MSc in Advancing Practice in Occupational Therapy

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/10564

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AN EXPLORATION OF THE VOCATIONAL TRAINING OF PEOPLE WITH AUTISM SPECTRUM DISORDER COMPLETING EDUCATIONAL AND TRAINING PROGRAMMES WITHIN VOCATIONAL REHABILITATION SETTINGS IN GREECE
(2019)
Objectives: The purpose of this study is to contribute to understanding of the issue of unemployment for people with Autism Spectrum Disorder (ASD) by exploring the educational and training process within vocational rehabilitation services in Greece. A clearer image of the factors that may hinder successful employment for people with ASD is also illustrated throughout this study. The study further aims to identify the content of the educational and practical preparation programmes for young adults with ASD in order to access paid employment. Additionally, the perceptions and experiences of the occupational therapists about the suitability, strengths and weaknesses of the educational system for people with ASD are also explored. This employment-related research study aims to achieve a better understanding of the challenges faced by this population in terms of gaining and maintaining a full-time job, based on the experience of occupational therapists within their work environment. Overall, an overview of the educational and training opportunities for people with ASD is provided throughout this study in order to achieve a deeper understanding of their preparation for real working conditions, and explore existing educational processes for young adults with ASD and their employment integration. Finally, it is hoped that this study will raise awareness about the employment issues and efforts of people with ASD, which may be used in correlation with findings from the literature in order to suggest areas for change and development. Methods: This study uses a generic qualitative approach informed by the paradigm of Interpretivism. Four occupational therapists working in three vocational rehabilitation settings in Greece were interviewed in order to gain professional insights of the educational and vocational training process in Greece. Semi structured qualitative interviews were used to gather descriptive data through the personal experiences of the occupational therapists. Thematic analysis was used to create related themes and interpret these patterns in order to explain the outcomes of the research.
EXPLORING HEALTH AS A UNDERPINNING CONCEPT IN THE DO-LIVE-WELL FRAMEWORK AND A COMPARATIVE EXPLANATION WITH THE CONCEPT OF HEALTH IN JAPAN
(2019)
Promoting people’s health is one of the important tasks for occupational therapists. The idea of occupation, health, well-being and their relationship in existing many occupational therapy theories are conceptualized and explained in the western context, although they can be varied depending on social structures or cultures. On the other hand, the importance of cultural relativities and social structure when considering occupation and health has been discussed in various literature. This research aims to examine how the concept of health is understood in the Do-Live Well framework and literature which underpins the framework. Additionally, how they might be different from the Japanese conceptualized health is analysed. The scoping review is chosen as a methodology to explore the health concept which underpins the Do-Live-Well framework. 7 themes of health concepts were identified including well-being, notion of resource for everyday life, flourishing, choices, abilities and chances to engage in meaningful occupation, a balance between enjoyment, productive and resting, importance of meaning in occupation, and a relation to an interactive focus on individual’s mind, physical and spirit. Three themes which are; health as well-being and flourishing; health as having abilities choices and chances to engage in a meaningful occupation; and importance of meaningful occupation for health, were discussed with the view of Japanese contexts. Analysing the result of scoping review with the Japanese context disclosed that the degree of collectivism or individualism influences the people’s experience of well-being. Also, it is indicated that the idea of flourishing might not always lead to improved well-being for Japanese people. Additionally, the importance of considering cultural relativities for the idea of relationship of health, wellbeing and occupation was confirmed. Finally, it was suggested that further investigation on spirituality for Japanese people might be important for health promotion in the Japanese context.
AN EXPLORATION INTO THE USE OF GROUP WORK AS A CORE COMPONENT OF OCCUPATIONAL THERAPY INTERVENTION IN AN OLDER ADULT PHYSICAL REHABILITATION HOSPITAL SETTING.
