hum occ II ch 12

what is an intervention

Participation in occupations is both the ends (end product of intervention) and means (agent of change) to making permanent changes during the intervention process. 

How OTPs utilize occupation,

the activities or tasks that people need or want to do, to facilitate meaningful engagement in daily life

Client factors

Includes one's value systems, body functions, and body structures. Each factor can be affected by the presence or absence of illness or injury, and can affect performance skills

Performance skills

(motor, processing, social) demonstrate a client's abilities to perform daily occupations; an injury that limits motor functions can affect functional mobility and ability to transfer from one position to the next; change in one performance skill can take effect on other performance skills and improve overall performance in the desired occupations

Performance skill

(habits, routines, roles, rituals) can support or hinder occupational performance

Context personal

- client factor

- performance skills

- performance patterns

context environmental

- personal abilities

- physical environment

- social environment

- contextual domains

Personal and environmental: cultural context

includes an awareness of and a respect for the customs, beliefs, behavioral standards, and expectations of the clients society

personal and environment: temporal context

time of day, chronological age (personal context), and expected length of stay, as well as anticipated duration of disability, stage of illness, and individual history (personal context)

therapeutic use of meaningful occupations and purposeful activities

promote health and wellness, prevent disability, restore function, maintain performance capacity, and modify factors related to participation; purposeful activities may include practicing medical management with beads and mock medication bottles, or practicing shower transfers in the hospital bathroom

Environmental modification/activity adaptions

OTAs analyze activities to determine what environmental what environment modifications and adaptions will enhance function, safety, and occupational performance.

Preparatory tasks and methods

- prepare for the engagement in therapeutic activities; typically include active client participation and occur in a clinical or simulated setting; are passive intervention applications used to improve a specific client factor in order to increase participation in occupations;

- Ex: include sensorimotor techniques such as the application of neutral warmth to decrease hypertonicity in the UE to increase engagement, and PAMs

Preparatory tasks

- TherEx

- strengthening

- endurance

- ROM (active) -needs to be occupation based

what are 3 methods of intervention (discharge plan is NOT an intervention)

- education

- advocacy

- environmental modification

Education and training

adaptive equipment training and family education are provided to promote increased independence

Advocacy

empowers clients and therapists ti strive for occupational justice

Occupational analysis

systematically analyzing the aspects of an activity and how a person or group of people completes an activity.

Adapting Activity (Adaptation/Compensation)

- consistently modifying the activity

- Components of an occupation that need to be adapted to increase participation may be discovered through activity analysis 

- If a client has decreased strength and endurance required to complete an ADL task, the method may be altered.

- Ex: sitting instead of standing, change of environment, adaptive equipment

Grading Occupations (Remediation)

- returning to previous function

- Grading activities by increasing or decreasing the demands facilitates skill development, increases the likelihood of success, and improves participation  

- Grading can be done through changing the activity itself, or changing the environment in which the activity is performed  

Activities

- should enable the patient to transfer the motion, strength, and coordination gained in adjunctive and enabling modalities to useful, normal daily activities

- should allow for active participation and opportunities for practice, such as those involving repetition of motion to benefit the patient.

Therapeutic activities

- are preparatory tasks

- are dynamic activities that develop or restore normal movement patternd, muscle strength, endurance, coordination, ROM deficits, and joint contractures.

forward chaining

Patient completes the first step, and OTA assists with remaining steps.

backwards chaining

OTA assists with the first 4 steps, and the patient completes the last step.