Health through Occupation

Created by NRosenhauer 

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Importance of theory

every profession must draw from well-formed knowledge base; unifies profession

What does a theory do?

organizes knowledge for the purpose of guided thinking; how we make decisions

theories serve as a foundation to what?

models of practice

What is a paradigm

Supports the professions identity, values, beliefs, and knowledge. It's the most central assumption or value and belief of a discipline.

What is OT's paradigm?

engagement and participation in occupation people find meaning, promotion of health and well being.

What is a model of practice?

Direct application of a theory. Defines the scope of practice or area of concern

what is MOHO?

Recognizes the importance ability, routine, motivation and influence of social and physical env. contributing to difficulties in everyday occupations.

What is a Frame of Reference?

Guides and links theory to practice. Guides type of assessments/eval and interventions consistent with theory base. A narrow and specific view.

What are the FOR in OT practice?

Biomechanical (movement), Motor learning (teaching brain), Sensory processing, Neuro-occupational (brain and env. interaction), Neuro-developmental (patterns of movement).

What is Occupational Science?

Looking at behaviors and experiences of everyday occupations. The scientific study of occupations.

What is the purpose of Occupational Science?

Generate knowledge of the Form, Function, and meaning of human occupation

Major concepts of OS

Occupations (form, fx, meaning), adaptations (selecting and organizing activities to improve QOL), and Culture (how people interact with their env.)

What is FORM in OS?

Directly observable aspects of occupation. are they satisfied/dissatisfied with the task?

What is FUNCTION in OS?

ways in which occupation serves adaptation by acting to promote person's health. Can be healthy or not.

What is MEANING in OS?

the significance of occupations within the context of real lives and in culture.

Temporal aspects of occupation

impacts daily patterns. Time is an important aspect of habits, routines, and patterns.

What are the concepts of MOHO?

Motivation of occupation, routine patterning, skilled performance, influence of env., finding meaning in occupations.

what are the concepts of EHP?

Occupational performance is the primary outcome. Is determined by the person, env., and task. Impact of the env. on occupational perf.

What are the concepts of OA?

Occupation and adaptation. Env., influences, the person's adaptability.

What is collaboration?

A mutual working together to determine the issues of priority, how they'll be addressed, and how the practitioner will be involved.

What are the practice settings?

Inpatient acute, inpatient rehab (acute and subacute), home and community (residental, ALU, home health), outpatient (day treatment), work site (industrial rehab), telerehab.

What are some advantages of telerehab?

increased accessibility, OT services to clients living in remote or underserved areas, removes barriers of travel, SES issues and cultural issues.

What is inpatient acute?

Client is a new med patient that is medically unstable. Provide safety, education, initiate rehab process and consultation.

What is inpatient rehab?

Medically stable, can tolerate 3 hrs of therapy/day

What is inpatient rehab - acute?

LOS 2-3 weeks, 3 hours of therapy split up.

What is Inpatient rehab - subacute?

LOS weeks to months, 3 hours of therapy (but vary), functional skills learned at slower rate.

What is a SNF practice setting?

long term institution, medicare/medicaid services, work on env. mod., cog/memory, leisure, energy conserv.

What is a residential practice setting?

group homes, staffed 24 hours, clients work on ADL's IADL's, safety, leisure, and env. modifications

What is a ALU practice setting?

assisted living unit, 55 y/o +, apt./cottage, enhance routines, envir. supports.

What do home health practice settings focus on?

accessibility, safety, exercise, endurance, ADL's, IADL's

What is an outpatient practice setting?

client lives at home and comes in weekly to work on specific skills.

What is a day-treatment practice setting?

Type of outpatient practice that the client lives at home and during the day they go somewhere for supervision.

What are nesting levels of occupation?

EX. homemaker is an occupational role. Occupation is to do laundry. One aspect includes hanging clothes. To hang clothes you must have dexterity to open a clothespin. To do that you need to know what grasp pattern to use. To use a grasp pattern your muscles need to use reflexive group.

Intervention approaches

Establish/restore, Modify, Maintain, create/promote, prevention.

Areas of occupation

ADL's, IADL's, education, work, leisure, play, rest, social

areas of occupation (specifically)

Performance skills, performance patterns, context and env., activity demands, client factors.

Types of interventions

Therapeutic use of self, therapeutic use of occupations, occupation based interventions, purposeful activity interventions, preparatory activity interventions, consultation process, education process, advocacy process.

