Article review: “Biopsychosocial Model – The integrated approach to health and disease” by Havelka, Lucanin & Lucanin (2009)

Article review: “Biopsychosocial Model – The integrated approach to health and disease” by Havelka, Lucanin & Lucanin (2009)

In this article, Havelka et al point out that the biomedical model was a valid model while infectious diseases caused by one factor prevailed and were the main healthcare problem for humanity, but now that chronic, lifestyle & non-infectious diseases with multiple influencing factors are the main health issue it is no longer effective or appropriate as the default model for healthcare. They are in favour of the biopsychosocial (BPS) model and say its implementation is taking too long. Their criticisms of the current biomedical model are:

  • the dehumanisation between healthcare staff and patients
  • continual improvement of increasingly advanced medical techniques leading to a rise in expenditure where only rationing of healthcare would allow for the continuation of technology-led healthcare (as opposed to psycho-social led)
  • reductionist i.e. reduces people to the smallest component -their cells- and separates mind and body in order to do this despite evidence to the contrary

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Just what IS occupation?

Just what IS occupation?

No, it’s not your job.

computer otter

Although in a way that can be part of one!  It’s any activity or task carried out which has an end goal and provides meaning to you. There are many definitions put forwards, all slightly different, which does make it hard to compare different articles or pieces of research effectively.  However it is generally agreed there are certain aspects of any occupation:

  • Form  the observable aspects of the occupation: what how & when
  • Function the way the occupation influences health, and its purpose or intended outcome
  • Meaning -the entire subjective experience of an individual who is engaging in the occupation

Considering occupations broken down in this way helps practitioners to understand why people choose to participate in certain occupations.

Analysing someone’s ability to carry out an occupational activity in order to assess where problem areas lie is the cornerstone of occupational therapy. The American Occupational Therapy Association (AOTA) has created a useful guide to the standardised terminology that should be used when documenting activity assessments (it can be found here for BAOT members).

Occupational science seeks to answer questions about the nature of occupation, such as:

  • WHO engages in occupations?
  • WHAT occupations are there?
  • WHEN do people engage in occupations?
  • WHERE do people engage in occupations?
  • HOW are occupations performed?
  • WHY do people engage in occupations?

 

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Sources:

American Journal of Occupational Therapy, March/April 2014, Vol. 68, S1-S48. [Access at: http://ajot.aota.org/article.aspx?articleid=1860439 for BAOT members]

Article review: “Occupational science: Adding value to occupational therapy” by Hocking & Wright-St.Clair (2011)

Article review: “Occupational science: Adding value to occupational therapy” by Hocking & Wright-St.Clair (2011)

Hocking and Wright-St.Clair outline the benefits that occupational science can bring to occupational therapy in practice.

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Source:

Hocking C and Wright-St. Clair V (2011) ‘Occupational science: Adding value to occupational therapy’ New Zealand Journal of Occupational Therapy 58(1): 29-35

Abstract:

We chart the scope, origin and purpose of occupational science, illustrating its relevance to occupational therapy with four case examples:

  1. using cooking to establish relationships with community leaders,
  2. applying theoretical understandings of the relationship between objects and identity to promote recovery,
  3. applying Lifestyle Redesign™ principles to practice with adults with arthritis
  4. addressing occupational deprivation in a secure dementia unit.

We argue that occupational science will expand the boundaries of occupational therapy, as graduates familiar with that knowledge enter the profession. To conclude, we outline how therapists can access occupational science knowledge to inform their practice.

Article review: “The Challenge of Occupation: Describing the Things People Do” – Clare Hocking (2009)

Article review: “The Challenge of Occupation: Describing the Things People Do” – Clare Hocking (2009)

Hocking says that occupational science must seek to provide in-depth information about what occupation is, rather than just how people engage with it or what they experience as a result of doing it. She outlines her idea of what the definition of occupation is and how it is context-dependent on the culture it occurs within.

otter reviewing paper
Story checks out.

As a result of increased knowledge she argues it would help OT practitioners to see people as ‘occupational beings’ and provide improved appreciation of the meaning occupation has to people’s lives, together with the demands required to carry them out. Using this knowledge would eclipse personal experience alone, for example you may know from personal experience that cooking a large meal is tiring and time-consuming and so may direct an Asian patient recovering from stroke to withdraw from the seemingly burdensome occupation of preparing dinner for her husband. But armed with research knowledge that meal preparation is seen as a gift to family, you could instead consider ways to adapt the occupation to allow the patient to continue since it holds meaning across this culture. Read more

How does sociology and culture affect occupation throughout someone’s life?

How does sociology and culture affect occupation throughout someone’s life?

Sociology is the study of human social life, groups, and societies (Giddens et al 2013:4). The type of society around us greatly influences our thoughts and actions whether we are aware of it or not. How does our behaviour (what we think, feel and say) as social creatures influence or affect the occupations we choose, and how we carry them out? Sociology can help OTs to understand whether something is a social/public issue, or a personal problem.

Sea Otters
Sociology is the study of groups’ behaviour

Some prominent sociological theorists are Durkheim, Marx and Weber. Emile Durkheim studied the effects of capitalism on increased suicide rates in the newly industrialised European countries. He attributed this to:

  1. increased individualism where rewards from good decisions are enjoyed by the individual alone, but so too are the consequences of bad ones. Previously the blame would be shared between other members of a family or group because the decision on whether to become say, a baker, was influenced by family tradition or the need for a baker in the village, rather than someone’s individual choice to strike out and open a patisserie in Hull.
  2. too much aspiration and subsequent disappointment when what is theoretically possible isn’t achieved. What we have isn’t actually all that bad but when compared to Khloe Kardashian, our life is a turdburger.
  3. too much freedom meaning there aren’t the same connections to other people as there used to be when social norms were around to tell us who to marry, what to do on a Sunday  or how much ankle to show. People can often feel more anonymous and less connected now as a result of increased personal freedom.
  4. increased atheism – while religions are based on questionable facts with a propensity for inciting prejudice and war, they do offer an important sense of community and shared experiences to draw people together; something capitalism doesn’t offer a replacement for.
  5.  decrease in national pride and family – national identities and family ties are more diffuse and no longer give people the feeling they are part of something bigger than themselves.

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