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Fall 97

Fall 1997

Fall 1997

Title: Assessing follow-through of occupational therapy feeding interventions in long-term care facilities.

Authors: Franklin, T., Pieninck, M., Porter, J., Springer, C.

Abstract: Objective: Thirty subjects, living in five different long-term care facilities, with feeding recommendations made by a registered occupational therapist, were involved in a quality improvement study to determine the degree of follow-through with feeding recommendations.

Method: During the midday meal, subjects whose occupational therapists made feeding recommendations relating to adaptive equipment, positioning, environmental adaptations and set-up were observed to determine the level of follow-through with recommendations. A two-tailed dependent t-test was conducted to compare the mean number of recommendations made by occupational therapists with the mean of recommendations implemented completely.

Results: A significantly lower follow-through rate was found between the number of recommendations that were implemented completely by the staff and the number of recommendations that were made by the therapists.

Conclusion: In this study the overall rate of follow-through with feeding recommendations (both full and partial follow-through) was approximately 75%. Of the four types of recommendations, follow-through was most frequent for environmental adaptations, followed by adaptive equipment, set-up and positioning.

Year: Weekend, Fall 1997

Chair/Reader: M. Holm, L. Shah

Keyword: Feeding, long term care

Published: Porter, J., Franklin, T., Pieninck, M., Springer, C., and Holm, M. (2001), Quality of Follow-Through with Feeding Interventions for Long-Term Care Facility Residents. Physical & Occupational Therapy in Geriatrics, 19(1), 77-90.

Title: Use of the lifestyle performance model with geriatric clients.

Authors: Lent, M., Speciale, H., Gearhart, L., Posluszny, M., and Redenski, D.

Abstract: Various theoretical models exist in occupational therapy, and the purpose of this study was to analyze the use of one of those models, the Lifestyle Performance Model (LPM), with geriatric clients. Participants were 367 Pennsylvania licensed occupational therapists who subscribed to the American Occupational Therapy Association (AOTA) Gerontology Special Interest Section. A 56% (N=204) response rate was obtained. The majority of the respondents practiced in long-term care, and the rehabilitative model was identified as the most commonly used model of practice. Out of the 204 respondents, only 12.3% used the LPM in a geriatric setting. The results suggest that registered occupational therapists may find the LPM of greater practical use with further research and clarification of the model.

Year: Weekend, Fall 1997

Chair/Reader: M. Holm, G. Fisher

Keyword: Life style performance model, geriatrics

Title: Investigating the truth value of the Life-Style Performance Profile

Authors: Broadhurst, S., Diamond, B., Kinhart, T., Miller, M.

Abstract: This study investigated the truth value of information elicited and interpreted using the Life-Style Performance Profile (LPP), a semi-structured interview tool based on the Life-Style Performance Model (LPM). Two separate participant samples were used that consisted of one 72 year-old woman with a physical disability and 26 college students from Dallas, Pennsylvania. A focus group of 3 individuals who possessed expertise in the use of the LPM was also used. A multistaged, qualitative design was instituted for the study. Results indicate that the LPP is capable of enabling students to identify with a moderately high degree of truth value that which would be meaningful for a client to address during occupational therapy. Future areas of research should focus on the applicability of results, the effects of supplemental background information on interview data interpretation, and on assessing the truth value of the LPP using methodologies that control for participant verification bias.

Year: Weekend, Fall 1997

Chair/Reader: B. Velde, M. Ciofalo

Keyword: Life-style Performance Model

Title: Spirituality and occupational therapy in geriatric practice.

Authors: Stock, K., Kushner, C., Cohick, B., Daubert, A.

Abstract: This study was the first to examine occupational therapists' opinions and use of spirituality in geriatric intervention. A questionnaire was mailed to 250 (61% response rate) registered occupational therapists practicing in geriatrics. Eighty-eight percent of the respondents reported that spirituality was important in their lives, and 82% believed spirituality belonged in their practice. While approximately 26% used assessments that addressed spirituality issues, 62% used treatments that addressed spirituality issues. Meditation techniques and discussion of spiritual beliefs were the most frequently used interventions. Spiritual leader (n=117) was selected most frequently as either the first, second, or third choice for assisting clients with spiritual needs. Therapists receiving spirituality education commonly used treatments that addressed spirituality issues. The role spirituality plays in gerontology assessment and intervention needs further definition.

Year: Weekend, Fall 1997

Chair/Reader: B. Velde, M. Holm

Keyword: Spirituality, geriatrics

Title: Critical Pathways: An Integrative Literature Review

Authors: Harkleroad, A., Schirf, D., Volpe, J.

Abstract: The purpose of this study was to analyze critical path development methods that have been used in association with various diagnoses. A comprehensive literature review using specified search criteria focused on the development of critical paths. The review was limited to articles published in occupational therapy, physical therapy, nursing, and medical journals between 1992 and 1997. Results are presented in tabular format representing each critical path development method and the steps or criteria specified from each method. This study should assist the occupational therapist working with various diagnoses to understand the methods and steps involved in the development of critical paths.

Year: Weekend, Fall 1997

Chair/Reader: M. Holm, J. Cipriani

Keyword: Critical pathways

Publications/Presentation: Published as : Harkleroad, A., Schirf, D., Volpe, J. & Holm, M.B. (2000). Critical pathway development: An integrative literature review. American Journal of Occupational Therapy, 54, 148-154.

Title: A study of occupational therapy benchmarks within orthopaedic critical pathways.

Authors: Novalis, S., Fricke, M., Morris, L.

