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OT unit notes - Summary Concepts of Occupational Therapy

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Concepts of Occupational Therapy (OCT1000)

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OT Process & Models

Describe and explain the purpose of the occupational therapy process An occupational therapist works systematically with a client through a sequence of actions called the occupational therapy process. The process includes the components of evaluation (or assessment), intervention, and outcomes. This process provides a framework through which occupational therapists assist and contribute to promoting health and ensures structure and consistency among therapists.

Describe and explain the difference between the occupational therapy process and occupational therapy models The process is an overview of where you must go, the direction/s you will take The model is what will help you to get from start to finish The OT process is a map whereas the models are the mode of transport.

Describe the different components of the Occupational Therapy Practice Framework (OTPF) Domain: What do we look at? What do we care about? Occupations, client factors, performance skills, performance patterns, contexts & environments. Process: Evaluation, Intervention, Targeting outcomes

Describe and explain the client and context/environment components that contribute to occupational performance Client factors: Values, beliefs and spirituality; Body functions; Body structures Context: Cultural – What behaviours are expected? What are accepted? Personal – Age, gender, sexuality, socioeconomics Temporal – Stage of life, time of year, length of occupation Virtual - Technology Environment: Physical (natural & built) & Social (relationships & their expectations)

PEOP model vs CMOPE model The PEOP model looks at occupational performance (ability to do an occupation to a desired level) C-MOPE looks at occupational performance & engagement (Be able to participate and engage in something that has meaning)

Communication

Discuss the importance of communication skills for occupational therapists One of the most fundamental skills needed throughout the occupational therapy process. At every stage of the occupational therapy process, we need to utilise different types of communication to engage with our clients, their families/carers, our colleagues and supervisors

Describe the Australian Occupational Therapy Competency Standard 4: Communication “Occupational therapists practise with open, responsive and appropriate communication to maximise the occupational performance and engagement of clients and relevant others”

Types of communication Virtual, verbal, augmentative & alternative, written, non-verbal, formal, informal

Recipe for great communication

  1. Clarity: Make your point clearly  When lots of complexity
  2. Brevity: Make your point quickly  When time/attention is short
  3. Context: Make your message relevant  Unfamiliarity with topic
  4. Impact: Make your message memorable  When there’s lots of noise
  5. Value: Make your message valuable  Scepticism/choices

Relationships

Why do we need good relationships? Because we want to achieve the best possible outcomes for our clients.

Clients: We want to establish rapport, be client-centered, therapeutic use of self, have empathy

Family: We want to give them a prognosis, inform them of support services, inform them what all the health professionals are doing, what discharge plans are etc. We need to be able to address concerns

Different audiences have different pallets, so adjust your ingredients to suit their taste

Ethics

4 principle approach to ethics

  1. Non-maleficence  Do no harm  Duty of care  Need to be aware of and consider potential harm caused by either well-intended actions or a failure to act
  2. Beneficence  Benefiting the client  Health professionals should add value to the lives of clients  Doing all that could possibly be done
  3. Justice  Fairness – Making sure people with the same needs have the same acess to services without discrimination or prejudice  Comparative justice – If someone has greater needs they should receive more of the available services without discrimination or prejudice  Distributive justice – How services or resources are distributed amongst the community or population. Usually based on societal rules/norms e. lower income gets lower tax  Compensatory justice – Acknowledging that if people have experienced discrimination or injustice in the past then they should have the opportunity to receive more resources or services to make up for the imbalance e. Close the gap (Caucasian senior age is 65+, Aboriginal senior age is 45+)
  4. Autonomy  Everyone has the right to their own values, beliefs and views  The right of self-determination  The values, beliefs and views of clients are prioritised over those of the health professional  Assumption: the individual has capacity

Additional ethical principles  Veracity – conformity to the truth/facts; honesty  Fidelity – Keeping promises; doing what you say you will do  Confidentiality – Keeping personal information private  Consent – Ensuring you have informed consent to proceed with OT process

Ethical theories Deontology - Actions are right or wrong We can use reason to determine if something is good/bad, right/wrong. An action is good if at the same time you would be happy for everyone else in the world to do it. E. Jack in a hole – would they be happy for everyone else in the world to blow someone up

Utalitarianism – For the greater good Morality is not based on the act itself but the consequences of the act. E. Big jack is one person, there are 2 other people. Blowing up big jack saves 2 lives

OT’s usually have a deontology approach but the healthcare systems have a utilitarian approach.

