Domains of Occupational Therapy Final

What are 2 purposes of the AOTA code of ethics?

1. Describes core values that guide members toward ethical courses of action 2. Outlines enforceable principles and standards of conduct that apply to AOTA members

What are the two major sections of the OT Framework?

1. Domain of Occupational Therapy 2. Process of Occupational Therapy

What are the different types of occupations?

ADLs IADLs Rest & Sleep Education Work Play Leisure Social Participation.

Description of Body Functions: Mental Functions

Affective Cognitive Perceptual

___ is the concern or wealth for the welfare of others

Altruism

What are the occupational therapy core values?

Altruism Equality Freedom Justice Dignity Truth Prudence

Mrs. Jones, who is indigent and lives in a nursing home, resists going to occupational therapy but rather constantly ask to return to her room. The therapist, Andrea, learns that Mrs. Jones is afraid someone will steal her things. Andrea deals with the issue by forcing Mrs. Jones to go to therapy despite learning the reason that Mrs. Jones is reluctant to go to therapy. What ethical principle has been violated?

Autonomy From Code of Ethics: Autonomy E. Respect the client's right to refuse occupational therapy services temporarily or permanently, even when that refusal has potential to result in poor outcomes.

___ is respecting the rights of individuals to privacy, confidentiality, and consent

Autonomy and confidentiality

What are Low touch societies?

Avoid touch, especially in public, except for hand shaking/greeting No touching between family members of opposite sex

An entry-level OT was hired recently to work in an inpatient rehabilitation setting. The therapist is a bit overwhelmed and is running behind with today's schedule. The occupational therapy aide, who has worked there for 15 years and is very good with clients, offers to help out. Which of the following tasks is most appropriate for the therapist to delegate to the occupational therapy aide? A. Teaching a client with a recent heart attach how to use a sock assist B. Asking a client to fill out a leisure inventory C. Determining whether the client requires any durable medical equipment (DME) for home D. Reviewing a client's home exercise program for accurate performance

B. Asking a client to fill out a leisure inventory It is not ethical for the OT to delegate a skilled occupational therapy task to an aide. However, an aide can ask a client to fill out a form that the OT will review with the client later. All the other answers require professional judgment and knowledge and are not appropriate for the aide to perform.

Steve, an OTA, was recently hired to work at a facility that has two OTs and three other OTAs on staff. Steve feels he needs more supervision from his supervising therapist than he has been receiving since starting work 2 weeks ago. What primary action should Steve take? A. Discuss concerns with rehabilitation director B. Discuss concerns with his supervising OT C. Wait and see whether supervision improves over the next several weeks D. Ask coworkers how much supervision time they each receive

B. Discuss concerns with his supervising OT Steve has mutual responsibility to ensure that he receives appropriate supervision levels. He should go through the proper chain of command and discuss his concerns with his supervising OT first. The therapist may not be aware that Steve has those concerns. If Steve and his OT supervisor are not able to come to a satisfactory arrangement, he might then seek help form the rehabilitation director. Although Steve could ask his colleagues about their level of supervision, their needs may not be relevant to Steve's, and it could also be perceived negatively as complaining or gossiping. Thus, it is best to speak to the therapist directly.

What is client centered care?

Based on the profession's belief in the worth of and respect for each individual Providing clients with unconditional positive regard Supports the premise that a client is capable of leading the therapy process and making decisions about his or her health, and that therapy is a collaborative process between the client and the practitioner

Examples of ADLs

Bathing Showering Bowel and bladder management Dressing Eating Feeding Functional mobility Personal device care Personal hygiene and grooming Sexual activity Toilet hygiene

___ are Cognitive content held as true

Beliefs

What are cultural issues that may impact cross-cultural interactions in occupational therapy?

Beliefs about health, well-being, and illness (folk medicine, supernatural) Gender and family roles The use of touch and space

___ is to demonstrate concern and well being and safety of others

Beneficence

You are working in a school system with children who have learning disabilities. There is a child on your caseload that you feel may benefit from receiving speech services; however, you do not recommend for an evaluation because you feel that others on the team do not see your perspective. What ethical principle has been violated?

