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PubMed1990

The effect of federal health policy on occupational medicine.

All three branches of the federal government affect occupational medicine. Notable examples include: 1) the Department of Transportation ruling (1988) requiring drug testing in diverse areas of the transportation industry (executive branch); 2) the Workplace Drug Act (1988) calling for organizations to have a policy towards drug and alcohol abuse (legislative branch); and 3) the Supreme Court ruling on the constitutionality of drug testing in the transportation industry (1989) and that infectious diseases are a handicap in accordance with the 1973 Federal Rehabilitation Act (1987). The executive branch plays a major role in occupational medicine primarily through the Occupational Safety and Health Administration (OSHA), which issues standards based on a rule making process; the executive branch can also affect occupational medicine indirectly, as evidenced by President Reagan's Executive Order 12291 calling for Office of Management and Budget oversight of regulatory initiatives. The legislative branch enacts laws, conducts hearings, and requests reports on the operations of federal agencies. The judicial branch addresses occupational health issues when people affected by an executive ruling want to challenge the ruling; or in the case of the Supreme Court, when deliberating an issue over which two circuit courts of appeal have come to divergent opinions. The Occupational Medicine profession can participate in the political process through awareness of proposed legislation and by responding accordingly with letters, resolutions, or testimony. Similar options exist within the executive branch by participating in the rule-making process. A representative of the Governmental Affairs Committee, through periodic visits with key Washington representatives, can keep members of the American College of Occupational Medicine informed about federal legislative and regulatory activities. In appropriate cases, the organization can then take a formal position on governmental activities that affect the speciality.

Health Policy↗
PubMed2003

Reliability and validity of the Canadian Occupational Performance Measure for clients with psychiatric disorders in Taiwan.

The purpose of the study was to examine the reliability and validity of the Canadian Occupational Performance Measure (COPM) in Taiwanese clients with psychiatric disorders. The COPM was translated into Mandarin and tested on 141 Taiwanese clients. The average age of the clients was 35.6 years; 94% were diagnosed with schizophrenia. The results of the study showed that the test retest reliability of the COPM was r = 0.842. The COPM identified occupational performance problems that included self-care (37%), productivity (25%), and leisure occupations (20%). Fifty percent of the therapists were receptive in adapting the client-centred approach and applying the COPM in their clinical practice. It was concluded that the COPM can be applied reliably to Taiwanese clients. Furthermore, the COPM was valuable in identifying information related to occupational performance that could not be identified elsewhere. Since 50% of the therapists felt reluctant about the appropriateness of the client-centred approach in their culture, it was important to examine the gap between clients' judgements and actual performance, as well as to evaluate the feasibility of the client-centred concept in clinical practice. Finally, the concept of the client-centred approach needs to be disseminated and communicated to the occupational therapy profession in order that the COPM can be adequately applied in mental health practice.

Adolescent↗
PubMed1980

Muriel Driver Memorial Lecture 1980--Directions for the decade.

Following an introductory summary of role theory, this paper examines one element of professional development -- that of ROLE NEGOTIATION. Research findings as outlined which provide evidence of the need for developing role negotiation skills within the occupational therapy profession in Canada. The paper describes four role strategies which can be used to professional advantage, as therapists negotiate their roles. The final emphasis is on the positive professional implications of effective role negotiations in the 80's.

Canada↗
PubMedDate not supplied

Angels and swingers, matrons and sinners: nursing stereotypes.

Media sexual stereotyping of the nursing profession is a well-recognized phenomenon; however the sexual stereotyping of the image of the nurse by the sex/pornography industry is a much less publicized or discussed phenomenon within the nursing profession. This paper aims to examine the presentation of the sexual stereotyping of nurses by newspapers and the sex/pornography industry. Both national and local newspapers in the UK frequently use derogatory terminology to depict the sexual stereotyping of nurses. Images and sexual stereotyping of nursing by the sex industry is also noted. The media was found to emphasize both positive and negative nursing stereotypes and in comparison with other occupations and professions sexual stereotyping was prevalent. The utilization of nursing imagery is also significantly visible across a wide range of pornographic and sex industry material.

Erotica↗
PubMed2003

[Understanding of workplace health promotion by occupational medicine physicians and perception of their roles in the implementation of relevant programs].