Abstract: Occupational therapy benchmarks within a sample of eight orthopaedic critical pathways were examined to determine commonalities and differences of benchmarks, disciplines involved, and identified allowable variances. Nursing, physical therapy, and occupational therapy were consistently involved in the sample pathways. Activities of daily living (ADL) related to self-care was utilized most consistently as a benchmark for occupational therapy within the sample pathways. Functional transfers were a second area of commonality. There was variety and ambiguity in relation to remaining benchmarks and frequency of the use of the benchmarks. Five of eight pathways specifically coded variances, with the remaining three providing space for explanation of the variance.

Year: Weekend, Fall 1997

Chair/Reader: M. Holm, B. Alder

Keyword: Critical pathways

Publications/Presentation: Published as: Novalis, S.D., Messenger, M.F., & Morris, L. (2000). Occupational therapy benchmarks within orthopedic (hip) critical pathways. American Journal of Occupational Therapy, 54, 155-158.

Title: Use of activity among occupational therapists practicing in adult/geriatric physical disabilities settings.

Authors: Early, A., Girondi, L. Haskell, L. T., Miller, K., Norton, J.

Abstract: Objectives: This study investigated activities therapists use to increase bilateral upper extremity coordination in clients diagnosed with a cerebral vascular accident. It also investigated whether the client's perception of activity relevance was related to the level of engagement in the activities, and if the ranking made by the therapist for the activities was related to the client's perception of the relevance of the activities.

Method: A survey was mailed to 250 occupational therapists practicing in adult/geriatric physical disability settings. The response rate was 40% (N=100) of which 67 were usable. Therapists were asked to rank order the five most effective activities used in treatment, rate the client's level of engagement in the activities, and to rate the client's perception of the relevance of these activities.

Results: According to weighted rank order in all categories, the five most effective activities in descending rank were dressing/buttoning, self range of motion (SROM), cones, weight bearing, and ball activities. Client engagement results in descending rank were dressing/buttoning, cones, ball activities, SROM, and weight bearing activities. Relevance to client in descending rank included dressing/buttoning, SROM, ball activities, cones, and peg activities.

Conclusion: This study surveyed occupational therapists about their use of activities when treating clients diagnosed with a CVA, and the perceived relevance of those activities to the clients. Dressing/buttoning was the activity most often used, had the highest level of engagement by clients, and was most relevant to them.

Year: Weekend, Fall 1997

Chair/Reader: M. Holm, C. Hischmann

Keyword: Purposeful activity

Title: Patient and therapist perceptions of the occupational therapy process: A pilot study.

Authors: McAndrew, E., McDermott, S., Vitzakovitch, S., Warunek, M.

Abstract: Recent literature in occupational therapy and nursing illustrate that collaborative goal setting can lead to increased patient satisfaction, shorter inpatient stays, and better goal attainment (Neistadt, 1995). Therapists and patient level of collaboration on goal formulation, beliefs of their relevance, and how they are to be accomplished, are essential for better treatment outcomes. Surveys from a convenience sample of 10 occupational therapy patients and 10 registered occupational therapists were analyzed to determine the patient/therapist level of agreement on the relevance of goals and their perceptions of how the goals were established. The results of this study illustrated that occupational therapists and patients view the occupational therapy process as one that is shared. Patients' perceptions were highest regarding whether or not their input was included in their goals. Their perceptions were lowest regarding whether or not their interests or hobbies were discussed. Therapists' perceptions were highest regarding their awareness of availability of assistance after discharge and their explanation of the purpose of activities/tasks/exercises to patients. Therapists' perceptions were lowest for discussing the patients' primary roles.

Year: Weekend, Fall 1997

Chair/Reader: M. Holm, C. Hischmann

Keyword: Collaborative

Publications/Presentation: Published as: McAndrew, E., McDermott, S., Vitzakovitch, S. , Warunek, M. & Holm. M. B. (1999). Patient and therapist perceptions of the occupational therapy process: A pilot study. Physical and Occupational Therapy in Geriatrics, 17(1), 55-63.

Title: The effectiveness of everyday occupations for changing client behaviors in a community living arrangement.

Authors: Brown, S., Santangelo, M., Fromuth, D., Walter, H.

Abstract: The purpose of this study was to examine the effect of three interventions on the rate of vocal disruptions, distracting behaviors, appropriate social interactions and the duration of time spent appropriately engaged, of two dually diagnosed residents in a Community Living Arrangement (CLA). The study employed a single subject AB multiple baseline across subjects design with two subjects and alternating conditions to assess the incidence of behaviors under three conditions: typical day, CLA morning and CLA evening. Both subjects showed improvement in their behaviors as a result of the occupational therapy intervention introduced in the CLA. The results of this study indicated that occupational therapy intervention for individuals residing in a CLA was effective for decreasing negative behaviors and increasing positive behaviors.

Year: Weekend, Fall 1997

Chair/Reader: M. Holm, D. Evans

Keyword: Community living arrangement, occupation

Title: The experience of being an occupational therapist with a disability.

Authors: Velde, B. P.

Abstract: This study addressed what it is like to practice as an occupational therapist with a disability. Open-ended interviews using a phenomenological approach were conducted with ten participants until data saturation was achieved. Transcripts were coded for categories on an individual basis and analyzed across transcripts to identify common themes. The following themes were identified: "I'm sensitive to their needs", "The issue is how to cope with life", and "Recognize Your Own Strengths and Limits". Therapists with a disability perceive themselves as uniquely skilled individuals who have developed successful strategies to cope with the experience of disability.