[Activities of the National Association of Nurses and other Health-Social Personnel. Physical therapy, occupational therapy and speech therapy sections].
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A working model for occupational therapy intervention in an industrial setting is presented. The model addresses both preventive and problem-solving aspects of practice. An overview of relevant industrial sociology, a discussion of the model, and implications for the therapist are given as well as the viability and benefits of a merger despite the disparate value systems associated with industry and the health services.
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The derailment of occupational therapy, exemplified by the profession's symbiosis with the medical model, its alignment with the rehabilitation movement, and its devaluation of the arts and crafts is the central theme of this article. The occupational behavior paradigm, which represents a recommitment to the values and beliefs of the profession's founders, has emerged to arrest the derailment process and thereby reinstate the substantive goals of occupational therapy.
The origin of occupational therapy is deeply rooted in psychiatry, and in psychiatry occupational therapy often found the support and guidance necessary for its deveolpment and recognition. Today this close association no longer exists. Some factors leading to this professional distance have been outlined and changes conducive to a greater awareness of the role and function of occupational therapy in psychiatry have been suggested. An attempt has also been made to clarify the concept of occupational therapy and to discuss the contribution of the occupational therapist in certain specific areas of psychiatric treatment.
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In 1968, the report of a conference sponsored by the American Occupational Therapy Association called for the development of an integrated theory of occupational therapy. A review of the practical problems faced by therapists today, contrasted with major developments in the art and science of the field during the past decade, suggests that this goal has not been attained. However, three major theoretical frameworks for therapy have evolved through the work of Fidler and Mosey, Wilbarger, and Llorens, who participated in the conference on theory. Reilly and associates developed a fourth framework of significance. Through analysis of theoretical constructs, generic concepts that characterize occupational therapy can be identified. Theoretical constructs and research validation of the four approaches to occupational therapy are discussed in this article. A second article to appear in a subsequent issue of AJOT illustrates the use of the four theoretical frameworks to derive a philosophical basis for practice and a model of the practice process called "human development through occupation."
The customs and cultural attitudes that determine occupational therapy practice cannot be transferred from one culture to another. However, the technology of occupational therapy can be transferred. The international consultant is responsible for such a technological transfer. The consultee is responsible for assimilating technology and creating a culturally appropriate treatment practice. Technological transfer in industry demonstrates that divergent cultural applications of the same technology are possible, that the autonomy of the consultee is of primary importance, and that government support of the consultation effort is crucial. Current practice and expectation in international occupational therapy consultation is examined. The author concludes that fluency in the language of the host country is a questionable expectation, and that short-term workshops by teams of therapists should supplement the traditional individual long-term consultancy. Japan is used as a reference for discussion.
A research study on the selection of students for entrance into the basic professional four-year occupational therapy curriculum at Elizabethtown College is presented in this paper. The study has tow primary objectives: the determination of factors that could serve to discriminate between prospective students who would remain in the program from those would withdraw; and the development of a mathematical model that could be used in future years for student selection to the occupational therapy program. It is suggested that the model can be applied to any educational setting, can effectively streamline the usual admissions process, and can ensure that qualified students enter occupational therapy programs and thus be an additional indicator for the success and continuation of the profession.
The client care record is a key document for determining standards of care in occupational therapy. The purpose of this study was to determine the effectiveness of a client care recording system for occupational therapy that combined the theoretical framework of the Developmental Analysis, Evaluation and Intervention Schedule, and the scientific method of the Problem Oriented Medical Record. The research form of the client care record was compared to a traditional client care record in current use in an occupational therapy clinic. An interdisciplinary panel of health professionals rated both the original and proposed form of the record on the variables of completeness, organization, understandability, and usefulness. The findings show statistically significant differences between the client care record based on the combined Developmental Analysis, Evaluation and Intervention Schedule and the Problem Oriented Medical Record and the currently used record system.
This paper reviews egocentric speech as a theoretical postulate of change relevant to the practice of occupational therapy. Egocentric speech, an important adaptive behavior in normal development, designates the verbalizations that usually occur while a child between the ages of two and seven performs an adaptive task and thereby increases problem-solving abilities. The behavior is first discussed as it relates to the structures of assimilation and accommodation in Piaget's earlier sensorimotor stage, then as it appears in the preoperatory level of the concrete operations stage of intelligence. The importance of the behavior as a foundation for the inner language and thinking capacities of the adult is supported by the research of Soviet scientists Vygotsky and Luria. Finally, three case studies are presented in which egocentric speech is used in conjunction with problem-solving tasks in occupational therapy.
In this study, a methodology was developed and tested for assessing the quality of care in occupational therapy between educational and noneducational clinical settings, as measured by process and outcome. An instrument was constructed for an external audit of the hospital record. Standards drafted by the investigator were established as normative by a panel of experts for use in judging the programs. Hospital records of 84 patients with residual hemiparesis or hemiplegia in three noneducational settings and of 100 patients with similar diagnoses in two educational clinical settings from selected Michigan facilities were chosen by proportionate stratified random sampling. The process study showed that occupational therapy was of significantly higher quality in the educational settings. The outcome study did not show significant differences between types of settings. Implications for education and practice are discussed.
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