Exam 1 - 5020; Foundations & Theory
IDEA - time period and effects (ch. 2)
"Individuals with Disabilities Education Act (IDEA) in 1991. Educate students disabilities in the least restrictive environment. OTs role in schools increased dramatically as a result of this law. 1997 Individuals with Disabilities education act amendments: Further improve educational opportunities
Table 1-3 - be able to identify the time period if given the description of theories, events, and/or health care trends (applied theories ch 1)
***Page 31-32 - Look more into this
Box 3.2 Core concepts of OT
*People are viewed holistically. • People are active beings for whom occupation is critical to well-being. • Occupations are classified as: activities of daily living, instrumental activities of daily living, self-care, education, work, play and leisure, sleep and rest, and participation in social activities. • Learning entails experience, thinking, feeling, and doing. • The profession views occupation as both a means and an end. • Every person has the potential for change. • The client, family, and significant others are active participants throughout the therapeutic process - the client-centered approach. • Occupational therapy is based on humanism, wherein the values of altruism, equality, freedom, justice, dignity, truth, and prudence are central to the profession.
Box 14-1 - General familiarity with what you should be observing during analysis of occ. Performance (Pg. 133) (ch 12)
- Client factors such as movement functions - Impression of activities such as approach to tasks - Specific qualities such as independence, ability to follow verbal instructions, interactions with others
Development of AOTA - time period (ch. 2)
- During or a little bit after 1914 Eleanor Clarke Slagle, returned to Chicago and her home was the first unoffical headquarters of the National Society for the Promotion of Occupational Therapy (NSPOT), later became AOTA - Formal birth of OT, March 15th, 1917, a small group of 6 convened the initial organizational meeting and produced the certificate of the (NSPOT), in Clifton Springs, New York. -1950s and 1960s brought organizational changes to AOTA. The AOTF was founded in 1965. The trend towards the reductionist approach continued throughout the 60s
6 emerging areas of practice and general familiarity with each (ch 4)
1. Aging in place -The OT practitioner offers a wide range of services to older individuals to allow them to remain at home and continue to be active in their community; these services include home modification, consultation, community mobility, energy conservation, education, and remediation. 2. Driver assessments and training programs = OT practitioners determine a person's ability to drive after a trauma, illness, or decline in function by evaluating cognitive and physical abilities. --occupational therapists are well suited to succeed as driver rehabilitation specialists. Namely, the OT practitioner evaluates and intervenes in physical, social, cognitive, and psychosocial aspects of functioning that affect driving skills. 3. Community health and wellness OT practitioners may develop programs to keep clients and communities healthy. Such programs focus on wellness and prevention of disability, and they help those with disabilities and chronic conditions integrate into the community and contribute to society (e.g., vocational rehabilitation programs). 4. Needs of children and youth OT practitioners are well suited to developing programs for children to address health and wellness. -Occupational therapy practitioners may design programs to increase physical activity and nutrition for children and youth. This child plays an active game of Twister. Or by finding fun ways to make healthy snacks 5. Ergonomics consulting refers to the study of the problems of people in adjusting to their work environment. Ergonomics consulting involves providing recommendations to individuals and companies on workstation setup to promote safety, efficiency, and comfort to prevent work-related musculoskeletal injury. 6. Technology and assistive-device developing and consulting 2 Assistive technology, or adaptive technology, commonly refers to "products, devices or equipment, whether acquired commercially, modified, or customized, that are used to maintain, increase, or improve the functional capabilities of individuals with disabilities.
