP) programme, which is tailored to meet their perceived needs for preventing health problems related to occupational workplace.

Design/methodology/approach

This study employed the qualitative action research approach. The participants (n = 136) were farmers from seven regions in the rural areas of East Java, Indonesia. The COHP was examined from public health centres (PHCs) in seven regions through eight steps, including recognition, analyses, planning, communication, preparation, implementation, evaluation and continuity of programme, for eight weeks. Data were collected through focus group interviews and examined using qualitative content analysis.

Findings

The findings revealed that the participants not only lacked health status but were also required to promote a comprehensive programme for occupational health and safety. The health problems of AFs were identified as the lack of nutrition and high blood pressure, which are related to un-ergonomic condition during work, limited use of personal protective equipment, high stress and workload. The lack of support for AF groups to prevent health problems and to access health services was a key theme for all the participants. Therefore, self-help group as social support was designed to solve the health problems among AFs.

Originality/value

The COHP, through action research, provided a change strategy for AFs to manage and promote occupational health and safety within their practice. The study findings could be used in the development of a framework for PHCs in delivering occupational health and safety practices in the agricultural sectors.

Details

Health Education, vol. 120 no. 1
Type: Research Article
ISSN: 0965-4283

Keywords

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Book part

Connie Snyder Mick and James M. Frabutt

Within tertiary education, service-learning can offer deeply engaging and transformational experiences for students, broadening their consideration of a host of social…

Abstract

Within tertiary education, service-learning can offer deeply engaging and transformational experiences for students, broadening their consideration of a host of social justice issues of our time, including diversity and inclusion. This chapter describes how service-learning interfaces with two areas in particular, both of which have wide-ranging public health implications and are generally misrepresented in public media: poverty and mental health. Representative studies are highlighted and case examples are presented in each domain, concluding with recommendations for future research. The authors argue that service-learning courses addressing social justice issues such as poverty and mental health can lead to deep learning in students if they are sequenced to include both direct service-learning that concretizes the issue and community-based research that highlights the public policy challenges and implications of addressing that issue systemically.

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Article

Beth Fields, Wendy Wood and Rebecca Lassell

Establishing acceptability of complex interventions to stakeholders is vital in early scientific development. The purpose of this paper is to ascertain the acceptability…

Abstract

Purpose

Establishing acceptability of complex interventions to stakeholders is vital in early scientific development. The purpose of this paper is to ascertain the acceptability of a program of equine-assisted activities (EAAP) for people with dementia by elucidating programmatic practices needed to enhance their safety and quality of life (QoL) from the perspectives of service providers.

Design/methodology/approach

Semi-structured interviews with five providers were analyzed using a basic qualitative approach.

Findings

Providers perceived the EAAP as acceptable and revealed potential mechanisms of change supporting well-being, including aspects related to the physical and social environment and person with dementia. Linkages identified among the EAAP and its physical and social context support its complexity. Providers explicated program practices that promoted safety and QoL, such as implementing staff trainings and tailoring activities to each person’s preferences and needs. These practices aligned with best dementia care approaches, underscoring that the EAAP is a promising complex intervention that merits further scientific development.

Originality/value

This work is novel and adds to the literature by illuminating the role of a community-based, animal-assisted program for enhancing the QoL of older adults with dementia residing in institutional care facilities.

Details

Quality in Ageing and Older Adults, vol. 20 no. 2
Type: Research Article
ISSN: 1471-7794

Keywords

Content available
Article

Hannah Catherine Spring, Fiona Katherine Howlett, Claire Connor, Ashton Alderson, Joe Antcliff, Kimberley Dutton, Oliva Gray, Emily Hirst, Zeba Jabeen, Myra Jamil, Sally Mattimoe and Siobhan Waister

Asylum seekers and refugees experience substantial barriers to successful transition to a new society. The purpose of this paper is to explore the value and meaning of a…

Abstract

Purpose

Asylum seekers and refugees experience substantial barriers to successful transition to a new society. The purpose of this paper is to explore the value and meaning of a community drop-in service offering social support for refugees and asylum seekers in the northeast of England and to identify the occupational preferences of the service users.

Design/methodology/approach

A qualitative approach using semi-structured interviews was conducted with refugees and asylum seekers using a community drop-in service. In total, 18 people participated from ten countries. Data were analysed using interpretive phenomenological analysis.

Findings

The value and meaning of the service was expressed through four key areas: the need to experience a sense of community; being able to make an altruistic contribution within the community; the need for societal integration; and having the opportunity to engage in meaningful and productive occupations.

Practical implications

Community and altruism have profound cultural meaning for asylum seekers and refugees and the need to integrate, belong and contribute is paramount to successful resettlement. Community-based drop-in services can aid this at deep, culturally relevant levels. This study may inform policy and practice development, future service development and highlight potential opportunities for health and social care services provision amongst this growing population.

Originality/value

To date there are no studies that provide empirical evidence on how community-based drop-in services for refugees and asylum seekers are received. This study provides a cultural insight into the deeper value and meaning of such services, and is particularly relevant for professionals in all sectors who are working with asylum seekers and refugees.

Details

International Journal of Migration, Health and Social Care, vol. 15 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

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