Study sets, textbooks, questions
Upgrade to remove ads
Foundations Exam 2
Terms in this set (138)
What are the 3 parts of cognitive process?
thought, evidence, experience
What are the 8 types of clinical reasoning?
What is narrative reasoning?
personal, focused on client,
past, present and anticipated future
helps build rapport
What is procedural reasoning?
use of protocols or specific therapeutic interventions, standardized assessments
- specific to each diagnosis
what is interactive reasoning?
directed toward building positive interpersonal relationships
- therapeutic use of self
what is pragmatic reasoning?
generally not focused on client or clients condition, focus on physical and social context
include: teamwork, scheduling, space/equipment, insurance coverage, resources
what is ethical reasoning?
selecting morally justifiable choices, use of code of ethics
what is scientific reasoning?
focused on diagnosis, condition, guiding theory and research
what is diagnostic reasoning?
takes into account client-based information and evidence-based
-blending of client's experiences with what evidence says
what is conditional reasoning?
combination of other types of reasoning, focus on the whole person
what is an activity?
general idea about the things individuals do and they way they typically do them
what is an occupation?
personal activities that individuals choose or need to engage in, within a specific context
what does the use of analyses require the OT to understand?
-properties and demands of activities
-occupationally relevant activities
-occupations valued by clients
What are the 8 components of activity analysis? (table 7, framework-III)
relevance and importance to client, objects used and their properties, space demands, social demands, sequencing and timing, required actions and performance skills, required body functions, required body structures
what is grading an activity?
making the activity easier/harder for the client
How can an activity be modified so its less impactful on body structures?
2) level of difficulty
3) level of assistance
4) change roles
What is an evaluation?
the process of obtaining and interpreting data to understand the client
What is an assessment?
tools used, instruments, procedures
occupation can be used as an?
end goal or means to achieve
what is occupation as a means?
use of occupation as a treatment to improve clients impaired capacities to enable eventual occupation functioning
- EX: using stirring a pot to improve other ROM and dexterity areas
what is occupations as ends?
-client's functional goal within a given environment
- done using capacities client possesses using any required adaptations
EX: using stirring a pot to improve their role and continue cooking for their families as a goal
What are the components of the OT process?
evaluation, intervention, re-evaluation, either continue or discontinue OT
What is included in the interview/occupational profile?
-summary of client's history, resources and performance
- understanding the clients occupation performance
-subjective data on clients
What are some examples of occupational profile assessments?
-Canadian Occupational Performance Measures (COPM)
- Occupational Self-Assessment (OSA)
- Child Occupational Self-Assessment (COSA)
What is involved in the intervention process?
-intervention plan, implementation, review
what are the outcomes of OT?
end result of OT process, describe what clients can achieve through OT intervention, directly related to targeted interventions provided, create goals, determine procedures to measure progress
what are the 7 elements of therapeutic relationships?
2) belief in dignity and worth
3) belief in innate potential for change and growth
4) effective communication
what is a therapeutic use of self?
relationships with clients by using narrative and clinical reasoning, empathy and a client-centered collaborative approach
what are key components to effective communication?
active listening, listening to emotions, nonverbal communication, asking questions and listening for silence
Center for Disease Control
-created in 1946 (communicable disease center)
-under Dept. of Health and Human Services
-global leader in public health
-Occupational safety and health administration
-part of US Dept. of Labor
-dedicated to promoting safe workplace environments
-enforce standards, provide training, outreach, education and compliance assistance
pathways through which infectious diseases spread
-touching infectious people or surfaces, objects, clothing, linens that carry body fluids
-coughs, sneezes, talking (spray)
- eating, drinking or handling infected food/water
- infected animals or insects
What are standard precautions?
Concepts in which all body fluids are assumed to be infected with blood-borne pathogens
what is the single most important factor in preventing the spread of pathogens and antibiotic resistance?
how often should hands be washed?
-before and after contact with every client
-body fluid exposure risk
what is PPE?
personal protective equipment
- gloves, gowns, masks, goggles, face shields
when is PPE needed?
-transporting in wheelchair
-taking vital signs
-cleaning bodily fluids
what is the sequence for donning PPE?
