Occ Sci Midterm all

Culture defined

-Comes from the latin colere, which means to tend or cultivate

-The word dates back to the 18th and early 19th century when it began to show up in literature to describe the growing of something or improvement of something, as in horticulture or agriculture

-Today is viewed as the customary beliefs, social forms, and material traits of a racial, religious, or social group

-Culture appears 16 times in the OTPF-4

Western worldviews

-Highlights a separation between the self and the environment and highlights the self as the central focus

-Science also focuses on empiricism (what can be measured and defined)

-Culture therefore os considered to be part of the person and usually related to race, ethnicity, and gender (things that can be measured and defined)

Eastern worldviews

-Regard humans as just another part of an environment that includes the totality of the universe

Science focuses on relativism. (truth is not universal but viewed as being multiple and changing according to the nuances of the environment)

-Culture therefore is viewed as socially constructed, and human occupation is not considered to be universal and varies based on the context

Western religions examples

-Omnipotent god individually central

-Single moral code guides life

-Actions are the result of the grand schema

Eastern religions examples

-No one person or thing. is above another

-Act do not have a specific purpose or outcome

-Things are not earned or achieved but rather dependent on each other

Historical view

Culture was thought to be marker of distinction that involved cultivation of one's mind. What is proper, good, and beautiful was something to be achieved

Current view

Culture is everything we do. It is the way we dress, the way we move, and the way we engage in occupation

Vertical

Social structure and occupations are dictated by hierarchical structure based on a person's job, age, frame of reference, organization, etc.

Horizontal

Occupation have both an inside quality (basic, personal intent) and outside quality (deliberate, public intent). Occupations viewed from an inside or outside perspective is situationally dependent

Definition

A system of inherited conceptions expressed in symbolic forms by means of which people communicate, perpetuate, and develop their knowledge about and attitudes towards life.

Meaning and purpose

Therefore, culture serves to ascribe meaning to the world make it understandable

IADLs subcategories

-Care of others

-Care of pets and animals

-Child rearing

-Communication management

-Driving and community mobility

-Financial management

-Home establishment and management

-Meal prep and cleaning

-Religious and spiritual expression

-Safety and emergency maintenance

-Shopping

Care of others

-Helping your grandma get dressed

-Putting your grandma's walker in the car

Care of pets and animals

-Feeding the dog

-Making sure the gate is closed before you let your dog out

Child rearing

Getting a babysitter

Communication management

Teaching ASL

Driving and community management

-Driving a car

-Riding the school shuttle

Financial management

-Paying electric bill

-Activating credit card

Home establishment and management

-Gardening

-Replacing siding on house

Meal prep and cleanup

-Making dinner

-Loading dishwasher

Religious and spiritual expression

Attending church

Safety and emergency maintenance

-Checking smoke detectors

-Having a fire escape ladder under upstairs beds

Shopping

-Buying groceries

-Making a list

The development of a concept

-Occupation used to "distract" the mind and produce a product

-The product is the person therefore, occupation is producing a person as opposed to a thing

-Occupation used as intervention without much research to support whether and how it is effective

-The kaleidoscope of occupation (will never be the same, always changing, a different occupation every time

The 3 paradigms of OT

-Paradigm of occupation 1917

-Mechanistic paradigm 1940s

-Contemporary paradigm 1980s

USC

-The faculty saw the need for a shift in thinking, a return to the roots of OT

-In 1989, created the first doctoral program in occupational science

-In 1997, the Well Elderly Study was published in JAMA

-In 2002, the SOciety for the Study of Occupation: USA was formed

-Today, many schools now offer undergraduate and graduate degrees and minors in OS

Basic vs. applied

-Is the focus on expanding current knowledge or looking for a solution to a problem?

-Exploring concepts just because

Quan vs. Qual

Are we looking for numerical data or word-based data?

Disability vs. wellness

Should the focus of OT and OS only be on those with a disability, or is there value in studying occupation in the well population?