(2019)
Occupation is a core component of occupation based practice promoted within occupational therapy provision. Within literature the growth of the body of knowledge and evidence has developed to confirm the importance of occupation and health and well being. Occupational therapists commonly work with all age groups and within a variety of settings. In the small evidence based occupational therapy literature available, the importance of occupation based interventions is often stated, alongside group work as a core component of occupational therapy interventions. Whilst there seems to be an agreement across the profession that group work is a core component within occupational therapy and can be used as a beneficial occupation based intervention there is little literature to evidence the following; in which settings and with which client group, group work is seen to be most beneficial and why or whether it is generally a useful occupational therapy occupation based intervention which can be successfully used across a wide variety of occupational therapy services and service users. Moreover, patient care is rarely one dimensional, the collective skills of healthcare workers can have the greatest impact on patient outcome, and hence why multidisciplinary working and group work should be at the forefront of focus. As this is such a broad topic within occupational therapy, for the purpose of this literature review, a specific service area and service user group will be identified and explored. An older adult physical rehabilitation hospital setting is the area of interest due to personal employment and interest through individual research around the ageing population. This literature review identifies a gap in current occupational therapy literature. It provides an in depth exploration of literature exploring our ageing population and the potential benefits of using group work as a core occupational therapy intervention in an older adult physical rehabilitation hospital setting.
AN EXPLORATION INTO THE LIVED EXPERIENCE OF TRANSITIONING FROM PRISON INTO THE COMMUNITY FOR MALE EX-PRISONERS IN SCOTLAND
(2019)
This study explored the experience of transitioning from prison for male ex prisoners in Scotland, focusing on the factors influencing this, and the support received in prison. This study utilised a generic qualitative methodology, partnering with a charity to interview 4 participants. It was found that the nature of locations could have implications for occupational participation in the transition. Additionally, participants noted the importance of avoiding locations, describing this in relation to drug use. It was inferred that avoiding locations could be instrumental in the transition for drug-addicted offenders. Another finding was the potential for meaningful occupation in prison, arguing that offenders should be given more choice in order for this to be realised. Furthermore, it was argued that there should be more continuity of occupation in the transition. Another finding was that the lack of occupational choice in prison could limit offenders’ ability to make positive choices upon release. Participants expressed an expectation of returning to high-risk behaviour, and it is argued that this may be indicative of a criminal or addict self identity. Furthermore, participants valued motivation, however it is posited that an expectation of relapse may impede the role of motivation. An interesting finding was that two participants declined support, leading to the conclusion that services may benefit from an individualised approach to increasing service engagement. However, two participants were ineligible for support due to their sentence length, adding to the evidence base regarding the challenges of short sentences. Findings also highlighted the role that family can have in making the transition easier or more complex. The final finding was that participants serving longer sentences, with a more rigid routine, experienced difficulty maintaining a productive routine upon release. It was concluded that they might have experienced institutionalisation, in comparison those serving shorter sentences with less structure.
Exploring the practice of Slovenian occupational therapists who work with older people at their homes – a mixed-methods study
(2020)
Background: In Slovenia, demographic data and government legislations suggest the move from the institutionalized to home care and the potential for home-based occupational therapy services exists. There is, however, no data about the provision of home-based occupational therapy services for older people. Aims: To explore the practice of Slovenian occupational therapists working with older people (65+ years) at their homes. Methods: Reviewing the literature, the questionnaire with three themes (External factors affecting practice, Service delivery and Future improvements of service delivery) was developed. It was distributed via email to 7 Slovenian occupational therapists working in the area. The unclear areas of practice from the questionnaire served as a basis for further questions. Semi-structured interviews with 4 participants were conducted. Results: Participants differed in the delivery of their services, but there were some commonalities: they were all a part of an interdisciplinary team, worked with people with different conditions, they all used occupational therapy models in their practice, set goals and used a variety of standardised assessments in their practice. Thematic analysis of the interviews revealed 7 interconnected themes: Reasons for referrals, The importance of professional development, Promotion of occupational therapy services, Possible use of higher budget, Cooperation with occupational therapists, Decisions on the direction of practice and Issues within the health care system. Conclusion: Client-centred and occupation-based practice are two strong areas of practice as described by the participants. The practice could be improved with increased professional cooperation, professional development and better promotion. The implications for future cooperation with the national occupational therapy association are proposed as well as implications for education. Even though this study is quite a comprehensive overview of the practice, it is important to note its limitations, such as small sample or limited data analysis due to extensive study findings.
Exploring Occupational Justice in Occupational Therapy Education: A Scoping Review
(2020)
Occupational justice is a developing concept within the occupational therapy practice since the late 1990s. Recently, the World Federation of Occupational Therapists have released position statements on upholding human rights and occupational justice in practice. There have also been calls for occupational therapy education to respond to the changing landscape of occupational justice in practice. Despite existing literature regarding the presence of occupational justice concepts in education, there is still no current published study consolidating the scope of this area of study. Following a scoping review design, this study aims to answer the question of “how is occupational justice taught in occupational therapy education?” The study included four articles, from which seven main themes were found regarding what occupational justice concepts are taught, what teaching/learning and evaluation methods are used, and what outcomes are related to occupational justice education. From these results, the review was able to provide an overview of what is currently being done in occupational therapy education to incorporate occupational justice concepts. The review has also brought about potential areas for further study and investigation.