Gown, mask, goggles or face shield, gloves (over isolation gown)
what is the sequence for removing PPE?
gloves, face shield/goggles, gown, mask
what temperature should water be above when washing clothes?
vaccinations CDC recommends for healthcare providers
-Hep B virus (HPV)
-measles, mumps, rubella (MMR)
- skin test for TB
"Who" of documentation
- multiple audiences: intervention team, client/family members, facility, 3rd party payers, peer reviewers, administrators, lawyers, researchers
"What" of documentation
accurate, complete and clear documentation of what has transpired in OT, clients reaction and plan for future service delivery
"Where" of documentation
client chart, IEP,IFSP
"When" of documentation
as close to time of service as possible
"Why" of documentation
document chronological sequence, show clinical reasoning, inform others, demonstrate effectiveness for 3rd party payers, legal reasons
15 fundamentals of documentation
client identification, date and time, type, signature, placement of signature, co-sign, compliance, terminology, abbreviations, corrections, technology, record disposal, confidentiality, record storage, clinical reasoning and expertise
correcting errors in documentation
-only correct your own errors
-only strike through (single line) or add an addendum to original
Documenting with CARE
what is the "clarity" of documentation?
the reader can understand what you are saying
what is "accuracy" of documentation?
chronologically, technically, and factually correct
what is "relevance" of documentation?
consistency between referral. evaluation, intervention, discontinuation
what is "exceptions" of documentation?
unusual occurrences or events are described
Functional Problem Statement: contributing factors
client factors, performance skills, performance patterns, context and environment
functional problem statement: examples
-Client unable to (engage in what occupation) due to (what contributing factor)
-client requires (assistance level) in (performing what occupational task) due to (contributing factor)
- (contributing factor) results in (what occupational deficit)
"Client is unable to dress self independently due to decreased active range of motion in bilateral upper extremities"
1)what is the area of occupation?
2)what is the contributing factor?
1) ADL- dress independently
2) decreased active ROM
"client is unable to complete laundry tasks due to lifting restrictions in post-surgical back precautions"
1)what is the area of occupation?
2)what is the contributing factor?
1) IADL- laundry
2) lifting restrictions post OP
Levels of Assistance categories
Total assistance (TOT), max. assist (MAX-A), Mod. assist (MOD), Min. assist (MIN), Contact guard assistance, standby assist (SBA), set-up assistance, mod. independent (MOD-I), independent (IND).
- client (0-24%)
- client (50-74%)
- client (75%+)
contact guard assist
pt requires contact from the therapist to complete the task; therapist always has contact on pt or gait belt
stand by assistance
- supervision or standby assistance for safe, effective task performance
Individual requires set-up of necessary items to perform tasks
- requires use of assistive device, or increased time
- no assistance or supervision is required
types of writing goals
- restorative, habilitative, maintenance, modification, preventative, health promotion
Used when a patient who used to be able to do something, but now cannot due to illness or injury.
Betty will put on her shoes with min A.
These reflect teaching a patient new skills that they didn't have prior (due to delayed development)
Erin will write her name legibly on all his school papers by June 10, 2014.
These goals are written to keep a patient at their current level due to a disease process that may decrease their overall function.
Client will maintain (IND) in dressing for the next 3 months.
Changes context or way of doing things
-by discharge, client's home will be modified to allow wheelchair access both inside and outside the house
May be written to prevent a client from getting hurt (repetitive motion injuries or self-injury behaviors)
By next week, client will identify three people she can call for help when she begins to feel depressed or overwhelmed.
health promotion goals
emphasis on enhancing the contexts and activities to enable maximum participation in life
- playground surfaces will be replaced to provide a safer play environment for children by Sept. 10, 2018
Long Term Goals (LTG)
-overarching goals that guide intervention
-will often determine discontinuation of therapy
-final product to be achieved
short term goals (STG)
specific periods of time
-sometimes called "objectives"
-lead up to the long-term goal
client, occupation, assistance level, specific condition, timeline
- Joe will feed himself 50% of the meal with min. physical assistance to scoop using a built-up spoon within 3 treatment sessions
Specific, Measurable, Attainable, Realistic, Timely
- mandy will cut out basic shapes with scissors within 1/4" of the line 4/5 times by the end of the school year
relevant, how long, understandable, measurable, behavioral, achievable
- by October 23, 2018 Hannah will maneuver her wheelchair around the classroom without running into objects in or near her path
subjective, objective, assessment, plan
SOAP Notes: Subjective
information reported by the client, family or significant other regarding the perspective of the condition
- may be a direct quote or paraphrase
SOAP notes: objective
measurable, observable data
- descriptive (NOT interpretive) statements about what the client did in therapy session
SOAP Notes: Assessment
-3 Ps: problems, progress and (rehab) potential
-S and O are analyzed
SOAP notes: plan
Record the plan of action.