Beneficence From Code of Ethics: Beneficence I. Refer to other providers when indicated by the needs of the client.

What are the 6 principles of the Code of Ethics?

Beneficence Non-maleficence Autonomy and confidentiality Justice Veracity Fidelity

___ is when those who believe that "there exist natural, physical divisions among humans that are hereditary, reflected in morphology, and roughly but correctly captured by terms like Black, White, Asian, and Hispanic

Biological Race

___ are Physiological functions of body systems.

Body Functions

___ are Anatomical parts of the body and their components.

Body Structures

Leila, an occupational therapy student, is performing Level II fieldwork in a school setting. During the first week, her fieldwork educator asked her to perform various standardized formal assessments on clients without direct supervision. Because Leila has never administered those particular assessments and did not learn about them in school, she informed her fieldwork educator about her inexperience. The fieldwork educator responded that the caseload is much busier than normal this week, she is confident in Leila's abilities, and that those assessments really need to be completed. The fieldwork educator also apologized for not having the time to watch Leila perform those assessments this week, but suggested that Leila take the assessments home to review them ahead of time. What should Leila's primary action be? A. Speak to the rehabilitation director B. Quit fieldwork C. Contact her academic fieldwork coordinator D. Take the assessments home to review them

C. Contact her academic fieldwork coordinator It is not ethical for Leila to perform those assessments because they clearly require supervision based on Leila's student status, lack of knowledge, and inexperience. Because Leila has already discussed her concerns with the fieldwork educator without a satisfactory resolution the next step is to ask her academic fieldwork coordinator to intervene. As a student, it would not be appropriate in this instance to go over her supervisor's head and speak to the rehabilitation director before contacting the academic fieldwork coordinator.

An OT is supervising a volunteer in the outpatient occupational therapy department. The volunteer is enrolled in college and studying to be an OT. As a result, the volunteer is familiar with how to use adaptive equipment. The volunteer is at the site because she wants to learn more about occupational therapy on her own. It is not a fieldwork experience. Which of the following is most appropriate for the OT to allow the volunteer to do? A. Review charts to learn more about occupational therapy documentation B. Teach a client how to use a buttonhook C. Cut out Velcro tabs for splint making D. Provide hand-over-hand assistance to help a client with decreased ahnd strength learn to use a reacher

C. Cut out velcro tabs for splint making It is not appropriate for a volunteer to review client charts because this would violate confidentiality. Teaching a client how to use adaptive equipment is skilled intervention that is not appropriate to delegate to a volunteer or aide. It is appropriate for a volunteer to assist with preparing equipment such as splinting components.

Description of other Body Functions:

Cardiovascular hematological immunological respiratory system functions voice and speech functions digestive,metabolic, & endocrine system functions genitourinary and reproductive functions skin related structure functions

Examples of IADLs

Care of others Care of pets Child rearing Communication management Community mobility Financial management Health management and maintenance Home establishment and maintenance Meal preparations and cleanup Religious observance Safety and emergency maintenance Shopping

___ are specific capacities, characteristics, or beliefs that reside within the person and that influence performance in occupations

Client Factors

___ is a sum total of a way of living, including values, beliefs, standards, linguistic expression, patterns of thinking, behavioral norms, and styles of communication to generation.

Culture

An OT has delegated a particular client intervention to an OTA today. The OTA tells the OT that he feels this intervention is not in the best interest of the client and is uneasy about implementing it. What is the therapist's best course of action? A. Tell the OTA not to treat the client and ask the rehabilitation director to fire the OTA B. Have a brief discussion to emphasize that the OT is his supervisor and the OTA must comply according to AOTA role delineation guidelines C. To avoid conflict, tell the OTA to do whatever he wants to do D. Have an honest and open discussion with the OTA to explain why this treatment is appropriate and provide evidence-based resources

D. Have an honest and open discussion with the OTA to explain why this treatment is appropriate and provide evidence-based resources If the OTA is merely expressing legitimate concerns, firing the OTA would not be an appropriate response. An OT should not "force" an OTA to perform a delegated task that the OTA believes will cause harm to the client. However, the therapist should have an honest and open discussion with the OTA to explain why this intervention is appropriate and provide evidence-based resources to alleviate the OTA's concerns. They might also establish the professional development plan for the OTA to obtain further information as needed for this diagnosis or intervention.