Occupational science: defined

The study of the human as an occupational being, including the need for a capacity to engage in and orchestrate daily occupations in the environment over the lifespan

First basic tenet

Occupation should be studied and supported scientifically to provide efficacy, value, and significance to occupational therapy practice

Second basic tenet

Humans are occupational beings with a biological need for occupation, which should be analyzed from an interdisciplinary perspective

Third basic tenet

Occupation has the potential to shape health and well-being through building functional capacity; makes us different

Fourth basic tenet

Occupational engagement promotes skill development and adaptation within context and environments

The self as a guide

-Necessary to look at occupation outside of the realm of disability, illness, or injury

-Important to understand yourself as an occupational being before looking at others

-Next, you can begin to think about other people's occupations and how they are similar or different from your own

-From there, you look at the occupations of the clients that you might serve, including: those with disability, those without disability but some other occupational need, groups or populations in need of programming, the well, and those without any defined occupational need

Major constructs in OS

-Occupational disruption

-Gender and identity

-Women's occupation

-Occupational deprivation

-Occupational justice and injustice

-Occupational balance/inbalance

-Occupational apartheid

-Occupational development

-Time use and life balance

-Incarceration

-Occupational transitions

-Co-occupations

-Occupation and health and well-being

-Space, place, and time

-Occupation and society

-Disability and ableism

-Decolonization of occupation

Activity

A form of action that is objective and not related to a specific client's engagement or context, and, therefore, can be selected and designed to enhance occupational engagement by supporting the development of performance skills and performance patterns

Occupations

Everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life. Include things people need to, want to, and are expected to do

Activity vs. occupation

What makes occupation different is the added influence of context, culture, meaning, and purpose, and the individual performance patterns, performance skills and client factors of the person performing the occupation

Contexts

-Environmental factors

-Personal factors

Performance patterns

-Habits

-Routines

-Roles

-Rituals

Performance skills

-Motor skills

-Process skills

-Social interaction skills

Client factors

-Values, beliefs, and spirituality

-Body functions

-Body structures

Analysis: a fundamental OT skill

Addresses the typical demands of the activity, the range of skills involved in its performance, and the various cultural meanings that might be ascribed to it

What can we learn from activity analysis

-The demands placed on the person performing the activity

-The tools, equipment, space, and time needed

-Where and with whom the activity takes place

-The sequence of steps and timing of those steps

-Body functions, performance skills, and body structures required to perform the activity

Steps of the activity analysis process

1. Activity awareness: what are you truly analyzing

2. Type: what type of analysis will you be conducting?

3. Relevance and importance: is this occupation-based?

4. Identifying steps: what are the steps, in what sequence, and with what timing?

5. Objects and properties: what tools, supplies, and equipment are needed?

6. Space: what specific space is needed?

7. Social demands: who is the activity performed with?

8. Required body functions: what body functions are demanded of the person?

9. Body structures: what body parts are needed?

10. Performance skills: what actions are needed

Personalized activities

Occupations occur within the context of a person or group. The occupation also has unique purpose and meaning to the person engaging in it

Meaning and purpose

Occupations are labeled by our culture, can change over time, and have significant, seemingly insignificant, or even unhealthy meaning for the individual

Something to consider...

Occupations are not linear, single-occurring activities that happen one right after the other. They are often enmeshed, co-occurring, hidden, complex, or otherwise difficult to define. This makes analysis sometimes challenging

Benefits of activity analysis for OTs

-Identified needed equipment, materials, space, and time

-Provides knowledge base for instructing others in the steps and how it is done

-Gives information on how an activity might be therapeutic and for whom

-Helps us to grade or adapt the activity to allow for success

-Gives specifics for clear documentation

-Assists in discovering how context influence performance

-Helps us select appropriate activities for the just-right challenge

-Identified areas for intervention

Medical science and disability

-A great deal about what we know to be health, wellness, and disability is rooted in the medical sciences

-While this has allowed us to build influence in the medical community and provide us with a common language to understand health, wellness, and disability, it has narrowed our focus substantially

