Studied by 55 people
occupational therapy
therapy based on engagement in meaningful activities of daily life (as self-care skills, education, work, or social interaction) especially to enable or encourage participation in such activities despite impairments or limitations in physical or mental functioning
occupational science
an academic discipline that offers support, reason, and scientific data that legitimizes the work that is done within that profession
form
direct, observable aspects of occupation objects and tools used steps involved environmental factors
function
human development health quality of life adaptation
meaning
looks at how people think, feel, and experience what they do discovered through qualitative measures such as interview encompasses the personal and cultural significance of occupations looks at how it influences choice through occupation we develop a sense of competence, self-esteem, and identity
occupation
the focus of occupation therapy and the unit of measure for occupational science
clinical reasoning
process used by practitioners to plan, direct, perform, and reflect on client care
William Rush Dunton
father of OT
Eleanor Clarke Slagle
mother of OT
George Edward Barton
leader of Arts and Crafts Movement
Susan cox Johnson
showed occupation can be positive for health
Thomas Bessel Kidner
established OT in Vocational Rehab.
Phillipe Pinel
conceived Moral Treatment Movement
Adolf Meyer
physch. who developed basis of OT
WWI
provided a motivation to the concept of OT (crafts, habit training)
WWII
provided more functional activities to enhance return of daily life; goal was rehab.
Biomechanical Frame of Reference (FOR)
emerged (Medical Model)
OT as a profession
seeks to improve the quality of life for individuals who are experiencing or are at risk for physical, cognitive mental, or psychosocial impairments
OT as art
it is different for every person - the therapist must learn to enter a client's life to understand
client-centered practice
the client determines what is meaningful and important for therapy
occupational-based practice
separates us from other allied health professionals; we use occupation as an end as well as a means
evidence-based practice
the use of research to guide clinical reasoning
thinking about the client
OT understanding their motivation, goals, developmental level, and personal expectations; OT needs to be realistic, ask Qs, and seek support
thinking about the family
the OT needs to perceive family members as listeners , supporters, motivators, and adaptable when necessary
OT role
respecting family values, beliefs, and routines not judging comm. with clean goals, expectations, and education to promote health, safety, and independence listening and trying not to fix everything being realistic HIPAA advocating for client/family establishing a professional relationship being human
thinking about the team
comm. with each other, the client, and the family everyone needs to be on the same page educate the family and client about outcomes, illness, disability, comm. resources, etc. provide necessary intervention/services
philosophy
a set of basic principles/concepts underlying someone's practice or conduct
metaphysical
the Qs concerned with the nature of humankind
epistemology
related to nature, origin, and limits of human knowledge; provides a base for understanding motivation, change, and learning; investigates how we know things and how do we know that we know?
axiology
examines the value of a profession and what's considered just and right; OT this = client-centered care, quality of life, ethics; explores Qs of desirability and ethics
reductionistic approach
humankind is reduced to separately functioning parts; successful in producing cures and technological advancements; inefficient and costly
holistic approach
emphasized the organic and functional relationship between parts and the whole being; core concept to our profession - this means that evaluations and intervention plans should reflect the needs of the whole person
active beings
how OT views humans; actively involved in controlling and determining their own behavior and are capable of changing behavior as desired; viewed as open systems in which there is continuous interaction between the person and environment
occupation as a means
the use of a specific occupation to bring about a change in the client's performance
occupation as an end
the desired outcome or product of intervention
culture
a set of shared distinct beliefs, values, and behaviors that help individuals to recognize who belongs and who does not belong to the collective group
culture is...
learned - not inherited real - influence can be felt shared - be group individuals dynamic - changes over time in response to politics and economics invisible - taken for granted until a different culture makes our own visible NOT race or ethnicity
cultural sensitivity
cultural differences impact OT assessment and intervention; if we are not addressing important occupations - why would the client continue participating in OT treatment?
spirituality
fundamental orientation in a persona's life; what inspires and motivates; may result in a connection with others; linked to hope, faith, coping, and self-transcendence; may imply religion
religion
an organized and culturally shaped avenue for spiritual expression
social position
the differences and inequalities among people or groups of people; can shape one's values, beliefs, and view of the world as they participate in it
social/material qualities
resources such as education, jobs, housing, food, sources, and health care
socioeconomic status
the occupational, educational, and income achievements by individuals or groups
poverty
lack of material resources that are necessary to live
working poor
people who work full time but still live within the poverty line
new poor
when an unplanned life change occurs and effects the resources required to meet basic needs
1960s
when medicare and medicaid are established
medicare
for people 65+, disabled of any age, and end-stage renal disease part A: inpatient hospitalization SNFs HHC hospice part B: physician and outpatient services HHC DME
medicaid
insurance for all who are unable to afford health care (requirements) federally and state funded varies by state with coverage/usage
SCHIP (State Children's Health Insurance Program)
established in 1997 to provide health care to uninsured children of working families who earn too little to afford private insurance but too much to be eligible for medicaid.