What are the variables of culture?

Demographic variables: Age Gender Place of resident Status variables: Social Educational Economic levels Affiliation variables

___ is treating people with respect for individuals

Dignity

___ Denies equal treatment to people because of their membership in some group

Discrimination

What is the AOTA code of ethics?

Document and a public statement tailored to address the most prevalent ethical concerns of the occupational therapy profession; it outlines standards of conduct the public can expect from those in the profession

___ outlines the profession's purview and the areas in which its members have and established body of knowledge and expertise

Domain

___ is treating all people impartially and without bias

Equality

___ is when two or more ethical principles collide with each other; no clear cut answer or solution

Ethical dilemma

___ challenges how we maintain our integrity and the integrity of the profession; psychological discomfort when blocked from acting ethically

Ethical distress ex. hospital policies

What are 3 types of ethical issues?

Ethical distress Ethical Dilemma Locus of Authority

___ is the study of the general nature of morals and of specific moral choices

Ethics

___ is a social grouping of people who share cultural or national similarities

Ethnicity

___ is a tendency of people to put their own group at the center; to see things through the narrow lens of their own culture and use the standards of that culture to judge others

Ethnocentrism

___ is standards of behavior considered good manners - within a profession we consider ideas of common courtesy or protocols

Etiquette

Which of the following is NOT part of the Learn Model of cultural communication? a. listen b. examine c. assess d. negotiate

Examine

___ is treating clients, colleagues, and other professionals with respect, fairness, discretion, and integrity; demonstrating professional loyalty

Fidelity

___ is people having the right to choose

Freedom

Description of Body Functions: Specific Mental Functions

Higher-level cognitive Attention Memory Perception Thought Mental functions of sequencing complex movement Emotional Experience of Self and Time

Types of proxemic distances:

Intimate distance - for embracing, touching, whispering Personal distance - interactions among good friends/family Social distance - interactions among acquaintances Public distance - used for public speaking

___ is having diverse communities that allow for participation of all groups or individuals

Justice

___ promoting fairness and objectivity in services; equal opportunity

Justice

Jill is working in a skilled nursing facility and sees a patient who clearly needs OT services. She is told by her manager that she cannot provide those services because the client has Medicade which won't cover OT treatments. Instead the manager insists Jill evaluate clients who have Medicare coverage, but don't necessarily need treatment. What ethical principle has been violated?

Justice From Code of Ethics: Justice B. Assist those in need of occupational therapy services in securing access through available means. C. Address barriers in access to occupational therapy services by offering or referring clients to financial aid, charity care, or pro bono services within the parameters of organizational policies. D. Advocate for changes to systems and policies that are discriminatory or unfairly limit or prevent access to occupational therapy services.

Kaitlin, an occupational therapy assistant (OTA), has moved to a new state. She begins working in a facility with older adults who have physical disabilities. Begins working with patients and her supervisor begins to notice that Kaitlin is using modalities which she in not allowed to use in treatment. What ethical principle has Kaitlin violated?

Justice From Code of Ethics: Justice G. Hold requisite credentials for the occupational therapy services they provide in academic, research, physical, or virtual work settings.

The occupational therapist, Karen started a daily self-feeding program for Mr. Parker. The therapist visits Mr. Parker at mealtime and explains the proper use of the adaptive equipment to the aide. Karen discusses how to work on independence and what assistance may still be needed upon discharge. The therapist bills Mr. Parker an excessive amount for the therapy she has provided. What ethical principle has been violated?

Justice From the Code of Ethics: Justice M. Bill and collect fees legally and justly in a manner that is fair, reasonable, and commensurate with services delivered.

___ are defined as a rule of conduct or action formally recognized as binding and enforced by a controlling authority

Laws

What does the LEARN Model stand for?