The effects of engaging in visual art occupations from the perspective of adults with mental disorders: A scoping review
(2020)
Mental disorders are a global issue with increasing prevalence. Adults who have mental disorders often experience symptoms and difficulties associated with their diagnosis, and also face discrimination, stigma and human rights violations. All this can impact individuals’ engagement in occupation, which in occupational therapy theory, is believed to be closely linked to health and well-being. Among the significant types of occupations, that have been used therapeutically since the beginning of occupational therapy in mental health care, are the occupations related to arts and crafts. While there is a vast amount of research to support the therapeutic potential of these occupations with various populations, the literature on the effects of visual arts for adults with mental disorders have not been previously mapped. Therefore, the aim of this scoping review was to map the literature on the effects of engaging in creative and arts-based occupations related to visual arts from the perspective of adults with mental disorders. The methodology followed the framework provided by Arksey and O’Malley (2005), combined with some suggestions made by Levac et al. (2010). Specifically, Stages 1-5 were implemented, with the addition of critical appraising the included studies. The results of this scoping review were presented through a map of the five P’s; reflecting the categories of Process, People, Product, Person, and Participation, which include different effects related to the engagement in creative and arts-based occupations. Discussion of the results focuses on the range of interpretations provided by the researchers, as well as the unique impact of arts and crafts with this particular population group. Overall, this scoping review indicates that there are numerous positive effects through engagement in arts-based and creative occupations, from the perspective of adults with mental disorders.
More than just a game: A scoping review considering the impact of sporting fandom upon occupational identity
(2020)
The occupations which we engage in have been consistently shown to influence and shape every facet of who we are, a concept referred to as occupational identity. Prominent conceptualisations of occupational identity display three distinct themes; assumptions towards freedom of occupational choice, an individualistic outlook within identity and consideration of productivity pertaining to work. Criticisms towards these conceptualisations call for consideration of collective identities and barriers to freedom of choice. Leisure based occupations are proposed to influence occupational identity particularly significantly. Consequently, sporting fandom was considered due to the inherently collective identity and potential to investigate barriers to occupational choice. Furthermore, despite the significant impact of sporting fandom upon identity and the considerable collective population of sports fans within the United Kingdom, sporting fandom remains poorly considered within occupational science and occupational identity literature. Consequently, a scoping review was conducted to facilitate consideration of the impact of sporting fandom upon identity, before contrasting these findings with underpinning occupational identity theory. 3 primary themes outlining the impact of sporting fandom upon identity emerged from the selected literature, pertaining to the emotional domain whereby the collective is formed, the cognitive domain which reflects productivity and the symbolic domain, influencing social values. Contrast of emergent themes within the scoping review with underpinning occupational identity theory demonstrated prominent correlations between collective identity and productivity. Collective identity generated within fandom was established to elicit a sense of belonging, in turn forming life meaning, reinforcing the need to develop understanding of this concept and replicate this in practice. Productivity within fandom was demonstrated through competence and social roles, reflecting a need to reconsider occupational categories due to the intertwined nature of leisure and productivity. Additionally, the potential utilisation of sporting fandom to consider both collective occupational identity and barriers to occupational choice was demonstrated.
