OT 241: Spatial, Temporal, and Sociocultural Dimensions

biotemporality sociotemporality subjective patterns orchestrating occupations developmental patterns

5 aspects of the temporal dimension

employment seeking and acquisition

Identifying and recruiting for job opportunities; completing, submitting, and reviewing appropriate application materials; preparing for interviews; participating in interviews and following up afterward; discussing job benefits; and finalizing negotiations

employment interests and pursuits

Identifying and selecting work opportunities based on assets, limitations, likes, and dislikes relative to work

job performance

Performing the requirements of a job, including work skills and patterns; time management; relationships with coworkers, managers, and customers; leadership and supervision; creation, production, and distribution of products and services; initiation, sustainment, and completion of work; and compliance with work norms and procedures

hurry sickness

Severe chronic feelings of time urgency that negatively affect one's lifestyle; feel "on" all the time; running from one thing to the next; example is a workaholic

temporal

a detailed understanding of the _____________ dimension in the single occupational experience of a client helps us to deal best with attention span, activity choice, appropriate pace, planning, reflection, and the creation of healthy habits and routines

embodiness

a physical knowing, rather than an abstract reasoning process through years of physical action/experience; interacting with the spaces and objects around our bodies without a need for us to conceptualize those actions; knowing how to perceive, move through, and interact with the world

ergonomics

adapting a person's work environment to promote functioning; the scientific discipline that deals with the worker; the tools, equipment, and machines that the worker uses; and the environment in which the worker interacts and operates; concerned with the understanding of the interactions among humans and other elements of a system, and the profession that applies theoretical principles, data, and methods to design in order to optimize human well-being and overall system performance

emic

an individual interpretation of an activity, influenced by personal experiences and perceptions

needs and abilities expectations and outcomes

as the OT, you have to match the client's current ______________ and _______________ with the _____________ and ______________

spatial sense

aspect of physical body which encompasses our vision

program goals

because recovery can be unpredictable, as the OT, if outcome expectations don't match present level of functioning, then adjust...? (2)

discharge planning

begins at initial evaluation and continues through the delivery of OT services

adapt; occupations

considering the spatial dimensions of physical embodiedness, environmental qualities, and social meanings of space will enable a therapist to ______________ an occupation, specific to the spatial demands of an individual, to better assist that person in engaging in valued ______________

contrived activity in a clinical environment --> simulated activity in a clinical environment --> simulated activity in a real environment --> real activity in a simulated environment --> real activity in a real environment

describe the continuum involving activities and treatment environments involved in the process in which a client is reintegrated into his or her environment (5)

sorting coins to increase fine motor in a therapy gym --> practice buttoning, zippering, snaps, clasps, etc. in a therapy gym --> practice bed mobility in the client's hospital room practice laundry in easy street practice laundry/bed mobility in the client's home

describe the continuum involving activities and treatment environments involved in the process in which a client is reintegrated into his or her environment using the example of laundry, bed mobility, and fine motor skills (continuum includes: contrived activity in a clinical environment --> simulated activity in a clinical environment --> simulated activity in a real environment --> real activity in a simulated environment --> real activity in a real environment)

work to the worker

do you fit the worker to the work or the work to the worker?

simulation

gives the appearance of being real but is not real

schedules and calendars

how can an OT help improve time management?

the person's reaction time, the difference between how they drive now and how they drove when they were first learning, etc.

how might a person's unique "embodiness" affect a person's experience with driving?

work-focused evaluation

in addition to the typical assessment methods, the OT focuses on the worker's capacity to meet the unique demands of the job, and may need to conduct a thorough job site analysis to determine the demands of the job

spatial perception

in occupational environment, understanding the world occupationally; knowing what to do in a bathroom versus a kitchen, for example

sundowning

in older adults, around late afternoon, become very confused and restless

mediums

include liquids, solids, and gases; offers special characteristics in terms of breathing, locomotion, transmission of light and sound, chemical diffusion, and gravity

work

includes activities needed for engaging in paid employment or volunteer activities; involves employment interests and pursuits, employment seeking and acquisition, and job performance

contrived simulated real

list 3 types of activities

clinical (structured) real (natural) simulated (structured)

list 3 types of treatment environments and whether they are structured or natural

health

measured by the quality of life a person finds in his or her patterns of occupation

M-time

monochronic time schedule, emphasizing efficiency of time use, doing one thing at a time, and being strictly observant of time commitments

P-time

polychronic time; encourages doing multiple things at once, values being with people and involved in events important to them, and is experienced as more fluid and adjustable

traditional/physical disabilities/biomechanical approach

practice that emphasizes physical change; using valued occupations to produce therapeutic changes in the physical body

hand

primary physical interface with the spaces and objects around us; feeling/sensation, extension of our body

egocentric

relating object location to one's own body as the center; typically in children

sociocultural dimension

relationship between social and cultural aspects of occupations

allocentric

representing space in terms of a layout of the environment unrelated to the individual; abstract, cognitive maps

false; circadian rhythms are influenced by factors from within the body, as well as environmental indicators

t/f: circadian rhythms are typically only affected by biological factors

mirroring

taking on the same posture of another individual; a particularly potent indicator of engagement and interest in another person

surfaces

the areas of the environment at which most perception and action occur

circadian rhytm

the biological clock; regular bodily rhythms that occur on a 24-hour cycle; biotemporal aspect of the temporal dimension

etic

the culturally interpreted meaning of an activity; somebody else's perception

needs and progress

the four general modes in the therapeutic use of context are dependent on ____________________ and _______________