Listen: identify and greet family/friends of the patient; ask patient if English is 1st/2nd language Elicit: the patient's health beliefs are elicited as they pertain to the health condition and the reason for the visit as well as expectations Assess: potential attributes in the person's life that may have an impact on their health and behaviors Recommend: a plan of action with an explanation for your rationale Negotiate: a plan of action with the patient after you have made your recommendations

___ is difficulty deciding who should be the primary decision maker You and your supervisor both feel like you're right about course of action; but course of actions are different

Locus of authority

What are High touch societies?

May seek out touch as means of communication and are comfortable with casual touch

___ are the principles of right and wrong; it implies conformity to established codes or accepted nation; it is the basis for ethical behavior

Morals

Description of Body Functions: Movement Functions

Motor Reflexes Involuntary movement reactions Control of voluntary movement Gait patterns

___ is An ideal in which diverse groups in a society coexist amicably, retaining their individual cultural identities

Multiculturalism

___ is the obligation not to impose risk of harm or potential risk without harmful intent; do no wrong

Non-maleficence

Education

Occupation: Activities needed for learning & participating in the educational environment.

ADLs

Occupation: Activities of Daily Living - activities oriented toward taking care of one's own body.

Rest and Sleep

Occupation: Activities related to obtaining restorative rest & sleep to support healthy, active engagement in other occupations.

Play

Occupation: Any spontaneous or organized activity that provides enjoyment, entertainment, amusement, or diversion.

IADLs

Occupation: Instrumental Activities of Daily Living - activities to support daily life within the home & community that often require more complex interactions than those used in ADLs.

Work

Occupation: Labor or exertion; to make, construct, manufacture, form, fashion, or shape objects; to organize, plan, or evaluated services of process of living or governing.

Leisure

Occupation: Nonobligatory activity that is intrinsically motivated and engaged in during discretionary time, that is, time not committed to obligatory occupations such as work, self-care, or sleep.

Social Participation

Occupation: The interweaving of occupations to support desired engagement in community & family activities as well as those involving peers & friends.

___ is Determined by one's values, interests and beliefs, social situation, gender, age, sexual identity, and physical, cognitive, and emotional abilities

Occupational Choice Ex. 65 year old african woman from northeastern part of US may choose activities such as snowshoeing with her grandchildren or meeting friends in nearby mall for lunch

___ is The accomplishment of the selected occupation resulting from the dynamic transaction among the client, the context and environment, and the activity

Occupational Performance Ex. eating a meal is important in many cultures, yet mealtime is performed differently - western countries sit in chairs at a table, while others sit on the ground; forks versus chopsticks versus hands

___ are Various kinds of life activities in which individuals,groups, or populations engage

Occupations

What are the 5 domains of OT?

Occupations Client Factors Performance Skills Performance Patterns Contexts / Environments.

Common OT areas of practice:

Pediatric - NICU Pediatrics - School System Health Promotion Mental Health - Community Mental Health Recovery Sleep Productive Aging Visual Impairment Dysphagia Acute Care Ergonomics Work Rehabilitation Psychiatry Community Programs Adult day social services Assistive Living

___ is Preconceived ideas and attitudes - usually negative about a particular group of people, often without full examination of the facts

Prejudice

___ describes "the actions practitioners take when providing services that are client centered and focused on engagement in occupations"

Process

What is the purpose of a framework?

Provide a structure or base on which to build a system of concept The framework must be used to guide OT practice in conjunction with the knowledge and evidence relevant to occupation and OT within the identified areas of practice and with appropriate clients

___ is The measurable distance between people as they interact

Proxemics

___ is using clinical reasoning, ethical reasoning and judgement and reflection to make decisions

Prudence

___ is most fundamentally the assessment of individual worth on the basis of real or imputed group characteristics; its evil lies in the denial of people's right to be judged as individuals, rather than as group members

Racism

Which of the following is not an area of occupation? a. ADL B. education C. work D. recreation

Recreation

Which of the following is NOT typically considered an OT area of practice? a. dysphagia b. respiratory care c. lower extremity d. cognition

Respiratory Care

___ is The aspect of humanity that refers to the way individuals seek and express meaning & purpose & the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred.

