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]

Anatomy: skeletal system

Anatomy: skeletal system

Bones are classified according to their shape, and are categorised as either long, short, flat or irregular.

  • Long– longer than they are wide eg femur
  • Short– the same length as width eg patella or carpal bones
  • Flat– flattened width bones eg ribs or skull
  • Irregular– bones that don’t fit into any other category and connect other bones together eg pelvis
  • Sesamoid are a type of irregular bone that fit around or between tendons eg pisiform bone in the wrist carpals
otter skeleton.jpg
Not a human skeleton.

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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

Article review: “Community Dwelling Elderly Women and Meal Preparation” by Eckel (2012)

Article review: “Community Dwelling Elderly Women and Meal Preparation” by Eckel (2012)

The researchers sought to identify which tasks in meal preparation were the most demanding for elderly women, and how they overcame these to continue preparing meals as they aged. Meal preparation was meaningful to the women as it was an important part of their self-identity.

prepping dinner of sea urchins.jpg

The COMP model was used to identify which tasks were important to the women. The PEOP model was then used by the researchers to carry out activity analyses for the chosen tasks.

They found that the difficulty in completing tasks as the women aged was not just due to biomedical functioning decreasing, but also environmental barriers. Often the women had carried out tasks habitually for a long time and when their physical functioning declined slightly it id not occur to them to change the environment to facilitate easier task completion. In this way the environment had become disabling since if it was altered the women would be able to carry out the tasks even with their decreased functioning.

This shows an example of the biopsychosocial (BSP) model in practice as it highlights the social/environmental factors affecting individuals (and influencing their physical functioning) as well as the traditional physical/medical factors according to the biomedical model, and highlights how other factors can influence or cause biomedical problems rather than them be the starting point.

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Sources:

Eckel E (2012) ‘Community Dwelling Elderly Women and Meal Preparation’ Physical & Occupational Therapy In Geriatrics 30(4) pp 344-360