Disability

A physical or mental condition that limits a person's movements, senses, or activities

Health

The state of being free from illness or injury

Wellness

A state of being in good health, especially as an actively pursued goal

Occupational dysfunction

Can be the result of physical or mental disease or disorder, but can also result from social, political, or environmental causes. Looking at it through a medical lens does not allow us to address things beyond physical or mental disability

Understanding occupation

-In order to move our thinking beyond the medical model, we need to understand:

-All the things people do

-The relationship of what they do and who they are

-That through occupation, people are in a constant state of becoming different

Doing

-What we do

-Exercise/maintains/develops physical and mental capabilities on which health is dependent

-Provides a mechanism for social interaction

-Allows for societal development and growth

-Creates and shapes the communities in which we live

-Can be injurous or dangerous to our health and well-being

Being

-The present version of ourselves

-Being true to ourselves and our natural essence

-Is what is distinctive about us that we bring to a relationship

-Requires time to discover, think, reflect, and simply exist

-Is considered to be the current state of a person

-Can be viewed as our occupational roles

Becoming

-The future version of ourselves, what we strive to do

-Holds the notions of potential and growth

-Is considered transformational, or the process of self-actualization

-Someone that we are not can lead to poor health and well-being, as well as occupational dysfunction

Maslow's hierarchy of needs

-Physiological needs: food, water, warmth, rest (doing)

-Safety needs: security, safety (doing)

-Belongingness and love needs: intimate relationships, friends (being)

-Esteem needs: prestige and feelings of accomplishment (being)

-Self-actualization: achieving one's full potential, including creative activities (becoming)

Belonging

Allows us to look at the bigger picture and be a part of it, fitting in and being an occupational being

Generative discourse

-Developing and using language

-Talking the talk

Demonstration sites

-How this looks in practice

-Walking the walk

Effective education

Ensuring OTs can effectively use occupation in practice

Occupations categories

-ADLs

-IADLs

-Health management

-Rest and sleep

-Education

-Work

-Play

-Leisure

-Social participation

The problem with categorization

-We live in a society that divides things rather sharply. it makes a vast difference whether something is primarily labeled work, play, learning, therapy, exercise, or stress reduction, even though it is intuitively clear that many activities belong experientially to more than one category

-Dissecting and analyzing the texture of human life

-Thus leading to the potential devaluation of human occupation and human beings as a whole

Addition

-As an OT, we are not just adding something to someone's life

-Ex. Teaching a client a craft to occupy them for the day or facilitating bed transfers

Multiplication

-What we are doing is multiplying what they can do, thus changing the whole

-Ex. Teaching a client a craft which not only occupies their time but also increases socialization, give them a new hobby or way to earn money, and increases fine motor skills

Appeal of occupation

-Productivity: How does the activity allow the person to feel productive?

-Pleasure: What kind of pleasure is gained from engaging in the activity

-Restoration: How does the occupation restore a person's energy levels and ability to continue to engage?

The need for storytelling and storymaking

-Occupational disruptions: over the course of a lifetime, we experience many events that challenge our occupational selves

-Adaptive strategies: oftentimes we possess the capabilities to overcome these challenges

-But sometimes we cannot. This is where OT comes into the picture. How do we know how best to help our clients? We need to understand their story

Constructing the occupational being

-An occupational being is a person fully engaged in the world of activity-work, play, and leisure-who is productive and feels a sense of self-worth

-Decoupling the self from activity is when we see poor functional ability, ill health, and disability

OS vs. OT

So what does this mean to us as occupational scientists? We can use storytelling and storymaking to help a client connect their former selves with their future selves. However, as occupational scientists, we can use a story to help us understand each other and build an occupational profile

Building a communal horizon of understanding

-When talking with another person about their occupation, it is important that we do not stand apart from them but rather engage fully and inextricably in their dialogue

-Horizon can also be understood as the standpoint of the person and the interpreter

-When interpreting an experience of another person, the interpreter's history and culture influence

