Professor Lunn OT Final

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occupational therapy

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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

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occupational science

an academic discipline that offers support, reason, and scientific data that legitimizes the work that is done within that profession

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form

direct, observable aspects of occupation objects and tools used steps involved environmental factors

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function

human development health quality of life adaptation

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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

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occupation

the focus of occupation therapy and the unit of measure for occupational science

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clinical reasoning

process used by practitioners to plan, direct, perform, and reflect on client care

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William Rush Dunton

father of OT

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Eleanor Clarke Slagle

mother of OT

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George Edward Barton

leader of Arts and Crafts Movement

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Susan cox Johnson

showed occupation can be positive for health

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Thomas Bessel Kidner

established OT in Vocational Rehab.

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Phillipe Pinel

conceived Moral Treatment Movement

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Adolf Meyer

physch. who developed basis of OT

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WWI

provided a motivation to the concept of OT (crafts, habit training)

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WWII

provided more functional activities to enhance return of daily life; goal was rehab.

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Biomechanical Frame of Reference (FOR)

emerged (Medical Model)

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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

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OT as art

it is different for every person - the therapist must learn to enter a client's life to understand

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client-centered practice

the client determines what is meaningful and important for therapy

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occupational-based practice

separates us from other allied health professionals; we use occupation as an end as well as a means

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evidence-based practice

the use of research to guide clinical reasoning

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thinking about the client

OT understanding their motivation, goals, developmental level, and personal expectations; OT needs to be realistic, ask Qs, and seek support

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thinking about the family

the OT needs to perceive family members as listeners , supporters, motivators, and adaptable when necessary

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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

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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

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philosophy

a set of basic principles/concepts underlying someone's practice or conduct

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metaphysical

the Qs concerned with the nature of humankind

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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?

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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

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reductionistic approach

humankind is reduced to separately functioning parts; successful in producing cures and technological advancements; inefficient and costly

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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

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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

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occupation as a means

the use of a specific occupation to bring about a change in the client's performance

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occupation as an end

the desired outcome or product of intervention

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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

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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

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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?

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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

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religion

an organized and culturally shaped avenue for spiritual expression

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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

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social/material qualities

resources such as education, jobs, housing, food, sources, and health care

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socioeconomic status

the occupational, educational, and income achievements by individuals or groups

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poverty

lack of material resources that are necessary to live

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working poor

people who work full time but still live within the poverty line

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new poor

when an unplanned life change occurs and effects the resources required to meet basic needs

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1960s

when medicare and medicaid are established

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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

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medicaid

insurance for all who are unable to afford health care (requirements) federally and state funded varies by state with coverage/usage

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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.

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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

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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

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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

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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

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CARF (Commission on Accreditation of Rehab Facilitates)

a voluntary organization for rehab providers

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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

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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.

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NHOTA ( )

advances the profession within the state; provides continuing education opportunities independent from AOTA, but they collaborate

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CHT

certified hand therapist

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CPE

certified professional ergonomist

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SCLV

specialty certification in low vision

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supervision

depends on skill, knowledge, and experience; promotes learning, autonomy, and professional growth; includes respect and trust; comm. needs and type of supervision

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service competency

demonstration and verification of skills and knowledge of treatment; this can be done by:

  • co-treatment

  • observation

  • individual education

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collaboration

respect, understanding, clear expectations, dependability

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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

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multidisciplinary

team members work side-by-side one another. Roles are clearly defined and team members are aware of each others' scope of practice

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transdisciplinary

team members work together to develop goals, and carry out patient care. Family interacts with a primary provider, based on patient needs

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ethics

clinical decisions based on professional judegment

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dilemma

involves personal and social morals and values; not a right/wrong answer

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OT code of ethics

(AOTA 2000) common set of values/principles that promote high standards of behavior and professional responsibility

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beneficience

demonstrates concern and well-being for the recipients of services

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nonmaleficence

do no harm to the recipients of service

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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

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social justice

providing service in a fair/equitable manner

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procedural justice

compliance with laws/policies

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veracity

the duty to tell the truth

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fidelity

treating colleagues and others with fairness, discretion, and integrity

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OT values

Altruism Equality Freedom Justice Dignity Truth Prudence

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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

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professional reasoning

used by practitioners to plan, direct, perform, and reflect on client care; complex' multifaceted; effected by the amount of experience one has

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metacognitive

thinking about thinking

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schemata

building up a representation of what to expect based on experience

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scripts

rules to guide thinking (initial treatment to discharge)

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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

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