Browsing by Person "Melton, J."

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A practice development programme to promote the use of the Model of Human Occupation: contexts, influential mechanisms and levels of engagement amongst occupational therapists
(College of Occupational Therapists, 2010-11) Melton, J.; Forsyth, Kirsty; Freeth, D.
This study evaluated a multifaceted, organisation-wide practice development (PD) programme in one National Health Service mental health and learning disabilities trust. Method: Individual differences in integrating the Model of Human Occupation in occupational therapists' daily practice were examined through in-depth qualitative, multimethod realistic evaluation. A stratified sample of all occupational therapists (n = 74) was achieved using a self-report survey. Semi-structured interviews at three time points, practice observation and documentation audit continued until saturation appeared highly likely and categories were well elaborated (n = 10). Findings: The findings indicated that environmental contexts, particularly the support of the immediate team, and the therapist's personal circumstances influenced MOHO use. The mechanisms that acted as catalysts for practice change were Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Know-how and Channelling Time. Four stages of MOHO integration, characterised as In the Hangar, On the Runway, Take-off and In the Air, were identified. Conclusion: Most studies of the uptake of PD treat people as relatively homogeneous, but they are not. Greater attention to individual differences, the mechanisms underpinning successful engagement and influencing contexts may result in better outcomes from PD investments. A degree of tailoring PD approaches to individual circumstances would be beneficial.
From graduate to reflective practice scholar
(College of Occupational Therapists, 2007-11) Quick, L.; Forsyth, Kirsty; Melton, J.
The National Health Service is currently striving to deliver evidence-based, effective and efficient services. In this climate, it is important to enable new graduates to develop their knowledge, skills and confidence to meet these exacting demands, in an effective and supportive environment. This is of particular importance because there is growing concern over the retention of new graduates. If new graduates do not receive effective support to complete the transition to a competent professional, then the concern is that they may choose to leave the profession and/or seek new roles. This opinion piece argues for an academic/practice partnership to provide the needed support structures to allow graduates to become competent professionals. Two examples are provided, which embrace such partnership working.
Impact of using the Model of Human Occupation: A survey of occupational therapy mental health practitioners' perceptions
(2012-09) Lee, S. W.; Kielhofner, G.; Morley, M.; Heasman, D.; Garnham, M.; Willis, Suzie; Parkinson, S.; Forsyth, Kirsty; Melton, J.; Taylor, R. R.
Aim: While little is known about how occupational therapists perceive the use of occupation-focused theory in their practice, evidence indicates that it has been called for in the profession. To date, the Model of Human Occupation (MOHO) is the most widely used model internationally. The aim of this study is to document practitioners' perceptions of how using MOHO impacted on their practice. Methods: A descriptive study using an Internet-based survey study design was conducted with 429 therapists in six National Health Service (NHS) trusts in the UK. Results: Of the 429 therapists, 262 completed the survey, for a response rate of 61.07%. Most were female (85.5%) with a varying range of years of experience. Most worked in community and/or inpatient mental health settings; 92.1% responded that they use MOHO as their primary model. Therapists reported using MOHO moderately to greatly improve their assessment, goal setting, and conduct of relevant interventions as well as professional identity as an OT in their mental health occupational therapy practice. Conclusion/Implications: This study examined therapists' perceived impact of using an occupation-focused model in mental health practice. The findings of this study provided promising results. Findings suggest that the utilization of MOHO increases service for clients and professional stature and identity for therapists. 2012 Informa Healthcare.
Inclusive communication: A tool for service innovation
(2012-01) Shute, R.; Davies, G.; Clee, S.; Coupland, T.; Melton, J.; Forsyth, Kirsty
There is global acknowledgement of the need to improve services for those experiencing mental illness, with learning disabilities or those who abuse substances (WHO, 2010). Government policy in the UK also outlines the importance of using resources efficiently, improving access to services and driving up quality (Darzi, 2009). Organisational transformation of this nature can create uncertainty, not only for those working within the service but those accessing services and wider stakeholder. This paper proposes that effective communication is a crucial ingredient of successful change and a tool that can be used in to support transitional change and those that may be affected but it. The paper describes the underpinning communication theories used by an NHS Foundation Trust in the United Kingdom to develop an effective, inclusive communication strategy to support a service delivery innovation.
Observational Assessments
(Lippincott Williams & Wilkins, 2008) Kielhofner, G.; Cahill, S. M.; Forsyth, Kirsty; de las Heras, C.; Melton, J.; Raber, C.; Prior, Susan
Program Redesign Based on the Model of Human Occupation: Inpatient Services for People Experiencing Acute Mental Illness in the UK
(2008) Melton, J.; Forsyth, Kirsty; Metherall, A.; Robinson, J.; Hill, J.; Quick, L.
This paper discusses the current context of the UK mental health service system and the resulting need for program change within acute-care inpatient hospitals. The primary focus is to illustrate through practice example what can be done to support the delivery of client treatment packages by using the concepts described by the Model of Human Occupation (MOHO). The paper concentrates on explaining how MOHO has helped to guide program redesign and develop an Occupational Therapy Care Pathway to support occupation-focused services. The example given is of a hospital service in Gloucestershire, England, which provides inpatient care for people experiencing acute mental illness. 2008 by Informa Healthcare USA, Inc. All rights reserved.
The Individual Practice Development Theory: An individually focused practice development theory that helps target practice development resources
(Wiley, 2012-06) Melton, J.; Forsyth, Kirsty; Freeth, D.
Background Research indicates that multifaceted practice development (PD) interventions are more effective than single strategies. However, models of education in health care need to consider cost-effectiveness. Objectives This paper presents a research-based, PD theory called the Individual Practice Development Theory. It argues that programmes that use the Individual Practice Development Theory to tailor PD support to the learning needs of practitioners will result in more engagement in PD and will target PD resources efficiently. Methods The in-depth qualitative, multi-method realistic evaluation was of a multifaceted, organization-wide PD programme in one National Health Service Mental Health and Learning Disabilities Trust. Semi-structured interviews, practice observation and documentation audit were used to gather data from occupational therapists. Findings Results indicated that environmental contexts, particularly the support of the immediate team, and the participant's personal circumstances affected PD behaviour change. Six mechanisms acted as catalysts. These were: Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Knowledge Know-how and Channelling Time. Four stages of PD characterized as: 'In the Hangar', 'On the Runway', 'Take-off' and 'In the Air' were identified. The research also illustrated the interconnectivity between outcome levels, contextual circumstances and activating mechanisms. Discussion The findings suggested that PD interventions need to be more individually tailored to achieve optimum learning outcomes. The identification of four discernable stages permits rapid understanding of PD support needs in order to focus PD support. Conclusion With a systematic and individualized approach to PD in health care, more target PD supports can be put in place. 2011 Blackwell Publishing Ltd.
The Model of Human Occupation
(Lippencott Williams and Wilkens, Baltimore., 2013-03) Forsyth, Kirsty; Taylor, R. R.; Kramer, J.; Prior, Susan; Ritchie, L.; Whitehead, Jacqueline; Owen, Christine; Melton, J.; Cohn, E. S.; Gillen, G.; Scaffa, M.; Schell, BA
The Model of Human Occupation In Crepeau
(Lippincott Williams & Wilkins, 2008) Kielhofner, G.; Forsyth, Kirsty; Kramer, Jessica; Melton, J.; Dobson, E.; Boyt Schel, B.; Cohn, E.; Crepeau, E.
Using theory in practice
(Elsevier, 2008) Melton, J.; Forsyth, Kirsty; Freeth, D.; Duncan, Edward