time

the impact of sudden disability often imposes tremendous distortions of daily life spaces by increasing the amount of ________ required for routine activities

toys

the objects and spaces of childhood play; support and advance development

environmental affordances

the opportunities that an environment provides to a particular individual; the specific opportunities that a surface provides to an animal or a human; benefits or positives of an environment; allows an individual to perform an action

vision

the primary sense of spatial perception

proxemics

the study of body language and proximity; use of space/body language; can express mood, receptivity, engagement, level of comfort, and many other feelings important to the success of an intervention session

work performance testing

used to determine the client's potential for returning to work; the client performs a battery of tests that simulate his/her work or may even observe the client performing actual work tasks following an eval of underlying client factors

role of simulation

used to improve or practice subskills (motor, cognitive, social); improve PS; improve OP; practice to develop confidence in one's skills/abilities; improve body mechanics and efficiency in work skills; is a tool for any age, gender, ethnicity, or cultural background; can control intensity and environment; motivating and fun (but not to all)

embodiness task analysis physical environment or context social meaning

what are 4 components of just right challenge?

-being egocentric v. allocentric (concrete --> abstract) -spatial negotiation (topographical orientation) -visual sensation -spatial perception (understanding the world occupationally)

what are aspects of the occupational environment? (4)

-stress management -consistent bedtimes -increase sleep (decreases hunger)

what are some examples of lifestyle changes to address sociotemporal rhythms? (3)

-head up -eyes looking forward most of the time -shoulders relaxed -back erect and supported -only moderate pressure at the front of the seat cushion/butt is far back in chair -feet firmly on footrest or chair is at appropriate height so you can keep both feet flat on ground -hands in line with the forearms (can use armrests to support forearms) -reference material is easy to look at (e.g., paper holder) -monitor is approximately at eye height and an arms distance away -use hands, a headset, or speakerphone to avoid holding a telephone between head and shoulder

what are some guidelines for good ergonomics? (10)

-anxiety about starting a task -extra mental energy to start

what are some possible reasons people experience starting a task as more challenging than continuing a given task? (2)

-meditating -listening to calm music

what are some relaxation techniques to lessen sleep disturbances? (2)

-limit eating before bed (nothing heavy 2 hours prior) -limit fluids before bed (no caffeinated drinks or alcohol) -level of activity -reading a book

what are some suggestions for sleep prep/bedtime routines to lessen sleep disturbances? (4)

-therapy occurs in the client's usual life setting -modifications are made to life settings -an activity setting new to the client is selected for its therapeutic qualities -changes are made in the traditional clinical setting to more closely approximate intactness for the client

what are the 4 general modes in the therapeutic use of context?

-can control for safety -address problems -gain insights

what are the benefits of providing OT in a safe and controlled clinic environment? (3)

hand spatial sense embodiness

what are three aspects of the physical body?

environmental physical body social meaning

what are three components of the spatial dimension of occupation?

-patient and family edu -assure them that steps backwards do not equal failure

what are two things to address with the client regarding the unpredictability of recovery?

-proper positioning -respect privacy during activities such as dressing

what can we do to make our patients more comfortable?

-work hardening (time efficiency) -lifestyle changes -time management -consulting with caregivers -consulting with care facilities for environmental design options that support sociotemporal patterns -advocating at a system level -advocating for undisturbed sleep

what is OT's role in addressing sociotemporal rhythms? (7)

-respect where clients are in learning new tasks or restoring previous level of function (complete one step at a time) -some people move slower/faster -some take more time to process info -analyze lifestyles that may have contributed to an illness or injury -overall, be patient

what is OT's role in addressing subjective time experiences? (5)

-time analysis -sleep logs -sleep prep/bedtime routines -education -relaxation techniques -advocating for undisturbed sleep

what is OT's role in sleep disturbances? (6)

get it done whenever versus need it done by

what is an example of M-time versus P-time?

grouping; for example, teach client UE dressing and then LE dressing (instead of both at same time)

what is meant by "chunking" in regards to occupational experience?

solitary --> shared --> co-occupations

what is the continuum of the social nature of occupations (begin with occupations requiring no/minimal social interaction)

grade an activity that is minimally challenging to meet a client's level of functioning (flow)

what is the goal of the just right challenge?

associated with meaning

what is the significance about the objects (tools, toys, symbolic objects) filling the spaces of humans engaging in various occupations?

provides solidarity and individuality

what is the significance of culturally accepted schedules?

life-space

where one or more roles change or end as a result of acquired physical disability, the individual may be unable to find new meaningful activities and roles to fill the _________________ (temporal dimension) formerly occupied by old ones

occupational environment

where to treat, the conditions of the environment, the objects that need to be available or that present barriers, and the social meaning of the space to the individual that play a critical role in the success of the intervention; the spaces in which occupation occur

intactness

which aspect of therapeutic power (appeal, intactness, or accuracy) aligns with context and environments?

no one is more important than the other

which dimension is more important or more frequently considered?

eye contact physical/personal space

which two features of proxemics are closely correlated with one's culture and are primary indicators of comfort and attentiveness between individuals?

-you're going into the client's space -want to make client comfortable

why is it important for an OT to be sensitive to the social meanings of spaces? (2)

seasonal affective disorder

"winter depression" tied to circadian rhythms, hypothesized to result from inadequate light cues in the environment; increased appetite for carbs, snacking and weight gain, daytime fatigue, anxiety, and inc sleep duration