The important place of culture within occupational therapy is widely recognized, and there is increasing emphasis on addressing the diversity of clients.
This study explores how occupational therapists perform cultural brokerage when providing culturally sensitive care to immigrant families.
A descriptive qualitative methodology was used for this study. A purposive sample of 17 occupational therapists from two Canadian paediatric rehabilitation centres were interviewed.
Participants encountered several cultural and structural constraints in providing culturally sensitive care. To overcome these constraints, clinicians used four strategies: (a) translating between health systems for clients, (b) bridging different meanings of occupational therapy to make it relevant for clients, (c) establishing long-term relationships by building trust and rapport, and (d) working with clients' relational networks to help them navigate the health system.
Occupational therapists should advocate for both the individual needs of immigrant families and for institutional level resources to better meet the needs of diverse clients.
The purpose of this study is to explore whether adolescents with disabilities disclose their condition and what types of accommodations are requested at work.
In-depth, qualitative semi-structured interviews were conducted with 18 adolescents with a physical and/or mobility-related disability. We also reviewed their self- and staff assessments completed throughout an employment training program in which they took part.
The findings show that most youth were able to disclose their conditions and recognize some of their limitations in performing tasks at work. Youth requested physical accommodations, more time to complete tasks and cognitive accommodations. Youth also performed several self-care tasks to manage their disability at work including personal care, pain management and fatigue.
Within the context of this employment training program, youth were able to disclose their condition to their employer, ask for accommodations and manage their disability in the workplace.
Educators and clinicians should: Assist youth in understanding whether, when and how to disclose their disability to their potential employer. Help youth to understand what accommodations are available to them in the workplace and how to access them, to help them to perform their job effectively. Coach youth on how to manage their disability in a work context, especially with regard to personal care, pain management and fatigue. Encourage and facilitate participation in experience-based opportunities to practice disclosure, requesting accommodations and self-management.
Having a disability is a barrier to securing and maintaining employment. Most research has focussed on employment barriers among adults, while very little is known about young people's experience finding paid work.
Young people aged 15-24 were selected from the 2006 Participation and Activity Limitation Survey to explore the barriers and discrimination they experienced in seeking employment (n?=?1898).
Our findings show that teens and young adults with disabilities encountered several barriers and discrimination in seeking paid employment. The types of barriers that these young people encountered varied by age and type of disability. There were fewer yet different types of barriers to working that were encountered between the two age groups (teens and young adults). Several socio-demographic factors also influenced barriers to working. Severity of disability, type and duration of disability, level of education, gender, low income, geographic location and the number of people living in the household all influenced the kind of barriers and work discrimination for these young people.
Rehabilitation and life skills counsellors need to pay particular attention to age, type of disability and socio-demographic factors of teens and young adults who may need extra help in gaining employment.
Although bullying amongst typically developing school-aged children has been well explored, it is under-researched for children with disabilities. The purpose of this study was to understand the experiences of exclusion and bullying among children with disabilities.
We draw on qualitative in-depth interviews and a focus group with children and youth with disabilities (n?=?15) to explore their experiences of exclusion and bullying.
Our results showed that restrictions in the socio-contextual environment influenced the social exclusion that children experienced. Youth encountered social exclusion from both teachers and peers. Children reported that teachers' attitudes toward children with disabilities often influenced the social exclusion experienced by peers. Bullies engaged in both implicit and explicit forms of social exclusion toward children with disabilities which often lead to verbal and physical bullying.
Children with cerebral palsy are victims of bullying and social exclusion within the school context. More opportunities for social inclusion are needed.
While sparsely researched, funding structures may play an important role in use of and satisfaction with prostheses and related health services.
The objectives of this study were to (1) quantify the direct costs of prosthesis wear, (2) explore variations in funding distribution, and (3) describe the role of affordability in prosthesis selection and wear.
An anonymous, online cross-sectional descriptive survey was administered.
Analyses were conducted of qualitative and quantitative data extracted from an international sample of 242 individuals with upper limb absence.