-In order to come to a communal horizon of understanding, you must fuse your interpretation of occupations with that of the person's interpretation

-As conversations unfold, this occurs naturally and should be recognized and fostered

Techniques for building a communal horizon of understanding

1. Collaboration: relinquishing power to control the dialogue

2. Building empathy: Stepping out of your shoes and into someone else's shoes. Being willing to self-disclose

3. Inclusion of ordinary: Using casual interchanges on any subject to normalize the interaction. Ordinary things so they don't feel like a patient

4. Listening: Being open to others in a caring exchange

5. Reflection: Verbally reflecting on the other person's statements

Evocation of stories of occupation

-Using semi-structured questions, ask about occupations that were/are engaged in

-Consider asking about childhood, current day, meanings, objects, etc

-Ideally, information should be obtained organically rather than through a preconstructed means

Story analysis and synthesis

-Data is often not presented in a coherent narrative

-Occupations need to be reflected upon and synthesized based on time and value

TIme

Chronicity of the occupations

Value

How does engagement shape the person

Important

The story should reveal in what activities the person has engaged in and whether they thought the investment in those occupations was worth it, how the occupations shaped personhood, what matters the most, and what occupations can be used to create a story moving forward

Occupational coaching

-Giving encouragement and positive remarks

-Teaching occupational strategies

-Teaching about occupation's role in recovery

-Marking and affirming

Evoking insight

-Will be unique to each dyad's communal horizon of understanding

-Should involve the searching for an engagement of occupations to solve problems

Broadening view of ADLs

-Consider occupations as more than just the mechanical process to complete something

-View them as ways in which a person can manage the environment

-Key component of understanding the PEO model

Image reconstruction

-Using occupation to define and create a new self

-Choosing words, objects, environments to create the image

-Not just getting back to the old self but creating a new self

Cultural place

Consider available resources, technology, adaptive systems, and family supports that can create a new story

Therapeutic intervention

As an OT, we would help to create a client's story through occupational interventions

A note about mistakes

In this process, we will inevitably make mistakes. If a solid communal of understanding exists, then these could also be used therapeutically if we are open to them, see them as such, and use them as a means to help move the story along

Occupational profile defined

Is a summary of a client's occupational history and experiences patterns of daily living, interest, values, needs, and relevant contexts

Formal interview techniques

-Questionnaires

-Formal interview questions

-Checklists

Informal interview techniques

-Casual conversations

-Observations

-Discussion

Purpose of the occupational profile

Provides an occupational therapist with an understanding of the client's perspective and background. It provides us with a snapshot of their occupational repertoire and occupational self

Elements of occupational profile

-Client report

-Contexts

-Performance patterns

-Client factors

-Client goals

Client report

-Reason the client is seeking service and concerns related to engagement in occupations

-Occupations in which the client is successful and barriers impacting success

-Occupational history

-Personal interests and values

Contexts

-Environment: natural environment and human-made changes, products and technology, support and relationships, attitudes, services, systems, and policies

-Personal: age, sexual orientation, gender identity, race and ethnicity, cultural identification, social background, upbringing, psychological assets, education, lifestyle

Performance patterns

-What are the client's patterns of engagement in occupations, and how have they changed over time? What are the client's daily life roles?

Client factors

- Values, beliefs, spirituality

-Body functions

-Body structures

Client goals

-What are the client's priorities and desired targeted outcomes related to the items below?

-Occupational performance

-Prevention

-Health and wellness

-Quality of life

-Participation

-Role competence

-Well-being

-Occupational justice

Use these techniques when practicing your interviewing skills

-Collaboration

-Building empathy

-Inclusion of the ordinary

-Listening

-Reflection

-Evocation of stories of occupation

-Story analysis and synthesis

Values

Acquired beliefs and commitments derived from culture, about what is good, right, and important

Beliefs

Cognitive content held as true to the client

Needs

Why someone needs to complete or engage in an occupation. May be unknown unless specifically asked