Box 4-1 be able to identify each law (ch 4)
1. Section 504 of the Rehabilitation Act of 1973: This law requires that programs or activities receiving federal financial assistance provide reasonable accommodations so persons with disabilities may participate. 2. Americans with Disabilities Act (ADA) of 1990: This law required that public places be accessible to those with disabilities. For example, OT professionals work with architects and employers to make work settings accessible to those with disabilities. 3. Individuals with Disabilities Education Act (formerly Public Law 94-142, or the Education for All Handicapped Children Act of 1975): **OT practitioners working in school systems work under this act. Requires public schools to make available to all eligible children with disabilities a free, appropriate public education in the least restrictive environment appropriate to their individual needs 4. Balanced Budget Act of 1997 Set out to contain health-care costs by placing caps on therapy services and resulted in a decrease in OT jobs. 5. Medicare: This health insurance program is for people 65 years of age or older and those with certain disabilities. It is a federally funded program that provides limits on spending and reimbursement for OT services 6. Patient Protection and Affordable Care Act of 2010 (ACA; Public Law 111-148): It includes a package of essential health benefits. Rehabilitative and habilitative services and devices likely include OT services, but this is decided at the state level
When was the baccalaureate degree phased out? (ch. 2)
2007
ACOTE Standards (Ch 1)
Accredited Council for Occupational Therapy (ACOTE) - General theory, skills training, and the foundation for therapeutic reasoning. - Evidence-based evaluations and interventions to achieve expected outcomes as related to the occupation
General familiarity with these concepts: Active beings, volition, adaptation, quality of life, client-centered approach (ch 3)
Active beings = People are actively involved in controlling and determining their own behavior and are capable of changing behavior as desired. volition = a client's desire, motivations, and interests. Includes a client's motivation and values Adaption = A change in function that promotes survival and self-actualization. Takes place as part of normal developmental progression, in the process of adjusting to stress or change Quality of life = What is meaningful and provides satisfaction to an individual is determined by the experience of that individual. Goal is achieved by helping the client develop greater independence in the performance of any area of OT. Client-centered approach = Central to OT practice because only the client can determine his or her quality of life, and, consequently, he or she must help the practitioner understand his or her experience.
ACA - time period and effects (ch. 2)
Affordable Care Act (Obama Care), signed into law March 23, 2010. The ACA was created to address the rising cost of healthcare, shortage of healthcare providers, and lack of insurance available to many Americans. caps out of pocket expenses and covers all preventative care. The intent of the law is to cover medical services that increase the client's ability to regain quality of life and avoid emergency room visits, which is congruent with occupational therapy services.
General familiarity with Core Values (altruism, equality, etc.) (ch 3)
Altruism = the unselfish concern for the welfare of others. This is done by caring, dedication, responsiveness, and understanding Equality = treating all individuals equally, with an attitude of fairness and impartiality, and respecting each individual's beliefs, values, and lifestyles in day-to-day interactions. Freedom = an individual's right to exercise choice and to "demonstrate independence, initiative, and self-direction. Demonstrated through nurturing which encourages independence. Justice = the need for all OT practitioners to abide by the laws that govern the practice and to respect the legal rights of the client. Dignity = the uniqueness of each individual is emphasized. OT practitioners demonstrate this value through empathy and respect for each person. Truthfulness = a value demonstrated through behavior that is accountable, honest, and accurate, and that maintains one's professional competence. Prudence = the ability to demonstrate sound judgment, care, and discretion.2 These values and attitudes are reflected in the Occupational Therapy Code of Ethics
ADA - time period and effects (ch. 2)
Americans with Disabilities Act of 1990. The ADA provides civil rights to all individuals with disabilities. It guarantees equal access to and opportunity in employment, transportation, public accommodations, state and local government, and telecommunications for individuals with disabilities.
General familiarity with the founders of the profession (their various backgrounds)
Backgrounds in a variety of disciplines that included psychiatry, medicine, architecture, nursing, arts and crafts, rehabilitation, teaching, and social work. - Their backgrounds served to enrich the depth and breadth of the profession of OT. William Rush Dunton originated the term occupation therapy, later George Barton recommended the term be changed to occupational therapy * Herbert Hall = arts and crafts movements * George Edward Barton = Britain's arts and craft movement *Dr. William Rush Dunton Jr. = "Father of OT" known for his writings on the value of occupation for treatment. Also served as treasurer and president of the National Society for the Promotion of the Occupational Therapy. * Eleanor Clarke Slagle = "Mother of OT" Developed the area of work "habit training." Organized the first professional school for OT practitioners, the Henry B. Favill School of Occupations. *Susan Tracy = nursing instructor involved in the arts and crafts movement and in the training of nurses in the use of occupations Susan Cox Johnson = was a designer and arts and crafts teacher from Berkeley, California. *Thomas Kidner = was a friend of George Barton's and fellow architect and teacher. He was influential in establishing a presence for OT in vocational rehabilitation and tuberculosis treatment
Evidence-based practice (ch 4)
Basing practice on the best available research evidence. Practitioners must be able to show that therapy is beneficial and cost-effective, due to all the available options for spending ones money.
