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Cegarra B, Cattaneo G, Ribes A, Solana-Sánchez J, Saurí J. Independent living, emotional well-being, and quality of life in people with disabilities: the mediator role of self-determination and satisfaction with participation. Front Psychol 2023; 14:1279014. [PMID: 38187437 PMCID: PMC10768016 DOI: 10.3389/fpsyg.2023.1279014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024] Open
Abstract
Background In the field of disability and rehabilitation, participation in society has become an important therapeutic objective due to its potential impact on rehabilitation, prognosis, and patient's mid and long-term well-being. However, only a few studies have explored this issue in relation with the subjective perspective of individuals with disabilities about their decision-making capacity and satisfaction with the activities in which they participate. Objective Our aim is to analyze the relationship between participation in society of people with disabilities and both emotional well-being and quality of life, including variables about subjective perspective of participation (satisfaction) and the ability to decide and pursue their own preferences. Method The cross-sectional study presented here includes 424 participants with disabilities over 18-years-old from Spain. This research is part of a larger ongoing longitudinal cohort study called Participa (https://participa.guttmann.com/en/). Participants were asked to complete several on-line surveys to explore quality of life, emotional well-being, participation in society, self-determination, and independent living. Results The results revealed an association between the dimensions of participation satisfaction, self-determination, and levels of independent living with both quality of life and emotional well-being. Mediation models indicated that satisfaction and self-determination partially mediated the relationship between independent living and both quality of life and emotional well-being. Conclusion The level of independent living, self-determination, and satisfaction with participation are fundamental aspects for promoting a high quality of life and emotional well-being in people with disabilities. These findings carry significant implications for health and social services, as well as policies guidelines, highlighting the need to prioritize empowerment and self-determination in all interventions designed for people with disabilities.
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Affiliation(s)
- Blanca Cegarra
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Departament de Teoria i Història de l’Educació, Facultat d’Educació, Universitat de Barcelona, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Alina Ribes
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Joan Saurí
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Caston S, Greenfield B, Piemonte N, Jensen G. Turning toward suffering: Rethinking the patient- clinician relationship in physical therapy practice. Physiother Theory Pract 2023:1-11. [PMID: 37916508 DOI: 10.1080/09593985.2023.2272844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
In this professional theoretical article, the authors argue that patient care should be centered on connection and that authentically turning toward suffering necessitates an approach to care that transcends medicine's traditional focus on cure and physical restoration and differentiates between pathology and disability. The meaning of illness and suffering for those who have experienced life-changing injuries or illness is explored. Strategies for approaching the lifeworld of these individuals are discussed using the concepts of phenomenology and embodiment, rooted in the work of philosophers from the phenomenological tradition. The authors also propose an approach to patient care offering a case-based example based on postmodernist concepts that elevate connection, relationship, and interdependency above the traditional focus of restoring normality and physical independence for individuals with disabilities. Traditional assumptions about quality of life, illness, and disability are called into question by focusing on the fluidity of being and disability identity, which serves to destabilize static, binary conceptions of individuals as either healthy or ill, disabled, or able-bodied. A postmodern lens invites healthcare practitioners to envision themselves as part of an assemblage that may promote a more expansive view of the relationship between patient and healthcare practitioner.
