Article review: “Articulating an Occupational Perspective” by Njelesani et al (2014)

Article review: “Articulating an Occupational Perspective” by Njelesani et al (2014)

This article investigated uses of the term “occupational perspective” in order to clarify a standard definition for use in occupational science. This should make it easier to apply occupational science research findings in practice, the authors argue. In the end they came up with

“a way of looking at or thinking about human doing”

What is an occupational perspective then? According to the authors it’s not an occupational therapy perspective, since this term was one of the exclusion criteria in the Method section. The authors describe in the Findings the term as being used in relation to employment until the 90s when it became associated with Occupational Therapy and Occupational Science.  Research investigating it is mainly qualitative suggesting it is something abstract perhaps also explaining why there were so many different interpretations of the term in the articles Njelesani et al (2014) shortlisted. The research on occupational perspective covered a wide variety of client populations indicating it’s a concept that applies to all people with disabilities/illness.

detective-otter

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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

Article review: “The ideal of biopsychosocial chronic care: How to make it real? A qualitative study among Dutch stakeholders” by van Dijk-de-Vries et al (2012)

Article review: “The ideal of biopsychosocial chronic care: How to make it real? A qualitative study among Dutch stakeholders” by van Dijk-de-Vries et al (2012)

Chronic conditions (such as COPD or diabetes) are increasing in Western countries like England and Holland. These long-term conditions need the patient to be active in managing their condition in order to achieve reduced financial healthcare burden and better quality of life for the patient.

In this way, evidence shows that a biopsychosocial model would benefit patient well-being and produce these financial improvements. However provision of care that starts from the medical, emotional or social needs of individual patients does not fit in easily with the current Dutch health care system.

So the biopsychosocial model is a great idea – how to implement it? Read more

Article review: “The role of mental health professionals in multidisciplinary pain rehabilitation programs” by Townsend et al (2006)

Article review: “The role of mental health professionals in multidisciplinary pain rehabilitation programs” by Townsend et al (2006)

Townsend et al (2006) write that traditional roles of psychologists are being challenged by the Multi-Disciplinary Team (MDT) treatment now required in order to treat patients with chronic pain according to the biopsychosocial model.

MDT of otters
MDT: Team Otter

Treatment of chronic pain was traditionally carried out according to a biomedical model- a patient after a car accident was treated for chronic pain syndrome but not assessed for PTSD, for example. Research has shown the efficacy of a biopsychosocial model in treating  pain, where social and psychological factors as well as biological are taken into account. Turk (2002) reported patient benefits of the biopsychosocial approach (with regards to chronic pain) as increase in functional ability, fewer disability claims, and less illness caused as side effects of medical treatment or examination. Where treatment ie pain reduction is not possible, the MDT will aim to maximise the patient’s functioning.

Townsend et al describe a case study about a patient Ann who underwent intensive 3 week programme with a MDT to cope with her lower leg pain and end dependency on pain medication. In the case study, the OT’s role in the MDT was to incorporate the various pain control strategies into activities of daily living (ADLs), using for example pacing techniques and appropriate body mechanics. They could possibly have been involved with the functional assessment and assisted with outcome measurement.

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Article review: “An On-Site Job Evaluation Performed Via Activity Analysis” by Canelón et al (1997)

Article review: “An On-Site Job Evaluation Performed Via Activity Analysis” by Canelón et al (1997)

Activity analysis is used to evaluate the motor, sensory, cognitive,emotional, behavioural, cultural and social areas of the tasks being carried out in order to complete an activity. In this example, the Biopsychosocial approach is being used to guide the assessment of the patient.

Canelón et al analysed a patient who was experiencing pain in her right wrist following an injury in the workplace and subsequent hand surgery. The patient’s job involved processing insurance paperwork based at a desk workstation, and she was experiencing continued pain despite having an operation and prescribed medication to help with the pain.

Otter co-worker
I can has RSI?

They carried out an on-site job evaluation and  analysed each motor movement she carried out in great detail at her workplace. They also evaluated her communication style and social interaction with colleagues, concentration and organisation, emotional areas such as her need for gratification, and cultural influences. Read more