Figure 3-1 Practice Areas OT philosophical Base (ch 3)
Branches: - Children & youth - Health & Wellness - Mental health - Productive aging - Rehab, disability, and participation -Work & industry - Education - Home, community, hospital settings -Technology -Telehealth Trunk: - Occupation is both a means and an end - Humans are active beings - Engagement in occupation -Holism -Purposeful activities -Potential for change -Humanism and values (altruism, equality, freedom, justice, dignity, truth, prudence) - Client-centered approach -Learning entails experiencing, thinking, feeling, and doing
Return to roots - time period (ch. 2)
By the 1970s large amount of OT practitioners urging the professions to return to its roots Model of Human Occupation, described earlier, developed by Kielhofner and his associates.16 The field of occupational science, a basic science that supports occupational practice, also emerged.
Prospective Payment System (PPS) and effects (ch. 2)
Created by the Social Security Amendments a nationwide schedule was established that delineated what the government would pay for each inpatient stay of a Medicare beneficiary. - Set by descriptive categories according to the individuals disability patient length of stay in acute care hospitals was shortened, and there was an increased use of long-term care facilities and home health services.
Occupational Science (ch. 2)
Created to examine the knowledge base and research related to occupation Occupational science has generated research that helps scholars and practitioners better understand the uniqueness of occupation to support the profession.
General familiarity with impact of culture on OT (ch 5)
Culture affects all aspects of OT. It is considered a context and is defined as "customs, beliefs, activity patterns, behavioral standards, and expectations accepted by the society of which the client is a member. The cultural context influences the client's identity and activity choices. One's beliefs influence the types of activities and occupations in which a person engages. Because OT practitioners are concerned with a person's activity choices, they must understand the influence of the culture culturally responsive care into the following five constructs: • Building cultural awareness • Generating cultural knowledge • Applying cultural skills • Engaging in culturally diverse situations • Exploring multiculturalism
Deinstitutionalization (ch. 2)
From the discovery of neuroleptic drugs (tranquilizers and antipsychotics) in the mid 1950s, this changed the course of psychiatric treatment. As psychotic behavior yielded to chemical control, it became possible to discharge many people, eventually leading to a national plan to release clients—the national deinstitutionalization plan. In anticipation of local care needs, community mental health programs were developed.
Moral treatment (ch. 2)
Grounded in the philosophy that all people, even the most challenged, are entitled to consideration and human compassion. Sought ways to make the existence of those confined more bearable. - one of the ways was by purposeful activity - The concept of moral treatment developed from this focus on the group of suffering humanity which was those with mental disorders * Philippe Pinel and William Tuke credited for conceiving the moral treatment movement
Interprofessional education (IPE) (ch 5)
Important part of OT education because it helps to prepare students for practice. Students are able to learn about culture through IPE by either incorporating global experiences as an opportunity for professional learning and other institutions have students travel to other countries to experience global health issues, some academic programs have classes, and seminars to learn more about interprofessional experience.
Examples of populations or specific diagnoses that OT may work with in each stage of the lifespan, what be addressed, and how (ch 11)
Infants: - Birth to 1 year - Work with them in Neonatal Intensive Care Unit (NICUS) hospitals, early intervention programs, community-based programs, outpatient clinics, and home health agencies. ex: Working with an infant in the NICU to intervene with motor skill development help and sensory regulation Childhood: - includes early childhood (1-6 years) and later childhood or school-aged children (6-12 years) -OT practitioners working with children provide intervention to children with such diagnoses as cerebral palsy, autism spectrum disorder, Down syndrome, intellectual disabilities, developmental coordination disorder, developmental delay, and others. - Intervention is designed to facilitate a child's participation in occupations. Adolescence: - 12-20 - OT practitioners work with adolescents who may have suffered disease, trauma, or a psychological event; they may require help to face the expected challenges of adolescence in addition to those presented by the disability. - OT practitioners work with adolescents in hospitals, day centers, school systems, or rehabilitation centers Young and middle adulthood: - Adulthood can be separated into young (20-40 years), middle (40-65 years), and late adulthood (over 65 years). -The goal of OT intervention with adults is to help individuals reengage in occupations that they find meaningful. Later adulthood: - Over 65 - OT practitioners provide resources and supports to enable older adults to remain independent and actively engaged in meaningful occupations - OT practitioners working with older adults consider safety in the home and community.
