The majority of occupational therapists in Sweden previously worked on large occupational therapy wards. Health care policy has changed over the years and the system has been reorganized accordingly. The employment situation for occupational therapists has also changed. This paper focuses on the perception of professional self among occupational therapists. The objective was to explore the professional self and to suggest components important to the occupational therapist profession. The Professional Self Description Form (PSDF) was used for the exploration of self. The 19 items in the PSDF cover areas relevant to professional functioning and activity. Sixty-eight employed occupational therapists participated. The results of the PSDF were subjected to factor analysis and five factors were obtained; Ability to solve problems, Professionalism, Management, Empathy, and Working capacity. We believe that these five factors can function as improving domains of the role of the professional occupational therapist in Sweden.
This paper investigates the possible relationship between job satisfaction and academic performance of occupational therapists who have graduated from the University of Western Ontario in the years 1975 to 1978. Fifty-four percent of the graduates of this time period filled out questionnaires eliciting information on their satisfaction with their jobs as occupational therapists and with the profession of occupational therapy. This information was analyzed with the therapists' academic performance of Grade XIII and their four years in the Occupational Therapy Program. The results indicated that although job satisfaction related significantly to three individual academic courses it did not relate to overall performance as measured by grade average.
Physical and occupational therapy are beneficial for persons with chronic arthritis; however, access is problematic. The goal was to examine issues related to access to these services for patients with chronic arthritis.
We used two data sources: 1) questionnaires sent to a random sample of 600 family physicians and to all 85 rheumatologists in the province of Quebec; and 2) interviews of 211 patients with physician-confirmed chronic arthritis recruited from 34 primary care settings in Quebec.
Only 11.5% of family physicians and 31.7% of rheumatologists referred patients with rheumatoid arthritis (RA) to rehabilitation, whereas 60.4% of family doctors referred patients with osteoarthritis. Only 26.1% of patients felt that they required rehabilitation and this was associated with lower self-efficacy (OR: 0.84, 95% CI: 0.72, 0.99) and higher educational level (OR: 2.10, 95% CI: 1.01, 4.36).
Family physicians are less likely to refer patients with RA to therapy. Only about a quarter of patients with chronic arthritis treated in primary care perceived the need for these services. Efforts to improve arthritis care should address education of physicians and patients regarding the benefits of rehabilitation and there should be efforts to increase therapy resources in order to enhance access.
The purpose of this study was to identify, from the personal perspective of students with disability, their needs for physical and social accommodations in upper secondary schools specially adapted for students with severe physical disabilities. The study also aimed to identify those areas of student-environment fit which were most often achieved. Forty-eight students in four schools in Sweden were assessed by occupational therapists using the School Setting Interview. Forty-seven students reported needs for accommodations in the school setting. The study indicates that schools generally were able to meet the students' accommodation needs in the physical environment. The schools also met students' accommodation needs for field trips, sport activities and assistance. Student-environment fit in occupations requiring reading, remembering and speaking was unsatisfactory. Accommodations on a general, group and individual level are highlighted and discussed. The study recommends that occupational therapists become more involved and offer society their expertise in barrier removal to a greater extent.
The BIA method, based on assessment of patients in activities, was developed to enable reliable assessment of clients' occupational functioning. The method evaluates the patient's ego functions and capacity for activity and participation. The aims of this study were to examine inter-rater reliability for the BIA method and to compare the experiences of staff working with the BIA with those of staff using standard assessment (SA). In SA, the patient's activity problems and capacities were assessed without using any structured protocol. Four staff members worked according to the BIA method and eight according to SA. The estimation of reliability was based on data from 14 patients who went through the BIA and were assessed by five staff members. These assessments resulted in all in about 400 statements, which were classified and compared for agreement between raters. In order to address the aim concerning staff experiences, a questionnaire was filled out anonymously by the staff. The inter-rater reliability of the nine ego functions varied from 0.76 to 1.00. The scale was deemed appropriate by the BIA staff and they had significantly higher median ratings on work satisfaction and appropriateness than the SA staff. In conclusion, the inter-rater reliability of the BIA was found to be good. The BIA method also seems to have a high degree of appropriateness, constituting a promising assessment tool when occupational functioning is addressed.
To investigate occupational therapists', physiotherapists' and speech language pathologists' family-related rehabilitation practice post-stroke and its association with clinician and environmental variables.
A Canadian cross-sectional telephone survey was conducted on 1755 clinicians. Three case studies describing typical patients after stroke receiving acute care, in-patient rehabilitation, or community rehabilitation, and including specific descriptors regarding family stress and concern, were used to elicit information on patient management.
One-third of the sample identified a family-related problem and offered a related intervention, but only 12/1755 clinicians indicated that they would typically use a standardized assessment of family functioning. Working in the community out-patient setting was associated (OR 9.16), whereas working in a rehabilitation in-patient setting was negatively associated (OR 0.58) with being a problem identifier, the reference group being acute care. Being a PT (OR 0.53) or an SLP (OR 0.49) vs an OT was negatively associated with being a problem identifier, whereas being older (OR 1.02 ) or working in Ontario (OR 1.58) was associated with being a problem identifier. To work in a community out-patient setting (OR 2.43), being older clinicians (OR 1.02) or not perceiving their work environment being supportive of an on-going professional learning (OR 1.72) was associated with being an intervention user,whereas being a PT (OR 0.50) was negatively associated with being a user.
For these 3 disciplines, the prevalence of a family-related focus is low post-stroke. Given the increasing evidence regarding the effectiveness of family-related interventions on stroke outcomes, it is imperative that best practice is implemented.
School of Physical & Occupational Therapy, Faculty of Medicine, McGill University and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montreal, Quebec, Canada. firstname.lastname@example.org
Cerebral palsy (CP) constitutes a substantial portion of paediatric rehabilitation, yet little is known regarding actual occupational therapy (OT) and physical therapy (PT) practices. This study describes OT and PT practices for young children with CP in Quebec, Canada.
This was a cross-sectional survey. All eligible, consenting paediatric occupational therapists (OTs) and physical therapists (PTs) were interviewed using a structured telephone interview based on vignettes of two typical children with CP at two age points--18 months and 4 years. Reported practices were grouped according to the International Classification of Functioning, Disability and Health (ICF).
91.9% of PTs (n=62; 83.8% participation rate) and 67.1% of OTs (n=85; 91.4% participation rate) reported using at least one standardized paediatric assessment. OT and PT interventions focused primarily on impairments and primary function (such as gait function and activities of daily living). Both professions gave little attention to interventions related to play and recreation/leisure. Clinicians reported the need for more training and education specific to CP and to the use of research findings in clinical practice.
Wide variations and gaps were identified in clinicians' responses suggesting the need for a basic standard of OT and PT management as well as strategies to encourage knowledge dissemination regarding current best practice.