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School of Health Sciences

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    Occupational Therapists' Perceptions Of Preterm Children's Academic Difficulties In The Early Years Of Mainstream Schooling
    (Queen Margaret University, 2011) Giatsi Clausen, Maria
    Preterm infants born before 37 weeks of gestation constitute up to 10% of all births, and can display development that, frequently, differs from those of full- term infants. Studies indicate that school children born preterm present with a, generally, higher incidence of performing poorly academically. The present study investigated the perceptions of paediatric OTs regarding the type of difficulties with which children born preterm present, and explored the role of OT. In the first, quantitative part of this study, paediatric OTs completed a postal questionnaire (N=353). The second, qualitative part, used asynchronous, online discussions (N=13), by utilising the virtual environment of WebCT, to further explore the topic. The survey was also designed to capture: • information on the extent of this paediatric population within OT services, and how identifiable and accessible it is • OT practices when working with these children • what informs therapists’ clinical decision making. The discussion groups provided a forum for OTs’ “reflexive comment” on the issues emerging from the questionnaire analysis. Despite sensorimotor and attentional difficulties reaching the highest frequencies, the findings revealed rather a combination of problems in most developmental domains. Writing emerged as the predominant problematic area within the school curriculum. A “persistence” of sensorimotor difficulties throughout the preschool years also emerged. More frequent and/or severity difficulties, more medical issues, a higher co morbidity of SLD with other conditions for the preterm group, were other findings. These insights could lead to a further exploration of the need for differentiating assessment and treatment practices for this group. Occupational therapy was highlighted as particularly “advantageous” for this population due to a number of OTspecific contributions e.g. ability to “detect “subtle” difficulties at a young age. The implications of a “shift” of more OTs into the area of early intervention, are discussed. The findings of the study constitute tacit, professional knowledge, and they are based on subjective clinicians’ views. They could, however, help frame hypotheses to be further explored verified with the use of empirical research. KEYWORDS: Prematurity; Specific Learning Difficulties; Early Intervention; Paediatric Occupational Therapy; School; Clinical Decision Making; Assessment; Intervention; Survey; WebCT; Asynchronous Online Discussions
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    Being Person Driven In A Service Driven Organisation: A Grounded Theory Of Revisioning Service Ideals And Client Realities
    (Queen Margaret University, 2010) Breckenridge, Jenna
    This thesis presents a classic grounded theory study of Condition Management Programmes, which form part of the UK Government Initiative Pathways to Work. Condition Management Programmes provide short, work focused interventions to help people claiming incapacity benefits to return to employment. Delivered jointly between Jobcentre Plus and the NHS, or by providers within the private and voluntary sectors, health care practitioners working in Condition Management Programmes are often faced with competing priorities. This thesis has identified practitioners' concern with being person driven in a service driven organisation, and presents the emergent grounded theory of Revisioning Service Ideals and Client Realities which explains conceptually the means through which this concern is continually resolved. Practitioners are conceptualised as 'revisioning' or making thoughtful, situational adaptations to their practice which either deviate from or retreat within service boundaries. By cycling iteratively between deconstructing and reinstating service ideals, practitioners are able to create a reverberating equilibrium between the expectations and realities of practice, negotiating a person driven approach without compromising service structures completely. The theory has been developed using the full complement of classic grounded theory procedures and is based on interviews with 35 practitioners and observations of 26 practitioner-client sessions. Additional informal observations, programme documentation, client case notes and extant literature were also included as data. The theory adds to current Condition Management literature by explaining the differences across and within programmes, highlighting some important considerations for future development and evaluation within welfare to work. Furthermore, the theory of Revisioning Service Ideals and Client Realities, on account of its conceptual nature, also demonstrates relevance outwith its substantive area. Most notably, offering contributions to current research on treatment fidelity, theories of organisations and bureaucracy, and professional and clinical reasoning by offering a conceptual explanation of the behaviour of practitioners in daily practice.