Arts and crafts movement (ch. 2)
Led by John Ruskin and William Morris in England The believed that using one's hands to make items connected people to their work, physically, and mentally, and thus was healthier. Arts and crafts societies were created to allow people to experience the pleasure of making practical and beautiful items for everyday use. Ex: working with clay was apart of this movement Helped influence the development of the OT profession
Impact of medicare on OT profession (ch. 2)
Medicare enacted in 1965, and increased the demand for OT services. - in 1988 legislation granted OT practitioners the right to medicare provider numbers, permitting direct reimbursement for OT services.
Whole section on practicing OT around the Globe
OTs consider the client's values, beliefs, and cultural expectations when designing occupation-based intervention. The intent of expert consultants traveling to places with limited resources is to teach local practitioners skills that they may be able to continue to provide after the consultant returns home. Community practice; Collaborating on techniques that were effective in one country may help another country justify services. OT practitioners who work in countries involved in war (such as Iran and Iraq) work with polytrauma and have limited resources. Polytrauma refers to multiple injuries, which can be life-threatening. Consequently, initial intervention is focused on medical management. These types of injury require intensive, long-term OT services.
Occupation as a means and an end (ch 3)
Occupation as a means is the use of a specific occupation to bring about a change in the client's performance. When occupation is used as a means, it may be equivalent to activity. Occupation as an end is the desired outcome or product of intervention (i.e., the performance of activities or tasks that the person deems as important to life), and it is derived from the person's values, experiences, and culture. Ex: The occupation is "meal preparation". The Occupation as a means is "increase fine motor skills by preparing a meal". The occupation as an end is "Make lunch for a family of three."
General idea of what OT's do (ch 1)
Occupational Therapy: A practice that uses goal-directed activity to promote engagement in those things that people find meaningful (i.e., occupations). - AOTA defines OT for professionals and consumers as a profession that uses therapeutic activities to help persons engage in meaningful activities. - OT practitioners work with clients of all ages and diagnoses. The OT practitioner interacts with a client to assess existing performance, set therapeutic goals, develop a plan, and implement intervention to enable the client to function in his or her world. The OT practitioner "guides" the person to actively participate in intervention.
Occupation vs. Activity vs. Task (Ch 1)
Occupations = Activities that have meaning and give people identity. ex: Being a mother is an occupation and this occupation requires a person to complete many tasks and activities. Activity = A mother shopping for food and cooking meals. Cooking is then the "Activity" associated with the occupation of being a mother. Tasks = The basic unit of action ex: Mixing the batter for cake is a "task" associated with cooking. * Box 1.1 pg.3 has more examples
Box 3.1 The philosophical base of OT
Occupations are activities that bring meaning to the daily lives of individuals, families, and communities and enable them to participate in society. All individuals have an innate need and right to engage in meaningful occupations throughout their lives. Participation in meaningful occupation is a determinant of health Occupations occur within diverse social, physical, cultural, personal, temporal, or virtual contexts. The focus and outcome of occupational therapy are individuals' engagement in meaningful occupations that support their participation in life situations... The use of occupation to promote individual, community, and population health is the core of occupational therapy practice, education, research, and advocacy.
Who do we serve (Ch 1)
People who have problems that interfere with their ability to engage in everyday activities. Serve all ages (infants to older adults) and clients with physical, cognitive, psychological, and/or psychosocial impairments. Clients present with a range of problems, including genetic, neurological, orthopedic, musculoskeletal, immunological, and cardiac dysfunctions, in addition to developmental, psychological, social, behavioral, or emotional disorders. Ex: OTs may teach a homemaker who has had a stroke, resulting in lack of use in one side of her body, how to manage her home and care for her family again.
Medical model and reductionistic views (ch. 2)
Postwar period allowed OT to become closely coupled with medicine and the medical model of education. Led to the beginning of specialization and of a more scientific approach. - Set the stage for attempts by physical medicine to control the developing profession of OT. The medical model was threatened by the "reductionistic views" of medicine at the time. This view is based on the belief that the structure and function of the whole can best be understood from a detailed study of the parts by observation and experiment leaning more towards a specialization in physical rehabilitation with increasing the use of technological interventions. - Decrease on emphasis of arts and crafts and focused more on medical and scientific approach.