BACKGROUND: The author addresses the issue of workplace health promotion (WHP) concept and its understanding by occupational medicine physicians as well as the perception of their roles in the implementation of WHP programs. MATERIALS AND METHODS: The data presented result from a part of a comprehensive survey carried out by the National Center for Workplace Health Promotion in 2002. The study covers a random sample of 325 physicians specialized in occupational or industrial medicine who attended at least 400 patients. RESULTS: The survey reveals that about 50% of respondents neither understand the concept of WHP nor the essential rules governing its organization. They perceive WHP as a novel label applied to the traditional prophylactics and health education. They do not comprehend that it is a new orientation of the system and a setting-based approach to initiatives in this area. Although, near 90% of them believe that the occupational medicine profession should be involved in health promotion, yet when directly asked about personal involvement only every tenth respondent was ready to play a leading role in a WHP program, whereas 63% of physicians wanted to limit the program to healthy life style education among workers and 54% wanted to only expand health checkups. CONCLUSIONS: The observed attitudes towards WHP in the profession and perception of their roles in its programs implementation clearly show an urgent need to provide an ongoing training of physicians in workplace health promotion and to convince them that WHP is a new area of expertise to be developed and a vital determinant of health promotion at workplaces in Poland.

Attitude of Health Personnel↗
PubMed2005

Utilization of evidence-based practice by registered occupational therapists.

Although the use of evidence-based practice (EBP) is presently on the rise, there have been limited studies examining its use by occupational therapists within the US. The purpose of this study was to examine the use of EBP among registered occupational therapists in the occupational therapy intervention planning process. This descriptive study surveyed 500 members of the American Occupational Therapy Association (AOTA), of which 131 participants responded (26%). The results of the study supported the hypothesis that, within the sample studied, a minority of registered occupational therapists in the US utilize EBP in the intervention planning process. Other results included: (1) As level of academic education increased, the view of the importance of research to occupational therapy decreased. (2) As the years of practice increased, the use of research evidence in making clinical decisions decreased. As the occupational therapy profession moves towards utilization of EBP as a professional standard, it is imperative that the profession examines specific strategies to promote the adoption of such practice by its members, including the promotion of competency in evidence utilization, and the valuing of the established clinical reasoning skills of the practitioner while integrating research evidence into intervention planning to support professional practice.

Evidence-Based Medicine↗
PubMed1989

An analysis of the educational levels of migrants.

"The educational level has significant bearings on the migration of population. As one of the factors that can brook no underestimation in the developing commodity economy, it determines, to a certain extent, the size, direction, and occupation or profession of population migration. The Institute of Population at the Academy of Social Sciences of China conducted a sampling survey of the migration of population in 74 cities of 16 provinces, municipalities and autonomous regions in 1986, and this paper presents a summary analysis of the dynamics of different educational levels of the migrating population surveyed."

Asia↗
PubMedDate not supplied

Observations of ethical misconduct among industrial hygienists in England.

Industrial hygienists are uniquely situated to help solve problems in the working environment, and failure to behave ethically might have serious and possibly fatal consequences. A survey was conducted to estimate the prevalence and nature of ethical misconduct within the UK occupational hygiene profession during the past 5 years. A postal questionnaire was sent to 50 professional industrial/occupational hygienists. Of the 43 respondents, 33 (77%) had witnessed activities of potential ethical misconduct in at least one of nine questionnaire categories. Additionally, greater than 20% of the hygienists had witnessed at least one incident of data fabrication, failure to share credit on work, failure to protect confidentiality, criticizing the integrity of another hygienist for one's own gain, and plagiarism. The investigation also asked hygienists for their opinions on the reasons for breaches as well as potential methods of improvement.

Confidentiality↗
PubMed1985

Occupational therapy's challenge: caregiving and research.

This article is based on the closing General Session presentation at the 1984 AOTA Conference in Kansas City, Missouri. The paper addresses the need for clinicians to become committed to research endeavors. The occupational therapy profession must heighten its commitment to the systematic documentation of its principles and the efficacy of its therapeutic approaches. The practicing clinician has the potential to maximize the outcome of these endeavors by contributing current practice knowledge and by participating in research projects themselves. The factors that seem to be having an impact on clinicians are addressed. External factors include social, technological, and economic pressures, and internal factors include lack of knowledge about the research process and the resulting anxieties about approaching a new territory. Acknowledging these factors, a variety of proposals are made to help the clinician make the transition to clinical researcher.

Attitude of Health Personnel↗
PubMedDate not supplied

How do perioperative nurses cope with stress?

In recent years there has been broad discussion on the nature of stressors experienced by members of "high risk" occupations and professions, for instance nursing and emergency workers, whose role is to support others through traumatic scenarios (Lam et al, 1999:23). Perioperative nursing is a major specialization in nursing practice in which there is an increased risk of exposure to traumatic events (Schwann, 1998:645). Moreover, the cumulative nature of critical events, if left undealt with that will potentiate attrition among nurses in the perioperative environment (Michael and Jenkins, 2001:39). This triangulated study using self-administered questionaires focused on how theatre nurses coped with contextual stressors in the work milieu. A purposive sample of 46 registered and enrolled nurses who worked at a major Brisbane hospital were asked to describe a recent stressful workplace event, and rate it using Horowitz's (1993) Impact of Event Scale (IES). Results indicated that nurses with the least general theatre experience, demonstrated the highest negative impacts. 25% of females demonstrated avoidance tendencies when stressed, while 83% of males used problem-solving strategies. Reactions following trauma among the nurses were predominantly negative, and included feelings of frustration and self-doubt. These findings support the eminent need for hospital organizations to take a more person-centered approach when dealing with workplace stress.

