PGDip/MSc in Occupational Therapy
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7223
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Item Sensory integration for children with autism spectrum disorder: examining the divergence between research and practice(Queen Margaret University, 2016)Background. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects 2.24% of American children. Sensory processing difficulties have been linked to ASD and can restrict a child's participation in daily living activities and impact social engagement. The sensory integration approach is widely used by occupational therapists to address these sensory processing difficulties and improve function, participation and engagement for children with ASD. Sensory interventions can be separated into two categories, Ayres Sensory Integration® (ASI) and Sensory Based Interventions (SBI). In the past, research has grouped both ASI and SBI under the rubric of sensory integration, which has resulted in controversy regarding the efficacy of sensory integrative practice. However, with the development of the ASI fidelity measure, there has been an increase in studies that aim to evaluate the effectiveness of ASI treatment. There is a need to synthesise and critique these studies to determine the efficacy of ASI as an intervention for children with ASD. Purpose. This literature review intends to 1) outline the current context of the sensory integration approach for children with ASD, 2) critically appraise the evidence related to ASI for children with ASD and 3) explore possible reasons for the divide between research and practice. Methods. A literature search was conducted using four scholarly databases. Articles identified through the literature were evaluated against inclusion/exclusion criteria and critically appraised. Conclusions. There are multiple studies showing that ASI continues to be a popular intervention for children with ASD; parents and therapists seem to find ASI to be very effective. However, research on the efficacy of ASI for children with ASD is largely inconsistent. There is a clear divide between research and practice. Various reasons exist to explain this divide. Reasons discussed in this review are the heterogeneity of the ASD population, inappropriateness of outcomes and outcomes measures, and the multiple evidence sources of occupational therapy. While more research is necessary to support the efficacy of this preferred approach, occupational therapists must also better integrate the science of 'best evidence' with the art of person-centred practice when using ASI for children with ASD.Item Environmental Assets That Enable Play for School-Aged Children with Physical Disabilities: A Literature Review(Queen Margaret University, 2016)Play in its many forms has a central role in paediatric occupational therapy practice. It is considered to be the primary occupation of childhood, through which children develop and attain health and wellbeing. Internal/personal factors and external/environmental factors affect the occupation of play, symbolised in the Person-Environment-Occupation Model. Although personal factors may pose limitations to engaging in play, particularly for children with physical disabilities, environmental barriers often have a greater negative impact. While much literature identifies such barriers, it is equally important that strengths, or assets, that mitigate these barriers are identified and boosted. The aim of this literature review is to focus on the environmental assets that enable play for school-aged children with physical disabilities, by collating and synthesising strengths-related findings from a comprehensive literature search. The literature search was performed using free text search terms and database headings in five databases, producing 490 results. Additionally, a hand search of the search results' reference lists was undertaken. A total of 21 articles concerning the participation of children with physical disabilities in play were chosen for critical appraisal. These articles yielded themes relating to four different environments-virtual, physical, institutional, and social-under which subthemes of powered mobility and computer-based assistive technology; accessibility and usability; transportation, community programmes, and schools; and parents, support workers and teachers, and peers are grouped, respectively. Following suit, implications of these assets are reviewed in consideration with their relation to individuals and occupation, theory, and inherent value. After exploration, analysis, and discussion of these environmental assets, recommendations for practice, research, education, and policy are suggested to contribute to and further the knowledge base and practice of the occupational therapy profession.Item A Qualitatative Exploration into the Lived Experience of Adults with Anxiety Using Mindfulness in Everyday Occupational Engagement(Queen Margaret University, 2016)Mental health is a major public health challenge both globally and nationally. Not only is there significant economic, health and social costs, mental health problems relating to anxiety have an occupational cost too. Consequently there is increasing emphasis on early detection and management. A method for managing these costs is to explore innovative and evidence-based interventions that might address these challenges. An intervention used in clinical and general populations with promising results in healthcare, education, and law enforcement is the use of mindfulness. The review of literature from psychology, nursing, business and occupational therapy, suggests that the regular use of mindfulness practice can enhance quality of life. Enhanced quality of life has been attributed to improved health and well-being resulting from symptom reduction, the development of better coping strategies and enhanced occupational engagement. Yet there is a paucity of research that in occupational therapy that specifically explores how adults with anxiety respond and experience the use of mindfulness in everyday occupational engagement. In order to address this research gap, the following research is proposed. The purpose of this qualitative research pilot study is twofold: 1) to explore the meaning and lived experience of adults with anxiety using mindfulness in everyday occupational engagement and 2) to investigate its feasibility with this novel population. In order to achieve this, participant's perspectives, insights and attitudes will be gained by recruiting four participants who would have attended a mindfulness training group run by occupational therapists. Rich phenomenological data will be obtained through semi-structured interviews at the end of the mindfulness training group (participants will be asked about their overall experience of participating in the training group and how these mindful experiences are being translated into daily life). Interpretative phenomenological analysis (IPA) will be used to discern findings by using literature to aid the interpretation of the significance that participants have ascribed to the structure and essence of their lived experience. The research aims to contribute to the existing occupational therapy research. This dissertation comprises of two sections. The first section will explore the experiences of using mindfulness with adults in relation to anxiety in everyday occupational engagement in a general sense (literature review). The second section will specifically explore the meaning and lived experience of adults with anxiety using mindfulness in everybody occupational engagement (research proposal).Item Occupational deprivation and frailty: the experiences of housebound older people(Queen Margaret University, 2016)Meaningful and purposeful occupation is central to occupational therapy practice. The person, their environment and their occupations are widely acknowledged as interdependent on each other to ensure meaningful occupation can be achieved. Older people who are housebound and living with frailty are at risk