Prep activity vs. purposeful activity vs. occupation-centered activity (ch 1)
Preparatory activities = help get the client ready for purposeful activity. ex: range of motion (ROM), exercise, strengthening, or stretching Purposeful activities = generally meaningful to the client but may be one task of the occupation. They have an end product and involve allowing the client to have a choice. Ex: Making a sandwich is only part of making lunch. Just as learning to put on a sock is only a part of getting ready. Occupation-centered activities = These help for clients to retain skills better and make them feel more motivated when performing the actual occupation. - They are performed in the natural setting (physical, social, and temporal). ex: Preparing lunch at home around noon using one's own kitchen supplies would be considered occupation-centered therapy.
Reductionistic vs holistic approach (ch 3)
Reductionistic approach: - What the US healthcare system typically uses. Human kind is reduced to separately functioning body parts. Successful in producing cures and technological developments - This is used by professionals who specialize in specific areas and treat these body functions independently for greater expediency and efficiency; purpose is to isolate, define, and treat body functions and focus on a specific problem. Holistic approach: - Emphasizes the organic and functional relationship between the parts and the whole being. Maintains that a person is whole - an interaction of biological, psychological, sociocultural, and spiritual elements. *** This is a core concept of the OT profession
Holistic perspective (ch. 2)
That each individual should be seen as a complete and unified whole, not merely a series of parts or problems to be managed. Adolf Meyer was committed to a holistic perspective as a physician and professor and developed the "psychobiological approach to mental illness"
AOTF (ch. 2)
The American Occupational Therapy Foundation (AOTF) founded in 1965 to promote research in OT through financial support.
General familiarity with the legislation of 70s and 80s that affected OT (ch. 2)
The US Congress passed several important pieces of legislation for persons with disabilities in the 1970s and 1980s: the Rehabilitation Act of 1973, the Education for All Handicapped Children Act of 1975, the Handicapped Infants and Toddlers Act of 1986, and the Technology-Related Assistance for Individuals with Disabilities Act of 1988. Rehabilitation Act of 1973 = Came with several important principles. 1. mandated that state agencies establish an order of selection that would place the most severely disabled person first for service. 2.under the act, every client accepted for services was mandated to participate in the service-planning process by completing an individualized written rehabilitation program (IWRP) 3. called for the development of a set of standards by which the impact of rehabilitation services could be assessed. 4.emphasized the need for rehabilitation research 5. it included civil rights provisions that gave equal opportunity for people with disabilities.It prohibited discrimination in employment or in admissions criteria to academic programs solely on the basis of a disabling condition. Education for all Handicapped Children Act of 1975 = This act establishes the right of all children to a free and appropriate education, regardless of handicapping condition The handicapped Infants and Toddlers Act 1986 *** These two laws increased OT services provided to children and the number of OT personnel employed within the school environment. The Technology-Related Assistance for Individuals with Disabilities Act of 1988 (PL 100-407) addresses the availability of assistive technology devices and services to individuals with disabilities. Many OT practitioners are involved in providing these services.
Minimum standards (precursor to today's ACOTE standards) (ch. 2)
The first set of standards for OT training, "Minimum Standards for Courses of Training in Occupational Therapy", was adopted in 1923 by the membership of AOTA. The standards included prerequisites for admission into training programs, length of courses, and content of courses. The standards stipulated that courses of training for OTs needed to be a minimum of 1 year, with 8 or 9 months of medical and craft training and 3 or 4 months of clinical work in hospitals. Lacking any legal ability to close schools that did not meet the standards, the association endorsed those schools that met the standards. These standards were revised twice by AOTA during the 1920s, with each revision requiring more training.
Therapeutic media (ch 1)
The objects and materials the practitioner uses to facilitate change. - Media may include games, toys, activities, dressing or self-care activities, work activities, arts, crafts, computers, industrial activities, sports, music and dance, role-playing and theater, yoga, gardening, homemaking activities, magic, pet care, and creative writing.
Rehabilitation movement (ch. 2)
The time from 1942 - 1960 The Veterans Administration (VA) hospitals increased in size and number to handle the casualties of war and continued care of veterans. The VA hospitals which employed OTs developed physical medicine and rehabilitation departments to serve veterans with physical disabilities. After the war in 1947, the US Army established the Women's Medical Specialist Corps, which classified OTs and 2 other areas as civilian employees during the war.