What is therapeutic of self?

knowledge, personality, experiences, establish trust, empathy

What is therapeutic use of occupations?

context, demands, and client factors, client learns parts of occupations.

what are Occupation based interventions?

engage in occupation in context. ex. put away groceries, apply for a job, etc.

what are purposeful activity interventions?

where a client practices skills. rehearse, think out loud, role play, practicing for purposeful activity

preparatory activity interventions

prepare client to participate in an occupation. ex. making them splints, working on muscle strengthening.

What are outcomes of OT?

supporting health and participation in life through engagement in occupation: health and wellness, participation, QOL, adaptation, prevention, self advocacy, occupational justice, prevention, occupational performance.

Define ACOTE

accreditation council for OT education. monitor accred. at all OT schools. makes sure faculty has curriculum appropriate for what students need. composed of OT educators and practitioners.

Define NBCOT

National Board for Certification in OT. Must have passing grade to get state licenses.

Why did they change Uniform Terminology to OTPF?

It did not describe our focus on occupation, which is the core of our profession

What is the purpose of the OTPF?

clearly articulate OT's unique focus on daily life activities and interventions that promote engagement in occupations to support participation in context (describe our DOMAIN). And give practitioners a way to think about and apply occupation across the OT process (outline an occupation based OT PROCESS)

What does DOMAIN describe?

is where the process is applied.

DOMAIN areas of occupation?

ADL, IADL, sleep, work, play, leisure, education, social participation

DOMAIN Performance skills?

motor and praxis skills
sensory - perceptual skills
emotional regulation skills
cognitive skills
communication and social skills

DOMAIN perf. patterns

habits, rituals, roles, routines

DOMAIN context and env.

cultural, social, physical, temporal, virtual, personal

DOMAIN activity demands

Objects used
space demands
social demands
sequencing and timing
required actions/perf. skills
required body functions
required body structures.

DOMAIN client factors

specific abilities, characteristics or beliefs that reside within the client and may affect performance in areas of occupation. Involves values, beliefs and spirituality, body functions and body structures.

what makes PROCESS unique to OT?

what is eval. (occupational needs, problems, risks and concerns)

how the problem is framed (occupational perf. and difficulties with daily life activities)

Type of intervention (selected thereapeutic activites and occupational to facilitate engagement in occupation

Outcome (directed toward facilitating engagement in occupation to support participation)

the evaluation consists of:

The occupational profile and the analysis of occupational performance.

Occupational profile

Info that decribes the client's occ. hx and experiences, patterns of daily living, interests, values, and needs. Used to gain understanding of the client's perspective and background.

Analysis of occupational performance

Requires an understanding of the complex and dynamic interaction among performance skills and patterns, contexts and env., general activity demands, and client factors. (identifying underlying factors which support and hinder perf.)

The intervention consists of:

The intervention plan, intervention implementation, and intervention review

Intervention plan

develop plan in collaboration with client based on assessment. Select a theory/practice framework. Select an intervention approach. Target desired outcomes.

Intervention Implementation

action to influence and support perf. Includes types of therapy interventions (use of self, use of occupations, occ. based activity, purposeful activity, prep. methods, consultation process, education process, and advocacy)

Intervention review

review plan, process and progress toward outcomes.
modify plan if needed.
determine future action.

Outcomes

engagement in occupation to support participation. Ex. occ. perf., adaptation, health and wellness, participation, prevention, QOL, etc.

What is a referral and where do they come from?

request for service. ex: referral for a splint.
Referrals come from a person's independently request for OT services and/or may receive a variety of health and social services professional referrals.

What is screening?

Brief review of patient record or obs., of pt to determine whether or not OT services are needed.

When would you not accept a referral?

When the client has a problem that can't be addressed by the facility or the referral is inappropriate and should be given to a different discipline.

context and env.

conditions external/internal to a person that influence occ. perf. Contexts are varied and include cultural, physical, social, personal, temporal, and virtual.

What is the purpose of a goal?

to indicate changes in baseline perf. in occupations or activities that are expected to occur as the result of planned intervention.

Re-evaluation may mean:

changing activities, re-testing, writing a new treatment plan, making needed referrals.

What are transition services?

Functional level (max A to min A)
Life stage (ex. will retire due to disability instead of RTW)
Program (from inpt to outpt
Env. (moving from home to nursing home)

d/c or F/O occurs when:

functional goals are reached, there's a plateau in progress, participation is restricted due to complications, OT maintenance program is followed indep. or w/ assistance, or discharge is requested.

d/c or F/O consists of:

preparing plan with goals and outcomes, refer to community resources, doc. changes from initial assessment to d/c, etc

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