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Affiliation(s)
- Sarah Caston
- Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Bruce Greenfield
- Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Nicole Piemonte
- Department of Medical Humanities, Creighton University School of Medicine, Phoenix, AZ, USA
- Department of Physical Therapy, Creighton University School of Pharmacy and Health Professions, Omaha, NE, USA
| | - Gail Jensen
- Department of Physical Therapy, Creighton University School of Pharmacy and Health Professions, Omaha, NE, USA
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Kessner K, Hitch D. Development of an evidence-informed education package for occupational therapists for palliative and end of life care: promoting occupational justice. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2022. [DOI: 10.1590/2526-8910.ctore23883117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction Death is inevitable, yet hospitals and health services continue to focus on life-sustaining practices despite clients presenting with clear decline related to life-limiting illness. Social and occupational injustice is common for clients receiving palliative or end-of-life care, as they experience increased occupational disengagement and disempowerment. A gap was identified in the Occupational Therapy department of a metropolitan Australian hospital regarding clinician skills, knowledge and confidence in working with these clients. Objective To describe the development of an evidence informed education package designed to support occupational therapists to provide the best possible quality of care and promote occupational justice for clients receiving palliative or end-of-life care. Method Consultation with key stakeholders and a review of existing resources including a skills audit, was conducted to identify current practice. A review of professional and grey literature was completed, and benchmarking with similar organisations provided a wider perspective on current Australian practice. Review of widely available educational resources were evaluated. Results Baseline data collection confirmed that promoting occupational and social justice for people requiring palliative or end-of-life care was under-recognised across the health service. Benchmarking identified significant variation in educational practices across similar Australian health services. The structure and content of a face-to-face clinical education session was formulated using evidence from the literature review and relevant available resources. There are plans to transfer this education package to an e-learning platform with evaluation built into the package to allow content to remain up to date. Conclusion Occupational Therapy clinicians are well placed to promote occupational and social justice for people requiring palliative or end-of-life care but require additional occupationally focused education to optimise their practice in this area.
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Jaiswal A, Aldersey H, Wittich W, Mirza M, Finlayson M. Factors that influence the participation of individuals with deafblindness: A qualitative study with rehabilitation service providers in India. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/0264619620941886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Evidence to inform rehabilitation service delivery for individuals with deafblindness, especially in the Indian context, is inadequate. Rehabilitation professionals often find it challenging to design rehabilitation interventions that promote participation for those with deafblindness. Therefore, our purpose was to understand the contextual factors that influence the participation of individuals with deafblindness in India from the perspectives of those who are involved in providing rehabilitation services to them. Using the International Classification of Functioning, Disability, and Health (ICF) as a framework, we conducted two focus group discussions with 16 rehabilitation service providers in India. We used a content analysis approach to examine the data. Rehabilitation service providers perceived participation barriers to be linked primarily to the social environment. Specifically, participants identified four major factors acting as barriers, including (a) lack of awareness about deafblindness; (b) negative attitudes and stigma associated with disability; (c) lack of access to resources such as assistive technology and interpreter support; and (d) communication challenges associated with severe impairments. Facilitators include accessibility of the built environment for multisensory impairments, affordable technology, provision of an interpreter and personal support worker, and training on deafblindness for professionals. The participation of individuals with deafblindness could be enhanced by identifying and removing environmental barriers and improving knowledge about deafblindness among rehabilitation professionals for proper identification, assessment, and access to rehabilitation services.
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Hammell KW. Securing occupational rights by addressing capabilities: A professional obligation. Scand J Occup Ther 2021; 29:1-12. [PMID: 33689552 DOI: 10.1080/11038128.2021.1895308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The World Federation of Occupational Therapists asserts that all occupational therapists are obligated to promote occupational rights, and has highlighted the importance of Amartya Sen's concept of 'capabilities' to the work of securing the occupational rights to which all are equally entitled. AIMS To outline the capabilities approach and highlight its relevance and importance for the occupational therapy profession. MATERIAL & METHODS Drawing from Sen's work, and that of other scholars who have critiqued and adapted his capabilities approach, this paper describes the foundational components of the capabilities approach and identifies important overlaps with issues of concern to occupational therapy. RESULTS Sen's capabilities approach employs a contextualised view of human wellbeing; attending to whether people have the abilities to do the things they would value doing, and whether their circumstances actually provide the real opportunities to choose to do what they would value doing. CONCLUSIONS The capabilities approach, with its attention to abilities and actions, options and opportunities, empowerment and choice, justice and participation, has clear relevance for occupational therapists. SIGNIFICANCE A capabilities perspective provides a valuable framework for occupational therapists striving towards equalising people's opportunities, possibilities and choices - their capabilities - to secure their occupational rights.