Adaptation, Psychological↗
PubMed2001

Icelandic occupational therapists' attitudes towards educational issues.

The purpose of this study was to assess the readiness of occupational therapists in Iceland to accept a professional as opposed to a technical view of the profession. Most Icelandic occupational therapists were educated in other countries, with little emphasis on liberal arts, sciences and research. The first Icelandic occupational therapy programme, a university-level programme, was founded in 1997. All Icelandic occupational therapists were surveyed. Eighty-seven questionnaires were sent out and 80 (92%) were returned and used for statistical analysis. The results of the study showed that Icelandic occupational therapists valued academic skills over technical skills, emphasizing occupational therapy theory unique to the profession and research to validate practice. More recognition among other health professionals was considered the most needed change in the profession. The results of the study showed that the clinicians' attitudes confirmed in general what is emphasized in the curriculum and in students' fieldwork. Further research is needed to explore whether the Icelandic occupational therapy profession succeeds in promoting research and recognition by other health professions.

Journal Article↗
PubMed2005

Religion and spirituality: a discussion paper about negativity, reductionism and differentiation in nursing texts.

BACKGROUND: The last 30 years have seen a proliferation of literature about spirituality in the nursing press. A dominant theme has been the need to differentiate spirituality from religion and this has provoked a number of authors to attempt to define and describe religion. As nursing advocates respect for the person's religious beliefs the way in which it is portrayed is very relevant. AIMS: This work explores how religion is defined and discussed in the nursing literature about spirituality to consider whether the way religion is portrayed could be said to demonstrate 'respect' for religious beliefs. METHODS: Texts about religion were examined in relation to theories of religion from anthropology, sociology and religious studies. These disciplines have produced substantive or irreducible accounts in contrast to functional and reductive theories about religion. RESULTS: The result of this analysis is that there appears to be a tendency to talk about religion without using sources which itself suggests a lack of respect as well as an inclination to view it only in reductive and functional terms. This is proved by the similarity of ideas in the nursing literature to the functionalist and reductionist theories of Frazer, Tylor, Marx, Durkheim and Freud. This approach is criticised with reference to the work of Otto, Bellah, Berger and Pals who suggest that religion should be seen as irreducibly to do with the sacred. It is proposed that this is a more appropriate outlook to take for an occupation which professes to respect the religious beliefs of all individuals. However, viewing religion in this more meaningful way, acknowledging their spirituality has implications for attempts to differentiate religion and spirituality. CONCLUSION: Reductive accounts of religion imply, probably inadvertently but nevertheless negative, attitudes towards religious belief. A more serious and deeper exploration of the meaning of religion from the standpoint of irreducibility might be more respectful and tolerant of religious belief. This is particularly salient in a society where religious practice is increasing both in the indigenous population and as a result of immigration.

Adaptation, Psychological↗
PubMed2005

Standards for education and training for interagency working in child protection in the UK: implications for nurses, midwives and health visitors.

This article presents a discussion of key issues for the education of nurses, midwives and health visitors following the completion of a Department of Health funded project, managed by the General Social Care Council and conducted jointly by two research centres; Salford Centre for Social Work Research and Salford Centre for Nursing, Midwifery and Collaborative Research. The work was initiated in response to Lord Laming's report on the circumstances leading to the death of Victoria Climbié. The project was conducted in relation to specified professions and occupational groups: doctors; health visitors; midwives; nurses; police; teachers, and social workers. It was undertaken in two stages. The first stage mapped existing material about standards in relation to education and training for interagency working. The second stage engaged in an extensive consultation exercise through which a model and a set of proposed standards for interagency education and training for interagency work were developed. The former is detailed fully in this report, while nine examples of standards are presented. The project final report was presented seven months after commencement.

Child↗
PubMed1997

Impairment in the medical and legal professions.

Male doctors and lawyers are among the job groups with high mortality from alcohol-related diseases, although the prevalence of substance misuse among these groups is not known. Both professions have occupational risk factors. This article describes aspects of the work environment which have facilitated substance misuse by doctors and lawyers, and describes the professional consequences of addiction. Data will be presented from two studies: a retrospective casenote survey of doctors treated for substance misuse; and a questionnaire survey of lawyers in recovery from alcohol problems. Mechanisms for assisting impaired professionals into treatment have been developed in the UK and the USA. The most successful models separate health procedures from disciplinary procedures as much as possible, and offer a confidential evaluation and treatment program. Self-help groups play a crucial role in these therapeutic processes.