Reconstruction aides (ch. 2)
They were civilian women with no military ranking. Included OT aides, physiotherapy aides, and vocational evaluators. They showed the validity of activity as therapy and linked OT with physical disabilities - Used arts and crafts to treat the mind and the body. They worked with both orthopedic and psychiatric patients. The purpose of the reconstruction program The purpose of the program was to rehabilitate soldiers who had been injured in the war so that they could either return to active military duty or be employed in civilian jobs.
Case Study (ch 5)
Thomas working with Maria who was new to the United States from the Dominican Republic. Thomas did more research upon her culture and found out that people in her age bracket in her culture, view professionals as the experts and follow their recommendations without question. Also, the culture reinforces that the women listen to the men, which was why Maria didn't seem actively engaged and was simply going with everything Thomas said. Thomas then had a female OT close by for the intervention sessions as well as her husband. Thomas demonstrated the techniques to her husband and was able to find out from Maria that she enjoyed cooking traditional meals, and so they were able to then incorporate that into her intervention plan.
Occupational performance analysis (ch 12)
What are the two primary methods of completing the Occupational Performance Analysis part of an OT evaluation? *** Ask about this, I think its interview and observation
General familiarity with OTs founders (applied theories ch 1 info)
o Barton invited the seven original founders of the National Association for the Promotion of Occupational Therapy to gather at Consolation House (a workshop for convalescents) in Clifford Springs, New York, including himself, Isabel Newton, William Dunton, Thomas Kidner, Susan Johnson, Susan Tracy, and Eleanor Clarke Slagl
Occupational Profile (via interview) (ch 14)
o Begin with referral, to screening, to the Occupational Profile, where information is gathered on the client so the Occ. Profile can be developed. (e.g., client's needs, problems, and priorities), o The initial review may provide information regarding precautions that need to be adhered to during the OT process. o Questions highlighted in yellow pg.128
General understanding of the clients served in each setting: hospitals, clinics, home health, schools, day-treatment, workshops, institutions, community mental health centers, supervised living (ch 12)(Pg.111)
o Biological Sphere = Hospitals, Clinics, and home health. - This refers to medical problems caused by disease, disorder, or trauma - targets such things as loss of capacity, diminished awareness or perception, limitation in development or growth, limitation in movement, pain, damage to body systems, and neuromuscular disorders. o Psychological Sphere= Institutions (psychiatric, mental retardation), community mental health, supervised living) - emotional, cognitive, and affective or personality disorders - OT practitioners address psychological problems that affect thinking, memory, attention, emotional control, judgment, and self-concept - Specifically focus on addressing issues that interfere with the client's ability to engage in desired occupations o Sociological Sphere = Schools (public, special—visual impairment, hearing impairment, cerebral palsy), Day treatment, workshops. Help clients meet the expectations of society. - OT practitioners address such things as the absence of the ability to take care of one's own needs, lack or loss of life skills, poor interpersonal skills, failure to properly adapt to environmental changes, lack of capacity for independent functioning, and improper or detrimental behavior patterns ** Case study pg.111 includes examples of all three
Case 1 & 2 (ch 11) (pg.96)
o Case examples 1 and 2 illustrate the varied approaches an OT practitioner may take with clients who range in age and ability. o Work with people of all ages, so need to understand the progression of developmental tasks throughout the life span o Case 1: Evn pre-mature infant weighing 4 to 5 pounds, parents taking long drives starting to wear on them, OT making suggestions to support the family and the client o Case 2: Grace-98-years old, lives alone, walks to get her mail, the OT evaluates the safety of her home and makes suggestions to grace and her family so that she can remain at home
Nontraditional OT settings (ch 12)
o Correctional facilities, therapeutic riding, aqua therapy, homeless people, victims of disasters.
Acute care, subacute care, long term care (ch 12)
o Healthcare provided to the consumer along a continuum, referred to as continuum of care. **1st level on the continuum = (pg. 110) Acute Care. A client at this level has a sudden and short-term need for services and is typically seen in a hospital. Services provided in a hospital are expensive. -**Shorter inpatient hospital stays also created a need for an interim level of care, referred to as Subacute care. --- At this level, the client still needs care but does not require an intensive level or specialized service, thereby reducing hospital costs. Typically these clients require 1 to 4 weeks more of rehabilitation. --- Types of clients usually have sustained a stroke, hip fracture, may have cardiac condition, or cancer ** Long-term care serves clients who are medically stable but who have a chronic condition requiring services over time, potentially throughout life.