- plan should be breif and must be justified by content in the SOA sections
- frequency, duration, and intensity of OT
Reasons for discharge
1. client achieves all goals
2. moves out of facility
3. refused to continue in program
4. achieved max. benefit from OT
components of discharge notes
client information, summary of client functional status at initiation of OT services, recommendations for follow up, reason for discharge
requirements for co-signatures
-written by licensed OT does NOT require
- written by student
-contact treatment note written by an OTA
HIPAA (Health Insurance Portability and Accountability Act)
law protecting privacy rights of consumers
-info documented in medical records
-conversations regarding client
- all incidents resulting in injury to client during treatment
- completed by therapist directly involved
-timeliness is important
-do not interpret! only document what you saw
Stage theories of development
1900s- age and stage process
- biological process
-dependent on maturation of body systems
-universal and predictably sequential
-series of stages in which people exhibit typical behavior patterns and establish particular capacities
-periods of transitions characterized by challenges individual needs to work
lifespan development theories- assumptions
- individual development lasts from conception to death
-interaction with social and physical environment play a role in development
-influences by historical and cultural context
life course perspective- assumptions
1. aging and transformations of occupations are lifelong processes
2. systematic changes occur from birth to end of life
3. past occupations influence current engagement
4. historical times and social events shape the life course and occupational opportunities
5.choices people make reflect their circumstances and opportunities at that time
human development is influenced by
biology and bio-psycholoical environmental experiences
Areas of development
sensorimotor (Sensory, reflex, motor), psychosocial, cognitive, play, self-care
years 0-2; most senses are not developed when born; no object permanence
- crucial in reflex development
Persistence or reemergence of primitive reflexes are indicative of:
involuntary movements that are elicited by environmental stimuli
-rooting and sucking
-stepping or walking
-atonic neck reflex
performance in occupational roles enhanced or inhibited by reflexive development and integration
- gross motor
motor sequence for infants
-head and trunk control (first months)
- rolling (3-5 mo)
-sitting alone (5-10 mo)
-crawling (6-8 mo)
-creeping (9-11 mo)
-standing along (9-13 mo)
-walk independently (9-17 mo)
types of early gross and fine motor development
bilateral integration, crossing midline, laterality
Bilateral Integration categories
1.symmetrical: both sides of body working in mirror-image
2. reciprocal: involves moving sides of body at same time in opposite motions
3. asymmetrical: involves each side of the body acting in a different way to complete a single specific task
- reaching across body to complete a task
solidifies at 5 years
psychosocial development theorists
Eric Erikson, Lawrence Kohlberg, Abraham Maslow
8 psychosocial stages of development
1. trust vs. mistrust (infancy 0-1 yr)
2. autonomy vs shame (1-3 )
3. initiative vs. guilt (3-6)
4. industry vs. inferiority (6-12)
5. self identity vs. role confusion (13-22)
6. intimacy vs isolation (23-35 )
7. generativity vs. stagnation (36-50)
8. integrity vs. despair (50+)
Stages of Moral Development
preconventional (8 yr)
conventional (9-10 yr)
hierarchy of basic human needs
Human needs in order of priority as theorized by Maslow
- physiological (survival)
-love and belonging (affection)