of becoming deprived from opportunities to engage in meaningful and purposeful activities, putting their health, well-being and quality of life at risk. This is due partly to the physical characteristics associated with becoming older and frailer and the environments in which they live. Older populations are also increasing, with an increase in older people living with occupational deprivation, the importance and necessity of understanding the lives of older people living with frailty and their experiences of living with occupational deprivation is highlighted. The following dissertation engages the reader in a thorough and comprehensive literature review surrounding older peoples' experiences of living with frailty. The literature reveals the significance and importance of occupation for older people. Relation is made throughout the review to the person-environment-occupation model to further establish the importance of ensuring older people, especially those living with frailty, are engaged in purposeful and meaningful activities. A lack of research focussing on occupation and occupational deprivation with frail older people is identified within the literature. This gap in the literature has informed the research proposal. Research is proposed using an interpretive phenomenological methodology with an aim to identify, explore and describe experiences of occupational deprivation of older people living with frailty who are housebound and living at home. Participants will be purposively sampled from referrals into an intermediate care service to ensure they are at home, housebound and living with frailty. Interviews and observations will explore individual experiences of occupational deprivation. Methods of using interpretive phenomenological analysis are proposed to analyse the data gathered and meet the aim of this study. The following research questions have been posed to meet the study aim. The principal question is; what are the experiences older people living with frailty have in relation to occupation and occupational deprivation? Secondary questions are; is being deprived from meaningful occupations being experienced by this group? What occupations are significant to older people with frailty? And how are these occupations significant and important to older people with frailty?Item An exploration of boredom within occupation(Queen Margaret University, 2016)Boredom is a universal phenomenon of which there is no clear definition or agreed understanding of the overall causes, but is linked with occupation and a sense of meaning. Boredom is an area of concern to occupational therapy due to the association with the ways in which people participate within their daily occupations. The dissertation explores the phenomenon of boredom in occupation by reviewing current literature within occupational therapy and also from generic sources such as psychology and nursing professions. Exploration of the literature reveals a lack of research into the experience of boredom within occupational therapy and is therefore necessary to establish the evidence base. Literature within psychology and nursing indicates potential causes and consequences of boredom using quantitative methodologies, but highlights the need for deeper understanding using qualitative approaches. Occupational therapy research in relation to boredom has tended to focus on groups such as young people and people with substance misuse, which have identified that boredom is an occupational concern risk. However, there is a distinct lack of studies exploring the perspectives of people with diagnosed mental health conditions. Part two of the dissertation will comprise of a research proposal to undertake research which aims to explore the experiences of boredom for people with a diagnosed mental health condition. Using an Interpretative Phenomenological Analysis (IPA) approach will use semi structured interviewing to explore the lived experiences of boredom for three people who have a diagnosed mental health condition and are acute psychiatric inpatients. The study aims to contribute to the evidence base by increasing understanding of the experience and enhancing clinical practice with the client group.Item Exploring the use of occupation based practice as a core component of Occupational Therapy.(Queen Margaret University, 2016)Literature suggests that occupation should be a core component of occupational therapy practice and that occupation based practice is a hallmark of excellence for occupational therapy provision. It is well recognised that since the emergence of the profession there have been a number of paradigm shifts for occupational therapy practice and a wide variation in the nature and purpose of intervention delivered. The growth of the body of knowledge and research evidence in occupational science and the recognition of the importance of occupation for health and wellbeing has raised the profile for the role of occupational therapy. In recent years this has increased the motivation and aspiration for the profession to return to an occupational paradigm and ensure that occupation therapy focuses on its unique contribution to health and wellbeing. Whilst there appears to be a consensus agreement across the profession that occupation based practice is beneficial and a desire to re-establish an occupational paradigm it is unclear if this is yet to be achieved. This literature review therefore provides an in depth exploration of the current literature in this topic area and discusses key findings in relation to the level of understanding of occupation, the factors which influences its use in practice and the subsequent challenges of quantifying the benefits of occupation based practice. As a result of the findings from the literature review, this paper also proposes a further area of study to gain an in depth understanding of occupation based practice in a clinical setting as a foundation for future evaluation of the benefits of occupational therapy intervention.Item Using Functional Capacity Evaluations in a UK Setting: Exploring Clients' Perceptions.(Queen Margaret University, 2016)Functional Capacity Evaluations (FCEs) promote occupational performance by providing answers to the questions of if and when an absent employee is safe to return to performing their work duties. Despite a recent focus on reducing sickness absence in the United Kingdom (UK), and increased use of FCEs, a comprehensive search of the literature found no evidence of their use in a UK setting. This proposed study will aim to fill this gap in order to ascertain whether there is merit in offering FCEs to clients coming through the Fit for Work Scotland service, as a means of providing objective information to allow employers to make the necessary adjustments to manage their employees back into work. Interpretative phenomenological analysis (IPA) will be used to examine the experiences of clients who have participated in an FCE during a period of sickness absence; qualitative methodologies have only been used in a handful of overseas studies. A homogenous sample of 5 clients will be purposively chosen. These NHS employees will: have been absent from work with a musculoskeletal condition; work in a light, medium or heavy job; and have undergone a traditional physical FCE, with the purpose of returning them to work. Three months following their FCE, semi-structured interviews will be conducted by a research assistant. The data will subsequently be analysed by this author, using double hermeneutics, following a step-by-step process which includes reading and re-reading interview transcripts, noting themes, searching for connections across emergent themes and looking for patterns across cases. This will be done systematically and rigorously to demonstrate trustworthiness. Ethical values will continuously guide this research in order to achieve maximum benefit with minimum risk to participants. The results will be shared with stakeholders who have a vested interest in employees' opinions regarding the overall utility of FCEs.