Ethical Decision Making Process

  1. Recognise & define the ethical question
  2. Gather relevant data
  3. Formulate a moral diagnosis & analyse the problem using ethics theory/principles
  4. Problem solve practical alternatives, weigh options & decide on an action
  5. Act on a morally acceptable choice
  6. Evaluate & reflect on the process/actions/results

Interview & Analysis

non-maleficence = Shoe hurts

beneficence = Shoe doesn’t add

value to outfit

Why is a narrative summary important? Putting all of the information together in this way is important to gain an holistic occupational perspective of the person, integrating the way in which different factors impact the person’s current occupational roles, their performance, and engagement

What is a narrative summary? The past, current and future perceptions, choices, interests, goals and needs that are unique to the person, organisation or population. Person:  Perception and meaning  Choices and responsibilities  Attitudes and motivation  Needs and goals Organisation:  Mission and history  Focus and priorities  Stakeholders and values  Needs and goals Population:  Environments and behaviours  Demographics and disparities  Incidence and prevalence  Needs and goals

Why do we do an occupational profile? To understand our patients as occupational beings

Interview format

  1. Gain consent
  2. Small talk – build rapport
  3. Do they know what an OT is?
  4. Typical day
  5. Focus on info given from this
  6. Ask why X is important to them
  7. Link things to keep flow going
  8. Don’t double barrel questions

Why is Activity and performance analysis important? Helps us to evaluate the strengths and challenges in the clients’ occupational performance and therefor give realistic intervention planning/implementation. Using occupation as therapeutic means and ends

Difference between Activity analysis and Performance analysis? Activity analysis is looking at general person and environment factors in a task/activity whereas a Performance analysis considers the specific person and their environment factors in the task/activity.

The OT Process Steps

Kavs format: Work Leisure Hobbies Family Living arrangements

Activity Analysis

(putting shirt on with some left arm paralysis – short version, should be 10-15 steps)

1. Use right upper limb to turn shirt so it is face down and bottom opening is toward you

2. Use left hand to grab corner of shirt whilst right limb pushes though shirt and sleeve

3. Use right upper limb, reach and grip left bottom corner of shirt and pull over head

4. Use right hand to grab left hand and pull through shirt and sleeve

5. Use right upper limb to pull down sides of shirt over the waist

Identify the area that the client had trouble with (step 3) to place intervention

Plan the intervention

Use PEO to plan the intervention

1. Occupation

Look at the occupation and see how

we can grade it to make the task easier or more challenging

Grading – measurable increase or decrease of an activity by altering factors such as

size, quality, intensity

e. support hip at step 3

2. Environment

Can we/should we adapt the environment?

Adapting – alterations/changes made to the environment (or objects in the

environment) to enable the person to complete the activity

e. high back chair, arm rest, button hook

3. Person

What prompts/cues and what type of chaining should be used to teach the client

Chaining

Forward chaining: Start at the 1st step of the activity and repeat until client is efficient.

Then do step 2 until efficient, then do steps 1&2 together until efficient etc

Backward chaining: Have the client complete the last step on their own and assist them

with the rest. Add in steps 1 at a time (reverse of fwd chaining)

Total task chaining: Prompt and correct as the person is doing the steps (this type of

chaining is not that great)

Prompts and cues

Use these whilst going the client goes through the steps of the activity

 Indirect verbal: Direct the client without telling them specifically what to do e. what

do we do next?

 Direct verbal: Tell the client what the next step is

 Gestural: Point to assist client

 Visual: E. show them the left side of the shirt, use cards illustrating steps

 Model: Do the activity with the client

 Direct physical: Assist the client with the activity

Indirect & direct verbal are good for people that have full cognition

Gestural & visual work well for kids and the elderly

Direct physical is for people with maximal dependence and disabilities

Be clear on these. Grading is only

done on the occupation and adaption is

only done to the environment

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OT unit notes - Summary Concepts of Occupational Therapy

Course: Concepts of Occupational Therapy (OCT1000)

29 Documents
Students shared 29 documents in this course

University: Curtin University

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OT Process & Models
Describe and explain the purpose of the occupational therapy process
An occupational therapist works systematically with a client through a sequence of actions called the occupational
therapy process. The process includes the components of evaluation (or assessment), intervention, and outcomes.
This process provides a framework through which occupational therapists assist and contribute to promoting health
and ensures structure and consistency among therapists.
Describe and explain the difference between the occupational therapy process and occupational therapy
models
The process is an overview of where you must go, the direction/s you will take
The model is what will help you to get from start to finish
The OT process is a map whereas the models are the mode of transport.
Describe the different components of the Occupational Therapy Practice Framework (OTPF)
Domain: What do we look at? What do we care about?
Occupations, client factors, performance skills, performance patterns, contexts & environments.
Process: Evaluation, Intervention, Targeting outcomes
Describe and explain the client and context/environment components that contribute to occupational
performance
Client factors: Values, beliefs and spirituality; Body functions; Body structures
Context: Cultural – What behaviours are expected? What are accepted?
Personal – Age, gender, sexuality, socioeconomics
Temporal – Stage of life, time of year, length of occupation
Virtual - Technology
Environment: Physical (natural & built) & Social (relationships & their expectations)

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