hierarchical development of cognition
a. sensorimotor period: ages birth to 2 years
b. preoperational period: ages 2 to 7 years
c. concrete operations: ages 7 to 11 years
d. formal operations: ages 11 through teen years
Categories of play
1. Exploratory (0-2 yrs.)
- sensory integrative and motor skills
2. Symbolic (2-4 yrs.)
- child formulates, test, classifies and refines ideas/feelings
3. Creative (4-7 yrs.)
-sensory, motor, cognitive and social
4. Games (7-12 yrs.)
-play with rules, competition, social interaction and skill development
development of self care: feeding
oral motor control cognitive abilities, and psychosocial development
- independent (or requiring set-up assistance) by 2.5-3 yrs
development of self care: dressing
motor skills development from gross to fine
- independent by 4-6 yr
development of self care: toileting
management of bowel and bladder control and increased fine motor
-independent by 4-5 yrs
development of self care: home management
developing motor skills and cognitive abilities to learn simple tasks (putting toys away, cooking meals and laundry tasks)
Mosey; 6 adaptive skills
1. sensory integration(0-3)
2. cognitive (0-13 yrs)
3. dyadic interaction (3-30 yrs)
4.group (18 mo-18 yrs)
5. self-identity (9mo-60 yrs)
6. sexual identity (4-60 yrs)
Havinghurst: 6 Developmental Tasks
1. Early Childhood (0-5) walk/talk, right/wrong
2. Middle Childhood (6-12) moral devl, getting along w others
3. Adolescence (13-18) learning to relate to opp sex. Role of gender in society
4.Early Adulthood (19-29) Long term relationship, career, family
5. Middle Age (30-60) finding adult rec. activities, helping children
6.Later Maturity (61+) adjusting to death of a spouse, affects of old age, finding ppl to interact with
Llorens: facilitating growth and development
1. sensorimotor (0-2yrs)
2. integration of both sides of body (1-4 yrs)
3. discrimination (3-7 yrs)
4. abstract thinking (3yrs-maturity)
study of the aging process
branch of medicine dealing with older individuals and their medical problems
Discrimination based on age
the natural physical decline brought about by aging
Categories of elderly
Young old: 65 to 74 years old
Old old: 75 to 84 years old
Oldest old: 85 years old and older
78.8 yrs in US (2013)
- females 81.2
individuals over 65 yrs represent rapidly growing segment of US population. currently 12.5%, expected to be ____ by 2030
leading cause of death in people over 65
1. coronary heart disease (31%)
2. cancer (20%)
3. cerebrovascular disease (stroke)
leading causes of disability/chronic conditions in person over 65
1. arthritis 49%
2. hypertension 37%
3. hearing impairments 32%
4. heart impairments 30%
5. cataracts and chronic sinusitis 17%
6. orthopedic impairments 16%
7. diabetes and visual impairments 9%
age related muscular changes
decreased strength (peaks at 30)
decreased muscle mass (33% loss at 70)
Age related skeletal changes
-decreased water content in cartilage
- decreased bone mass/density
- flattening of intervertebral discs
Age-related neurological changes
-nerve cell atrophy
- decreased cerebral blood flow
-slowed synaptic transmission
- age-related tremors
age related sensory changes
- decreased vision/visual perceptual skills
- hearing loss
- decreased vestibular sensitivity/balance
-somatosensory changes (proprioception/touch)
-decreased taste and smell
Age related cognitive changes
- decrease in perceptual speed, numeric abilities, verbal abilities, memory learning
Age related cardiopulmonary changes
-due to more inactivity and disease than to age
-degeneration of heart muscle, decreased coronary blood flow, heart valve and vascular changes
-decreased respiration, decline in lung
age related other changes
-skin becomes thing
-loss of protective barrier
-digestion slows, decreased absorption of nutrients
-decreased kidney functioning and filtration
-bladder muscle weakness-incontinence (risk of UTI)
lifespan implications for OT
1. consider stage of life of client
2. utilize occupational profile during evaluation
3. explore occupations associated with particular period of individuals life
4. provide strategies and interventions to slow or reverse change associated
a) growth and development
b) gross and fine motor
d) sensory regulation
a) refining skills
b) coordination and strength
c) play (parallel, imaginative, games with rules, cooperative)
d) education (follow rules, cognitive skills, social, behavior, motor skills)
b) sense of self
c) peer pressure
d) role confusion
e) sexual identity
g) social participation
h) career paths
j) independence from parents
a) assume responsibility for own development
b) time of achievement
c) family, social, interest, civic
d) finding significant relationships
e) securing employment
f) determining career path
g) establishing a home
h) raising a family
summary: later adulthood
a) reflection and evaluation of life
c) decrease in workload
d) physical declines
f) cognitive changes
g) family and community involvement
Sets found in the same folder
OT Foundations Midterm
OT Documentation Abbreviations and Symbols
Stanbridge Human Movement-The Hand
Models of Occupational Therapy
Sets with similar terms
Chapter 3: Human Development and Aging
Pysc Exam 2
Lifespan Motor Development
Other sets by this creator
Leadership 2 FINAL
Foundations- Clinical Reasoning and Analyzing Act.…
Human Movement exam 1
NUTR 302 Carbohydrates
Other Quizlet sets
Lecture Exam Chordata
Ch. 2 Tani notes of cells and organelles
Colonial Literature Test