Family-centered care (ch 11)
o OT practitioners working with infants provide this kind of care. The OT's collaborate closely with the families. o They work with the families on goals that are considered important to them. o Works best when members of the team respect and listen to one another. Supports parents as they "experts"
Understand differences between public agencies, private not-for-profit and private for-profit agencies (ch 12)
o Public Agencies (pg.110) = Operated by federal, state, or county governments. - Federal agencies include: Public Health Services Hospitals and Clinics, Veterans Administration Hospitals and Clinics, and Indian Health Services - State-run agencies: May include mental health centers, correctional facilities, medical school hospitals and their clinics - County: The county may operate county hospitals, clinics, and rehabilitation facilities that deliver services to clients in the same way as federal and state facilities. -- County follows different rules and regulations which may effect employment of method of reimbursement o Private not-for-profit: receive special tax exemptions and typically charge a fee for services and maintain a balanced budget to provide services. - These agencies include hospitals and clinics with religious affiliations, private teaching hospitals, and organizations such as the Easter Seal Society and United Cerebral Palsy o Private for-profit agencies: are owned and operated by individuals or a group of investors. - In business to make a profit - . Large for-profit corporations may form multifacility systems. - A multifacility system is able to buy supplies and equipment in bulk at a lower rate
Standardized vs non-standardized test (ch 12)
o Standardized test = one that has gone through a rigorous process of scientific inquiry to determine its reliability and validity. - Carefully established protocol for administration - Based on normative data o Non-standardized tests = Used for measuring function. - Non-standardized tests have guidelines for administering and scoring but may not have established normative data or established reliability and validity. - more subjective and rely on the clinical skill, judgment, and experience of the therapist
General understanding of intervention planning, implementation, and review (ch 12)
o The initial step in developing the intervention plan is problem identification. From this, the occupational therapist uses clinical reasoning (also known as therapeutic reasoning) to determine the problem areas that need to be addressed through intervention. o More highlighted in pink pg. 134 o Practitioner then determines a Plan of action (POA). The first step in developing a plan of action is the creation of long- and short-term goals that address the problems identified. o Intervention methods to help the client achieve their goals are next. Based on the "selected frame of reference" o Outcome of intervention planning process is a written report or intervention plan. Figure 14.7 pg. 135 o Review is re-evaluating the clients progress in therapy
General understanding of transition services and discontinuation of services (pg. 136) (ch 12)
o Transition services = the coordination or facilitation of services for the purpose of preparing the client for a change. - may involve a change to a new functional level, life stage, program, or environment - the transition plan needs to be individualized to meet the goals, needs, and environmental considerations of the individual client. o Discontinuation of services = (pg. 137) Last step of the intervention process. - The client is discharged from OT when he or she has reached the goals delineated in the intervention plan, when he or she has realized the maximum benefit of OT services, or when he or she does not wish to continue services. -The discharge plan is developed and implemented to address the resources and supports that may be required upon discharge
Developmental frame of reference (ch 11)(pg.99)
o Used to evaluate infants. It presumes that practice in a skill set will enhance brain development and help the child progress through the stages. o When using this, the OT practitioner begins by evaluating the current level of skill development. - Next the underlying client factors that may influence development are examined. (muscle tone, coordination, symmetrical movements, and posture may influence motor development)
validity, reliability, test-retest reliability, interrater reliability (ch 12)
o Validity = A test is considered to have validity if the research testing shows to be a true measure of what it claims to measure o Reliability = A measure of how accurately the scores obtained from the test reflect the true performance of the client o Test-retest reliability = An indicator of the consistency of the results of a given test from one administration to another o Interrater reliability = An indicator of the likelihood that test scores will be the same no matter who is the examiner. OT practitioners can place more confidence in instruments that have high validity and reliability
General familiarity with Dunton's Principles of OT - Be able to discuss what is still relevant today (ch. 2)
• Any activity should have a cure as its objective. • The activity should be interesting. • There should be a useful purpose other than to merely gain the patient's attention and interest. • The activity should preferably lead to an increase in knowledge on the patient's part. • Activity should be carried on with others, such as a group. • The occupational therapist should make a careful study of the patient and attempt to meet as many needs as possible through activity. • Activity should cease before the onset of fatigue. • Genuine encouragement should be given whenever indicated. • Work is much to be preferred over idleness, even when the end product of the patient's labor is of poor quality or is useless.