WHAT HAS BEEN THE IMPACT OF COVID-19 ON THE LIVES AND OCCUPATIONAL BALANCE OF IN TERNATIONAL STUDENTS: AN EXPLORATORY CASE STUDY
(2021-08-05)
Rationale Among the varying groups of individuals affected by COVID-19, international students were amongst the most impacted. The traditional peer supports and university clubs that would enable their integration into the new community were significantly altered due to the COVID-19 lockdowns. The students’ ability to engage in meaningful self-selected occupations were likely to be negatively influenced. Therefore, this exploratory case study sought to understand the impact of COVID-19 on students’ lives and occupational balance. Methods A case study methodology was chosen as this matched the research question, aim and objectives. Additionally, the inductive and interpretive philosophical underpinnings were aligned closely with a case study approach. Three differing methods of data collection were used including questionnaire, semi-structured interview and personal reflective diaries; because of the value to case study methodology of multiple methods of collecting information, as this allows the researcher to create a detailed picture of the lived experience of a phenomenon (Mayer 2001). Data triangulation was utilised to merge themes across the three data sources. Following this, thematic analysis using Braun and Clarke (2006) six steps was completed to allow inductive emergent themes. Key findings Three key themes emerged from the findings: COVID-19’s impact on mental health; adaptation for self-preservation and finding occupational balance. COVID-19’s impact on students’ mental health led the students to seek out appropriate supports, adapting their engagement with meaningful self- selected occupations and using occupation as medicine to maintain their mental wellbeing. Conclusion 3 This study highlighted the multifaceted impact of COVID-19 on the lives of three international students, each completing study at Masters level in one small Scottish university. Each student was forced to adapt to their circumstances, demonstrating remarkable resilience. They built routines around meaningful self-selected occupations to give their life meaning and execute control. Alongside the support of the university, these self-selected occupations functioned as a tool for regulating their mental health. There is the potential for this work to be understood as a pilot for a larger study, to build on these themes and sub-themes, to understand how best to support international students during adverse circumstances.
Person-centredness and attention to the occupational participation of older people within discharge practices - does this happen? A scoping review
(2021-08-08)
Background: Person-centred practice puts people at the forefront of care, attention and planning. Healthcare policies highlight that participation and input from patients should be increased and become more authentic so that patient participation is grounded within a holistic approach. However, older people’s autonomy and opportunity to participate in healthcare decisions seem to be at risk due to cultural prejudice and stereotyping that perceive all older people as frail, thereby limiting person-centred practice and occupational participation during discharge practices. Discharge practice is a complex and vulnerable transition for patients. Ensuring person-centred practice and occupational participation of older people in transitional discharge practices may prove challenging due to multi-faceted factors. Aim: The scoping review aimed to discover how and if, a person-centred approach which also considers occupational participation, was detectable within discharge practices for older people from hospital to community. Method: The scoping review followed Arksey and O’Malley’s structural framework. Ten articles were eventually selected and included in the study followed by a consultation exercise with respondents who were practitioners in this area. Findings: Attention to person-centredness and occupational participation of older people during the discharge process was found to be a complex and multi-faceted process with many issues affecting implementation and ability to work in a person-centred manner. Environmental factors of time constraints and capacity, as well as assumptions of frailty and reduced ability of older people to participate in decision-making affected the ability to work in a person-centred way with opportunity of older people to participate in discharge processes. Furthermore, person-centred practice was found to have different meaning amongst occupational therapists. Conlusion: To ensure that person-centred practice and occupational participation is carried out by healthcare professionals, a regular process of reviewing practice seems necessary for individual and collective learning to happen and therefore avoid unreflective work practice which may result in professional dominance and minimal involvement of older people in the multifaceted processes of discharge.
Has occupation centred practice been achieved – A scoping review to locate the views of practitioners and students of occupational therapy
(2021-08-15)
Introduction: Occupation-based practice engages clients in occupation as the principle therapeutic modality of change, specifically within the evaluation and intervention stage. Due to a paradigm shift over time from a mechanistic to a contemporary paradigm, it is unclear whether all occupational therapists utilise occupation in their everyday practice. This study explores both occupational therapy practitioners, and student's perceptions of occupationbased practice and tries to identify the link between theory and practice and factors associated with implementing and embracing the occupation-based practice. Method: The philosophical underpinning for the scoping review is subjectivism and interpretivism of selected literature to explore the perception of occupational therapy practitioners and students. The study included sixteen articles, and the structure for the work was based upon Arksey and O’Malley (2005). Numerical and thematic findings were generated and presented. Findings: Three key themes and supporting sub-themes were generated through thematic analysis and were (a) holding occupation at the centre of practice, (b) challenges to implement occupation-based practice, (c) contextual influence on practice. Conclusion: The findings highlighted that most practicing occupational therapists acknowledged the core principles of occupational therapy; however, they found it challenging to embrace the occupation-based practice in everyday clinical practice. Factors responsible for restricting occupation-based practice varied across the literature; however, a few common factors noted were time constraints, funding, lack of knowledge and experience. Findings also highlighted a need to enhance therapist’s and student’s knowledge of occupation-based practice through continuing professional development and modifying the university curriculum for future therapists.