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The cultural brokerage work of occupational therapists in providing culturally sensitive care.

https://arctichealth.org/en/permalink/ahliterature104129
Source
Can J Occup Ther. 2014 Apr;81(2):114-23
Publication Type
Article
Date
Apr-2014
Author
Sally Lindsay
Sylvie Tétrault
Chantal Desmaris
Gillian A King
Gènevive Piérart
Source
Can J Occup Ther. 2014 Apr;81(2):114-23
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Canada
Child
Child, Preschool
Cultural Competency
Emigrants and Immigrants
Female
Humans
Male
Middle Aged
Occupational Therapy - organization & administration
Physical Therapists - psychology
Professional-Patient Relations
Abstract
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.
PubMed ID
25004587 View in PubMed
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Disclosure, accommodations and self-care at work among adolescents with disabilities.

https://arctichealth.org/en/permalink/ahliterature114670
Source
Disabil Rehabil. 2013;35(26):2227-36
Publication Type
Article
Date
2013
Author
Sally Lindsay
Carolyn McDougall
Robyn Sanford
Author Affiliation
Department of Occupational Science and Occupational Therapy, University of Toronto , Toronto, ON , Canada .
Source
Disabil Rehabil. 2013;35(26):2227-36
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Canada
Disability Evaluation
Disabled Persons - psychology
Employment - psychology
Female
Humans
Interviews as Topic
Male
Qualitative Research
Self Care
Self Disclosure
Urban Population
Workplace
Abstract
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.
PubMed ID
23594050 View in PubMed
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Discrimination and other barriers to employment for teens and young adults with disabilities.

https://arctichealth.org/en/permalink/ahliterature139400
Source
Disabil Rehabil. 2011;33(15-16):1340-50
Publication Type
Article
Date
2011
Author
Sally Lindsay
Author Affiliation
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital and Dalla Lana School of Public Health, University of Toronto. slindsay@hollandbloorview.ca
Source
Disabil Rehabil. 2011;33(15-16):1340-50
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Chi-Square Distribution
Cross-Sectional Studies
Databases, Factual
Disability Evaluation
Disabled Persons - rehabilitation - statistics & numerical data
Employment - statistics & numerical data
Employment, Supported
Female
Health services needs and demand
Humans
Job Application
Logistic Models
Male
Multivariate Analysis
Ontario
Prejudice
Questionnaires
Risk factors
Young Adult
Abstract
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.
PubMed ID
21067349 View in PubMed
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Experiences of social exclusion and bullying at school among children and youth with cerebral palsy.

https://arctichealth.org/en/permalink/ahliterature131848
Source
Disabil Rehabil. 2012;34(2):101-9
Publication Type
Article
Date
2012
Author
Sally Lindsay
Amy C McPherson
Author Affiliation
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. slindsay@hollandbloorview.ca
Source
Disabil Rehabil. 2012;34(2):101-9
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Bullying - psychology
Canada
Cerebral Palsy - psychology
Child
Crime Victims - psychology
Disabled Children
Dominance-Subordination
Female
Focus Groups
Humans
Interviews as Topic
Male
Qualitative Research
Questionnaires
Schools
Social Distance
Social Isolation
Young Adult
Abstract
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.
PubMed ID
21870932 View in PubMed
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Implications of prosthesis funding structures on the use of prostheses: experiences of individuals with upper limb absence.

https://arctichealth.org/en/permalink/ahliterature135020
Source
Prosthet Orthot Int. 2011 Jun;35(2):215-24
Publication Type
Article
Date
Jun-2011
Author
Elaine Biddiss
Patricia McKeever
Sally Lindsay
Tom Chau
Author Affiliation
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada. ebiddiss@hollandbloorview.ca
Source
Prosthet Orthot Int. 2011 Jun;35(2):215-24
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Amputees
Artificial Limbs - economics - utilization
Canada
Child
Child, Preschool
Cost of Illness
Cross-Sectional Studies
Female
Health Care Costs - statistics & numerical data
Health Services Accessibility - economics
Humans
Infant
Insurance, Health, Reimbursement - economics
Language
Male
Middle Aged
Netherlands
Outcome Assessment (Health Care) - economics
Patient satisfaction
Questionnaires
United States
Young Adult
Abstract
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.
PubMed ID
21515898 View in PubMed
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Perceptions of health care workers prescribing augmentative and alternative communication devices to children.

https://arctichealth.org/en/permalink/ahliterature144782
Source
Disabil Rehabil Assist Technol. 2010 May;5(3):209-22
Publication Type
Article
Date
May-2010
Author
Sally Lindsay
Author Affiliation
Bloorview Kids Rehab, Bloorview Research Institute, and Dalla Lana School of Public Health, University of Toronto, Ontario, Canada. mail: slindsay@bloorview.ca
Source
Disabil Rehabil Assist Technol. 2010 May;5(3):209-22
Date
May-2010
Language
English
Publication Type
Article
Keywords
Child
Child Welfare
Communication Aids for Disabled
Decision Making
Disabled Children - rehabilitation
Health Services Accessibility
Health services needs and demand
Humans
Occupational therapy
Ontario
Perception
Physician's Practice Patterns - statistics & numerical data
Qualitative Research
Social Support
Speech Therapy
Abstract
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.
PubMed ID
20302418 View in PubMed
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Predictors of unmet needs for communication and mobility assistive devices among youth with a disability: the role of socio-cultural factors.

https://arctichealth.org/en/permalink/ahliterature141097
Source
Disabil Rehabil Assist Technol. 2011;6(1):10-21
Publication Type
Article
Date
2011
Author
Sally Lindsay
Irina Tsybina
Author Affiliation
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital. slindsay@hollandbloorview.ca
Source
Disabil Rehabil Assist Technol. 2011;6(1):10-21
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Canada
Communication Aids for Disabled - utilization
Cross-Sectional Studies
Cultural Characteristics
Disabled persons - statistics & numerical data
Family Characteristics
Humans
Language
Orthopedic Equipment - utilization
Residence Characteristics
Self-Help Devices - utilization
Severity of Illness Index
Sex Factors
Socioeconomic Factors
Wheelchairs - utilization
Young Adult
Abstract
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.
PubMed ID
20809875 View in PubMed
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Working with immigrant families raising a child with a disability: challenges and recommendations for healthcare and community service providers.

https://arctichealth.org/en/permalink/ahliterature125782
Source
Disabil Rehabil. 2012;34(23):2007-17
Publication Type
Article
Date
2012
Author
Sally Lindsay
Gillian King
Anne F Klassen
Victoria Esses
Melissa Stachel
Author Affiliation
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada. slindsay@hollandbloorview.ca
Source
Disabil Rehabil. 2012;34(23):2007-17
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Canada
Child
Child Health Services - organization & administration
Communication
Cultural Competency
Culture
Delivery of Health Care - organization & administration
Disabled Children
Emigrants and Immigrants - psychology
Family
Female
Focus Groups
Health Personnel
Health Services Accessibility
Humans
Interviews as Topic
Male
Professional-Patient Relations
Qualitative Research
Urban Population
Abstract
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.
PubMed ID
22455458 View in PubMed
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8 records – page 1 of 1.