IDEA (Individuals with Disabilities Education Act)
a school-based program that focuses on care in school systems; highest % of OTs work in school-based programs; partnerships between state and federal gov. and school systems
workman's compensation
state-run; pays for healthcare related to a work injury; pays for medical services, salaries, vocational training, and for disability if determined by an MD; uninsured
JCAHO (Joint Commission on Accreditation of Healthcare Organizations)
evaluates an organization's compliance with the standards established; organization being evaluated must comply with essential standards in order to receive Medicare reimbursement; hospitals utilize this organization by choice
NCQA (National Committee for Quality Assurance)
assesses and reports on the quality of managed care plans; voluntary service for MCO's; standards relate to member satisfaction, quality of care, access., and services provided
CARF (Commission on Accreditation of Rehab Facilitates)
a voluntary organization for rehab providers
NBCOT (National Board for Certification in Occupational Therapy)
credentials OT's and COTA's to be able to work within the profession; and examination in taken after a master's education and 6 of fieldwork
State Regulatory Board
after passing the certification exam (NBCOT) an OT/COTA can apply for licensure within the state in which they want to practice; each state has specific criteria regarding the duties and responsibilities of the OT/COTA.
NHOTA ( )
advances the profession within the state; provides continuing education opportunities independent from AOTA, but they collaborate
CHT
certified hand therapist
CPE
certified professional ergonomist
SCLV
specialty certification in low vision
supervision
depends on skill, knowledge, and experience; promotes learning, autonomy, and professional growth; includes respect and trust; comm. needs and type of supervision
service competency
demonstration and verification of skills and knowledge of treatment; this can be done by:
co-treatment
observation
individual education
collaboration
respect, understanding, clear expectations, dependability
interdisciplinary
team members have shared responsibility for providing services and support one another's goals for treatment. Separate assessments, then shared results to develop integrated and coordinated care
multidisciplinary
team members work side-by-side one another. Roles are clearly defined and team members are aware of each others' scope of practice
transdisciplinary
team members work together to develop goals, and carry out patient care. Family interacts with a primary provider, based on patient needs
ethics
clinical decisions based on professional judegment
dilemma
involves personal and social morals and values; not a right/wrong answer
OT code of ethics
(AOTA 2000) common set of values/principles that promote high standards of behavior and professional responsibility
beneficience
demonstrates concern and well-being for the recipients of services
nonmaleficence
do no harm to the recipients of service
autonomy and confidentiality
respect the right of the individual to self determination; collab with all, inform recipients of potential risks of intervention, respect decisions, HIPAA
social justice
providing service in a fair/equitable manner
procedural justice
compliance with laws/policies
veracity
the duty to tell the truth
fidelity
treating colleagues and others with fairness, discretion, and integrity
OT values
Altruism Equality Freedom Justice Dignity Truth Prudence
process of ethical reasoning
identify the ethical dilemma
gather relevant facts about the case
apply ethical theories and guiding principles to analyze the case
problem solve practical alternatives
decide on an action
act on that choice
evaluate how to prevent or cope with the dilemma should you encounter it again
professional reasoning
used by practitioners to plan, direct, perform, and reflect on client care; complex' multifaceted; effected by the amount of experience one has
metacognitive
thinking about thinking
schemata
building up a representation of what to expect based on experience
scripts
rules to guide thinking (initial treatment to discharge)
scientific reasoning
focuses on the diagnosis of the illness or condition; guided by theory; considers evidence from research to guide practice; does not consider the patient on a personal level
narrative reasoning
personal; includes info from the patient and family; focuses on the patient's history and story; considers the patient's culture; helps the therapist make sense of the patient's circumstances
pragmatic reasoning
practical; considers scheduling options, payment, equipment needed/available, therapist's skills, organizational policies; not focused on the client's condition, but the realities of providing services
ethical reasoning
a systematic approach to a moral conflict; analyzes the dilemma; helps generate alternative solutions; determines actions needed
interactive reasoning
thinking that helps the therapist build a positive relationship with the patient; uses positive communicative skills; allows for collaboration in treatment; identify and solve problems
OT process
involves the interaction between the practitioner and the client; collaborative; dynamic process with the focus on
evaluation process
to find out what the client wants/needs; based on age, diagnosis, developmental level, education, socioeconomic status, cultural background, and abilities
referral
starts the OT process; a request for service for a particular client is made from a medical prof.
screening
OT practitioners gather prelim. info about the client and determine whether further evaluation and intervention are needed; involves interview, screen test, observation, discussion, and referral
occupational profile
gather basic demographics: age, gender, diagnosis, reason for referral, etc.; provides OT with a history of the client's background and functional performance with which is to design interventions
occupational performance analysis
uses the occupational profile to provide a direction to the practitioner to the areas that need further examination; involved analyzing all aspects of the occupation to determine the client factors, patterns, skills, and behaviors required to be successful
observation
the means of gathering info about a person or an environment by watch/notice; ex: posture, dress, social skills, voice, behavior, physical abilities, etc.
structured observation
watching the client perform a predetermined activity
intervention
working with the client through therapy to reach client goals
occupational justice
to develop an understanding of the political potential of OT to create situations in which all individuals, regardless of race, ethnicity, socioeconomics, class, or disability status, can engage in meaningful occupations by choice that support their participation in everyday life
occupational dysfunction
impaired or disordered occupations
occupational apartheid
segregation of groups of people through restriction or denial of participation in occupations if daily life; can be based on race, color, disability, sexual preference, political beliefs, etc.
Note
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