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Affiliation(s)
- Karen Whalley Hammell
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Experience of Filipinos with Spinal Cord Injury in the Use of Assistive Technology: An Occupational Justice Perspective. Occup Ther Int 2020; 2020:6696296. [PMID: 33304205 PMCID: PMC7714598 DOI: 10.1155/2020/6696296] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 11/18/2022] Open
Abstract
Assistive technology (AT) is often required to facilitate the performance of occupations and promote inclusion and reduction of dependency among persons with spinal cord injury (SCI). However, only 5-15% of individuals in developing countries have access to AT. This study is aimed at exploring the experience of Filipinos with SCI as they use AT and understand these from an occupational justice (OJ) perspective. This study utilised a hermeneutic phenomenological approach to explore the participants' experiences with AT usage. Ten participants were recruited from a hospital and communities within Metro Manila, Philippines, and interviewed last January 2020. Hermeneutic analysis was done to interpret the shared meaning embedded within their experiences and was informed by an occupational justice perspective. Exploring the experience of the participants in using AT yielded four themes, namely, (1) engaging in occupations despite limited opportunities, (2) going to various locations amidst an inaccessible environment, (3) striving towards inclusion in spite of attitudinal barriers, and (4) securing needs in light of unfavourable life conditions. Filipinos with SCI deal with numerous structural and contextual factors in daily life. There has been partial enablement of OJ as they incorporate AT in their daily lives as occupational rights are far from being recognised and respected. In infusing an OJ perspective to understanding AT use, OT practitioners are bound to identify problems and courses of action that go beyond traditional service delivery.
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Alberti G, Campodonico F, Acquaviva G, Chiariello V, Desideri L. Persons with intellectual and multiple disabilities activate via non-verbal responses a smartphone's Google Assistant to access preferred stimulation. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:518-527. [PMID: 35937160 PMCID: PMC9351553 DOI: 10.1080/20473869.2020.1827213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/18/2020] [Accepted: 09/13/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The present study evaluated a new smartphone-based program to help 12 participants with intellectual disability plus visual and motor impairments to self-regulate their stimulation input (thus avoiding their dependence on staff) through simple non-verbal responses. METHOD Nonconcurrent multiple baseline designs across participants were used to assess the effects of the program. The technology used for the program involved a Samsung J4 Plus smartphone with Android 9.0 operating system, two voice recording devices, smart-plugs, and a mini speaker. The smartphone was provided with a Google account and Internet connection, which allowed the participants to access Google Assistant and Google Play Music. The participants could make requests for two different types of stimulation (e.g. songs and familiar voices or noises) by activating via hand pressure the two voice recording devices. The verbal request messages emitted by the devices were recognized by the Google Assistant, which led the smartphone to deliver the related stimulation. RESULTS During the baseline sessions (without the support of the voice recording devices), the participants failed to access any stimulation. During the intervention and post-intervention phases (with the support of the voice recording devices), all participants managed to access the types of stimulation available independently. The mean frequency of responses (i.e. activations of both voice recording devices) per session ranged between about 8 and 14. CONCLUSION The new smartphone-based program can be viewed as a useful resource to enable individuals like the participants of this study to access preferred stimulation independently.
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Affiliation(s)
- Giulio E. Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Nirbhay N. Singh
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Mark F. O’Reilly
- Department of Special Education, University of Texas at Austin, Austin, TX, USA
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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Milbourn B, Mahoney N, Trimboli C, Hoey C, Cordier R, Buchanan A, Wilson NJ. "Just one of the guys" An application of the Occupational Wellbeing framework to graduates of a Men's Shed Program for young unemployed adult males with intellectual disability. Aust Occup Ther J 2019; 67:121-130. [PMID: 31769055 DOI: 10.1111/1440-1630.12630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/30/2019] [Accepted: 11/06/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Conceptualisation of occupation requires understanding of subjective wellbeing and experiences of occupation. Opportunities for participation in productivity activities, such as employment, may be limited for people with intellectual disability (ID). An occupational wellbeing framework was recently re-imagined to focus on the subjective meaning of a person's occupational life rather than occupational performance. This study analysed experiences and possible benefits to occupational wellbeing of young adult men with ID in an intergenerational mentoring program based on Australian Men's Sheds using this revised occupational wellbeing framework. METHODS A qualitative approach was used to gather individual semi-structured interviews at the end of an intergenerational mentoring program to explore occupational wellbeing experiences. Eight individual mentees and five parents of mentees (n = 13) from the different Men's Sheds sites agreed to participate in an individual interview about their experiences of the program. All mentees were male aged between 17 and 24 years. Family members included four female mothers and one male father. Data were highlighted, selected and deductively coded using content analysis according to the five occupational wellbeing domains of the framework. RESULTS Mentees reflected upon their experience with their mentor, the program, activities and environment of the Men's Shed. Findings were organised in relation to each of the five domains of occupational wellbeing, including contentment, competence, belonging, identity and autonomy. Experiences of mentees and their family members reflected the positive impact of participation on each domain and occupational wellbeing, including opportunities for socialisation outside of the program, mastery of skills and knowledge and validation of belief in self. CONCLUSION Mentees involved in an intergenerational mentoring program in Australian Men's Sheds report benefits of participation in activities that foster and increase occupational wellbeing experiences. The experience of such domains should be considered when attempting to understand the quality of life and function for people with disabilities.