Spirituality

___ occurs when one attributes certain characteristics to an entire group of people

Stereotyping Examples: All black people can dance Obese people are lazy Feminists are man-haters Old people are grumpy Gay men are promiscuous

___ is providing moral, accurate information/communication

Truth

What is the Explanatory Model used for? What questions should you ask the client?

Used to understand the patient's perception of their disease or illness What do you call the problem? What do you think the illness does? What do you think the natural course of the illness is? What do you fear? Why do you think this illness or problem has occurred? How do you think the sickness should be treated? How do you want to be helped? Who should be involved in the decision-making?

___ are principles, standards, or qualities considered worthwhile by the client who holds them

Values

Where do we learn about ethical behavior?

Values, beliefs, systems, morals, and shaping of ethical behavior is learned throughout childhood and shaped through the maturation process and experience

Which of the following is a core value of OT according to the Code of Ethics? a. veracity b. prudence c. altruism d. dignity

Veracity

___ is providing comprehensive, accurate, and objective information when representing the profession; being truthful and information disclosure

Veracity

You are working on a research paper and you use information from other authors and you neglect to provide the appropriate citations. What ethical principle has been violated?

Veracity Code of Ethics: Veracity H. Give credit and recognition when using the ideas and work of others in written, oral, or electronic media (i.e., do not plagiarize).

Ricardo, an OT, accepted a new job in a school system that occasionally uses sensory integration therapy. Ricardo's only exposure to SI was in school several years earlier, and thus he does not feel qualified to us SI therapy. Despite this Ricardo begins to treat a child with SI issues. What ethical principle has been violated?

Veracity From Code of Ethics: Veracity A. Represent credentials, qualifications, education, experience, training, roles, duties, competence, contributions, and findings accurately in all forms of communication.

You have just finished working with a client and realized you do not have time to document what you did in your treatment session. Before you know it a week has gone by and you failed to document his progress. What ethical principle has been violated?

Veracity From Code of Ethics: Veracity C. Record and report in an accurate and timely manner and in accordance with applicable regulations all information related to professional or academic documentation and activities.

Lindsay, an OT Student, just completed her thesis for her master's degree. Lindsay received an invitation stating that her professor is presenting a paper on the same subject matter that Lindsay wrote. Lindsay realizes that it is her paper that the professor is presenting on. What ethical dilemma has been violated?

Veracity From Code of Ethics: Veracity H. Give credit and recognition when using the ideas and work of others in written, oral, or electronic media (i.e., do not plagiarize).

What is the OTPF?

an official document of the American Occupational Therapy Association. It presents a summary of interrelated constructs and describe occupational therapy practice

What is an Individualistic society?

believe in individual rights, and each person within the family or work unit is viewed as a separate entity Value: Self expression Persona choice Autonomy Individual responsibility Independence

Description of Body Functions: Global Mental Functions

consciousness orientation temperament and personality energy and drive sleep

Description of Body Functions: Neuromusculoskeletal and movement-related functions

joint mobility joint stability

Tonya, a 15 year old teen attending an outpatient group for eating disorders, becomes exceptionally attached to the OT practitioner, Mark. The teen calls Mark at home and begins to discuss her intervention plan, telling Mark she got his phone number from her cousin who Mark knows from school. Mark continues to speak term-26with Tonya and they arrange a lunch date for the next day. What ethical principle has been violated?

nonmaleficence From Code of Ethics: Nonmaleficence F. Avoid dual relationships, conflicts of interest, and situations in which a practitioner, educator, student, researcher, or employer is unable to maintain clear professional boundaries or objectivity. G. Avoid engaging in sexual activity with a recipient of service, including the client's family or significant other, student, research participant, or employee, while a professional relationship exists.

What is a collectivistic society?

tend to put more value on the family as a unit than on the individual Value: interdependence ; "we" not "i" Decisions made by family Harmony and cooperation

How is occupational therapy defined in the OTPF?

the therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of enhancing or enabling participation in roles, habits, and routines in home, school, workplace, community, and other settings

Description of Body Functions: Sensory Functions

visual functions hearing functions vestibular functions taste functions smell functions proprioceptive function touch functions pain sensitivity to temperature and pressure