Access to prosthesis funding was variable and fluctuated with age, level of limb absence and country of care. Of individuals who gave details on prosthetic costs, 63% (n = 69) were fully reimbursed for their prosthetic expenses, while 37% (n = 40) were financially disadvantaged by the cost of components (mean [SD] US$9,574 [$9,986]) and their ongoing maintenance (US$1,936 [$3,179]). Of the 71 non-wearers in this study, 48% considered cost an influential factor in their decision not to adopt prosthesis use.
Prosthesis funding is neither homogeneous nor transparent and can be influential in both the selection and use of a prosthetic device.
Inequitable access to prosthesis funding is evident in industrialized nations and may lead to prosthesis abandonment and/or diminished quality of life for individuals with upper limb absences. Increased efforts are required to ensure equitable access to upper limb prosthetics and related services in line with individuals' needs.
Access to assistive devices is critical for most children with disabilities to function in society. Despite this, there remain high levels of unmet needs and an underutilisation of augmentative and alternative communication (AAC) devices. Yet, relatively little is known about the challenges that clinicians encounter in prescribing AAC devices.
In-depth qualitative semi-structured interviews were conducted with 11 speech language pathologists and occupational therapists who are current authorisers for AAC devices.
The findings suggest that there are several barriers (technical, social and political) influencing clinicians' decision to prescribe AAC devices. Technical challenges include the complexity of devices and viewing technology as a cure. Social barriers involve socio-demographic differences, readiness to use a device, social acceptance, attitudes, family's view of technology, and the priority of communication. Finally, several political barriers such as a shortage of speech pathologists, a complex prescription review process, inconsistent follow-up procedures, limitations of the consultative model, and gaps in funding and policy influenced clinicians' ability to prescribe AAC devices. Differences in philosophy of technology also influenced health providers' decision to prescribe AAC devices.
Service providers and policy makers should be cognizant of the contextual factors influencing health provider's decision to prescribe AAC devices.
Despite the importance of ensuring access to assistive technology, high rates of underutilization remain. Relatively little is known about the characteristics of young people reporting unmet needs for assistive devices, so our study examined this further.
Data were analyzed using the 2006 Participation and Activity Limitation Survey. Youth aged 15-24 were selected to explore the characteristics associated with those currently using or reporting unmet needs for communication or mobility devices (n = 15,817).
Family structure and language spoken influenced the likelihood of using a communication device for two age subgroups. Meanwhile, language spoken influenced the likelihood of reporting unmet needs for communication assistive devices. The following factors influenced the likelihood of using a mobility device: age, gender, language spoken, income, family structure, and severity of impairment. Gender, geographic location, language spoken, family structure, duration and severity of impairment and presence of other impairments influenced the likelihood of reporting unmet needs for mobility devices.
Clinicians need to pay particular attention to the socio-cultural factors of young clients transitioning to adult care.
Although providing culturally sensitive care is an important element of family-centered rehabilitation very is little known about providers' experiences working with immigrant families in pediatric settings. The purpose of this study is to develop a better understanding of the experiences of service providers working with immigrant families raising a child with a physical disability.
We draw on a qualitative approach involving in-depth interviews and focus groups with healthcare and community service providers (n = 13) in two multi-cultural Canadian cities.
The findings indicate that healthcare and community service providers encounter several challenges in providing care to immigrant families raising a child with a disability. Such challenges include the following: (1) lack of training in providing culturally sensitive care; (2) language and communication issues; (3) discrepancies in conceptualizations of disability between healthcare providers and immigrant parents; (4) building rapport; and (5) helping parents to advocate for themselves and their children. Service providers also have several recommendations for improving services to better meet the needs of immigrant families.
Clinicians should be cognizant of how culture influences the care they provide to clients. More training opportunities are needed for enhancing culturally sensitive care.
• Pediatric rehabilitation providers working with immigrant families raising a child with a disability should engage in training and education around culturally sensitive care to better meet the needs of these clients. • More time is needed when working with immigrant families to build trust and rapport. • Clinicians need to be sensitive around gender issues and try to involve both parents in the decision making around the care for their child. • Healthcare providers should help clients to become more aware of the resources available to them in the hospital and in the community.