Adult↗
PubMed2006

The acquisition and exercise of nephrology nursing expertise: a grounded theory study.

AIMS AND OBJECTIVES: This purpose of this study was to describe the process of expertise acquisition in nephrology nursing practice. BACKGROUND: It has been recognized for a number of decades that experts, compared with other practitioners in a number of professions and occupations, are the most knowledgeable and effective, in terms of both the quantity and quality of output. Studies relating to expertise have been undertaken in a range of nursing contexts and specialties; to date, however, none have been undertaken which focus on nephrology nursing. DESIGN: This study, using grounded theory methodology, took place in one renal unit in New South Wales, Australia and involved six non-expert and 11 expert nurses. METHODS: Simultaneous data collection and analysis took place using participant observation, semi-structured interviews and review of nursing documentation. FINDINGS: The study revealed a three-stage skills-acquisitive process that was identified as non-expert, experienced non-expert and expert stages. Each stage was typified by four characteristics, which altered during the acquisitive process; these were knowledge, experience, skill and focus. CONCLUSION: This was the first study to explore nephrology nursing expertise and uncovered new aspects of expertise not documented in the literature and it also made explicit other areas, which had only been previously implied. Relevance to clinical practice. Of significance to nursing, the exercise of expertise is a function of the recognition of expertise by others and it includes the blurring of the normal boundaries of professional practice.

Clinical Competence↗
PubMed2005

Do all health and social care professionals interact equally: a study of interactions in multidisciplinary teams in the United Kingdom.

Problems around deficits in interprofessional collaboration have been identified since the National Health Service (NHS) was introduced. It is within the context of the current policy focus on improving collaborative working that this study was undertaken. A direct observational study using the Bales' Interaction Process Analysis tool was carried out in two older persons teams to explore patterns of interaction in the multidisciplinary team meetings. Analysis revealed some key differences in the way in which different professions interacted. Occupational therapists, physiotherapists, social workers (SW) and nurses rarely asked for opinions and for orientation. The consultant (the individual in charge of the medical team) tended to have high rates for asking for orientation, giving opinions and giving orientation. Although some nurses did have high individual rates for the giving of orientation. The data from the research has highlighted that therapists, SWs and nurses are reluctance to voice their opinions in multidisciplinary teams and thus conformity may dominate its culture. It is suggested that therapists, SWs and nurses need to cite their opinions in teams more effectively if they are to be competent and committed patient-centred practitioners.

Attitude of Health Personnel↗
PubMed1990

Historical perspectives of oral biology: a series.

From antiquity, individuals, tribes, and cultures have sought the abilities of singular individuals to try to heal them or to help them to endure the onslaughts of disease. For thousands of years before recorded history, these services were provided by the medicine man or shaman of the tribe, whose secret treatments were passed from generation to generation by the apprenticeship methods of teaching. For the most part, their therapies were at best palliative and their effects were placebo and psychological in nature. Reliable written records of healing practices began with the ancient Greek civilization about 400 years before Christ. The written recording of rational therapies and practices established the "physician" as one of the premier occupations (or "professions") of ancient Greek society. About 160 years after Christ, the Greek physician Galen began the practice of examining the post-mortem anatomy of various animals and extrapolating his findings in an attempt to understand the structure of the human body. This was the first well-recorded and documented effort in what we, today, would term "biomedical research". While Galen's efforts and written production were massive, his impact on medical practices beyond Greece was minimal due, at least partially, to the lack of mass printing and distribution methods. Ironically, at almost the same time that Galen's complete works were published, Andreas Vesalius of Brussels published the most startling and exquisite book in the history of medicine. Vesalius' De Humani Corporporis Fabrica (1543)2 was a lavish and beautiful exposition of human anatomy. This event, for all intents and purposes, formalized the separation of the science of medicine from its art. We suggest that this event established the division of medicine into two historical streams--the "healers" and the "scientists" (or Streams "H" and "S"). However, even to the present, the biomedical scientists remain dependent on the established institutions of the healers for their very existence and continuity. Very early the dental healers developed as a distinctly separate branch of the H Stream, due to the efficacy and directness of the therapy of tooth extraction and the need for mechanical aptitude for its execution. This was exemplified in the long and successful history of the barber-surgeons, or their earlier equivalents, as therapists in every society on Earth, including the U.S., up to nearly the turn of the 20th century.(ABSTRACT TRUNCATED AT 400 WORDS)

Asia, Western↗