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Biomedical subjects

Brent Braveman

Publications and source records attributed to Brent Braveman.

13 recordsLinked to original sources
PubMed2006

Impairments and perceived competence in persons living with HIV/AIDS.

Medical advances have transformed HIV/AIDS from a short-term terminal illness to a long-term chronic condition. Consequently, the disability experience of persons with HIV illness has shifted from issues related to physical well-being to those concerning performance of daily life activities and wider community participation. These changes have necessitated rehabilitation interventions for persons with HIV/AIDS to focus on issues related to enabling participation in all spheres of everyday activities. However, limited information is available on the impairments prevalent in the emergent population of people living with HIV/AIDS and on the impact of these impairments on the person's functional performance and participation in various occupations of daily living. The present study attempted to explore these issues as they are experienced by the emergent population of people living with HIV/AIDS. The purpose of the study was: (1) to explore occupational functioning across various activities, (2) to describe the various impairments prevalent in this population, and (3) to examine the impact of these impairments on the person's perceived occupational competence. Two instruments, the Sign and symptom checklist for persons with HIV disease and the Occupational Self-Assessment were administered to a sample of 35 individuals (Mean age=42.8 yrs.) living in supportive living facilities. Impairments most commonly identified by the participants included: fatigue; fear/worries; difficulty concentrating; muscle aches; and depression. The two primary areas of occupational functioning where participants reported experiencing moderate to severe difficulty included: managing finances and physically engaging in activities which were reported by 67.7% and 35.5% of the participants respectively. No statistically significant correlation was observed between various measures of impairments and the overall measure of perceived occupational competence for the sample of individuals living with HIV/AIDS included in this study.

Adult↗
PubMed2006

Occupational identity, occupational competence and occupational settings (environment): influences on return to work in men living with HIV/AIDS.

AIMS: The aim of this study was to examine and describe the relationship between the efforts of twelve men living with AIDS to reestablish a worker role following completion of a vocational rehabilitation program and changes in their occupational identity, occupational competence and perception of occupational settings (environment). METHODS: A series of in-depth interviews were conducted, transcribed and analyzed via categorical content analysis using sections of the text as the unit of analysis. FINDINGS: Findings illustrate how constructs measured by the sub-scales of the OPHI-II may be helpful in understanding how persons frame past, present and anticipated experiences as they attempt to reestablish a life role lost after the onset of disability. The findings are supported by the quantitative item hierarchies of the occupational identity, occupational competence and occupational settings (environment) scales established in earlier quantitative research via Rasch analysis. CONCLUSION: The constructs of occupational identity, occupational competence and occupational settings (environment) are useful constructs to aid in understanding the experiences and narratives of persons attempting to reenter a major life role.

Employment↗
PubMed2006

Interdisciplinary staff perceptions of an occupational therapy return to work program for people living with AIDS.

The purpose of this qualitative study was to identify the perception of interdisciplinary staff members regarding the impact of a model work and independent living oriented program for residents in supportive living facilities. This study used focus groups and individual interviews to collect these perceptions. Staff members identified four areas of impact: utilization of a holistic and process-oriented approach, an ability to identify and work with the strengths of clients, emphasis on the learning of practical skills, and creating an intersection for all aspects of services. These findings point to the fact that staff members found the value that occupational therapy has to offer their overall programming by improving participation of clients with HIV in learning practical skills for use in their daily lives and in developing work related skills.

Attitude of Health Personnel↗
PubMed2006

HIV/AIDS and return to work: a literature review one-decade post-introduction of combination therapy (HAART).

It has been a little over one decade since the introduction of the first protease inhibitor that ushered in new era of treatment for persons living with human immunodeficiency virus (HIV) and Acquired Immune-Deficiency Syndrome (AIDS). As of the end of 2003, an estimated 37.8 million people worldwide were infected with the HIV. It is estimated that there are 850,000-950,000 persons in the United States living with human immunodeficiency virus (HIV) and that the incident rate is new cases each year. Since AIDS affects so many people of working age in the US, issues of employment, work rehabilitation and AIDS in the workplace have all become major concerns. The paper presents a review of the literature published during a ten year period that is relevant to understanding the various needs and barriers related to work as well as services designed to address them.

Antiretroviral Therapy, Highly Active↗
PubMed2006

Psychometric properties of the Worker Role Interview.

OBJECTIVES: This study examined the psychometric properties of the rating scale of the Worker Role Interview (WRI). The study also asked whether the scale's items formed a valid measure of the construct, psychosocial capacity for work, and whether they were targeted to and could effectively discriminate between persons at different levels of psychosocial ability for work. METHOD OF STUDY: Data were collected from 21 raters on 440 participants from the United States, Sweden and Iceland. A many-faceted Rasch model was used to analyze the data. RESULTS: Most items of the scale worked effectively to measure the underlying construct for which the WRI was designed. In addition, the items were ordered from least to more of the underlying construct as expected. The scale validly measured 90.23% of the participants, who varied by nationality, culture, age and diagnostic status. The scale's items distinguished participants into approximately three different strata and were appropriately targeted to the participants. Seventeen of the 21 raters used scale in a valid manner. CONCLUSIONS: The WRI scale and items are valid across ages, diagnoses, and culture and effectively measure a wide range of persons.

Adult↗
PubMed2003

The narratives of 12 men with AIDS: exploring return to work.

Analyses of life stories has increasingly been used to understand how different individuals interpret and respond to an experience such as the onset of disability. This paper presents findings of a prospective qualitative study of 12 men living with AIDS who attempted to return to paid employment. Narrative analysis of four interviews over 12 months was used to explore the relationship between return-to-work efforts and whether participants' narratives progressed, remained stable, or regressed. Findings suggest that the men who demonstrated progressive narratives recreated an identity including a view of themselves as workers and recaptured a sense of competence. Men with regressive narratives demonstrated decreased identity and competence while men with stable narratives showed little change in either identity or competence. This paper contributes to our understanding of how the framing of an illness or disability by an individual may influence the progression of his life history narrative.

Acquired Immunodeficiency Syndrome↗
PubMed1999

The model of human occupation and prediction of return to work: a review of related empirical research.

The purpose of this paper is to investigate through a review of research literature whether empirical support exists to support the theoretical arguments of the Model of Human Occupation. A literature review of 44 predictive studies of factors influencing return-to-work published over the last 25 years was conducted. The factors most commonly found to be associated with return to work or with long-term disability were then organized according to the subsystems of the Model of Human Occupation.

Journal Article↗
PubMed1999

The model of human occupation: understanding the worker who is injured or disabled.

This paper discusses application of the model of human occupation to the worker with an injury or disability. Concepts from the model of human occupation (MOHO) are used to frame potential work-related strengths and weaknesses. Using MOHO as a framework to understand the worker with an injury or disability provides a more complete and holistic understanding of the many factors which can affect a worker. In particular, the model illuminates how factors of capacity, motivation, lifestyle, and environment inter-relate in determining a worker's success or failure. Implications for using the model to achieve a more effective work-related practice are discussed.

Journal Article↗
PubMedDate not supplied

Outcomes of a vocational program for persons with AIDS.

Advances in medical treatment combined with changes in the demographics of persons who are becoming infected with autoimmune deficiency syndrome (AIDS) have transformed this illness from a rapidly progressing to a chronically disabling condition in a short period of time. This paper describes the development, implementation, and outcomes of a program of vocational services for persons with AIDS. This program was studied using a single group design, in which participatory action research strategies were used to investigate and improve the program as it unfolded. In addition to examining the overall outcomes of services, the study aimed to discover which components were most helpful to participants and which participants were most likely to benefit from the program. Of 129 participants of who initially enrolled, 39 dropped out before finishing the program. Sixty of the 90 participants who completed the program achieved employment, returned to school, or began a volunteer position or internship. Consequently, the overall success rate was 46.5% and the success rate for program completers was 66.7%. The occupational narrative, which participants told in their initial assessment interview, was closely associated with both program completion and successful outcomes. This association adds support to the importance of narrative for understanding participants and predicting future behavior, as well as for the therapy process.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Developing and evaluating community-based services through participatory action research: two case examples.

Occupational therapy has a strong history of embracing concepts of client empowerment. However there is limited literature in the field on how to achieve empowerment, or on how to extend empowerment to the level of the community and social groups and services within it. This article discusses how concepts and strategies of participatory action research, an extension of empowerment theory, can be used to inform service development and evaluation in occupational therapy. The participatory action research approach is illustrated using two case examples of participatory action research programs for persons with chronic fatigue syndrome and individuals with autoimmune deficiency syndrome (AIDS). A critical analysis of the application of this approach to research and practice is provided. Finally, the paper identifies key principles of participatory action research that can be used to guide occupational therapy services and empower both individuals and communities.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Resident and staff perceptions of barriers to independence and employment in supportive living settings for persons with AIDS.

The purpose of this study was to identify perceived barriers to independent community living and employment among clients and staff members in a transitional living facility for persons with AIDS. This qualitative study used focus groups to collect these perceptions from staff members (N = 21) and clients (N = 16). Whereas staff identified both systemic and personal barriers, clients only identified systemic barriers. These findings suggest that both clients and staff recognize the types of environmental barriers to participation that have been identified by disability scholars. The findings also underscore a consequential gap between clients' exclusive emphasis on environmental barriers and staff emphasis on clients' personal barriers that impact upon participation.

Acquired Immunodeficiency Syndrome↗