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Affiliation(s)
- Benjamin Milbourn
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Natasha Mahoney
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Concettina Trimboli
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Ciarain Hoey
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Reinie Cordier
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Angus Buchanan
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia
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Sterman JJ, Naughton GA, Bundy AC, Froude E, Villeneuve MA. Mothers supporting play as a choice for children with disabilities within a culturally and linguistically diverse community. Scand J Occup Ther 2019; 27:373-384. [PMID: 31703170 DOI: 10.1080/11038128.2019.1684556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Play is a right for children; an essential childhood occupation influenced by their family environment. Despite increasing recognition of unstructured outdoor play benefits, children with disabilities experience limited play opportunities.Aim: To apply a capabilities approach lens to understand outdoor play decision-making by mothers of children with disabilities within a culturally and linguistically diverse community.Materials and methods: Data collection for this case study involved semi-structured interviews with five mothers of primary school-aged children with disabilities and a week-long survey that profiled their children's outdoor play. Analysis was thematic and involved identifying barriers and opportunities at each ecocultural layer, aggregating strategies families used to address the barriers, and understanding their overall play decision-making.Findings: Mothers considered the child's interests and abilities, valued play as both a means and ends, planned for play, and facilitated in the moment as required. Multiple factors influenced mothers' outdoor play decisions. Mothers' values were child-centred, positively influencing the child's play opportunities.Conclusion and significance: This study's capabilities lens could inform professions such as occupational therapy to support families of children with disabilities from culturally diverse communities to advocate for play opportunities across settings.
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Affiliation(s)
- Julia J Sterman
- Department of Occupational Therapy, University of Minnesota, Minneapolis, MN, USA.,Centre for Disability Research and Policy, Faculty of Health Science, The University of Sydney, Lidcombe, Australia
| | | | - Anita C Bundy
- Centre for Disability Research and Policy, Faculty of Health Science, The University of Sydney, Lidcombe, Australia.,Faculty of Occupational Therapy, Colorado State University, Fort Collins, CO, USA
| | - Elspeth Froude
- School of Allied Health, Australian Catholic University, North Sydney, Australia
| | - Michelle A Villeneuve
- Centre for Disability Research and Policy, Faculty of Health Science, The University of Sydney, Lidcombe, Australia
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Hart HC. ‘Keeping busy with purpose’: How meaningful occupation can shape the experience of forced migration. MIGRATION STUDIES 2019. [DOI: 10.1093/migration/mnz046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Forced migration creates multiple barriers to everyday life, including individual’s access to dignified and meaningful daily occupations. Without the activities that form family life, self-care, work, leisure, and community participation, individuals can find themselves struggling to fill the hours in their days and feeling they exist on the margins of society. This article reflects the findings of a small-scale phenomenological study exploring the meaning of everyday occupations to people seeking asylum in the UK. A series of in-depth interviews, conducted with 10 people, explored the role of daily occupation in their country of origin and in the UK. The study found that restrictions on daily activities had a significant impact on their well-being and sense of self-worth. They highlighted how limited their opportunities were and acknowledged the value of meaningful daily occupations as a means to ‘keep busy with purpose’. There is growing evidence that occupation has the potential to be of benefit to people during the post-migratory period: maintaining health, preserving key skills, retaining a sense of self, and increasing integration. This study shows the multiple gains associated with purposeful activity, including how the right kind of occupation can promote self-worth at a time when people often feel devalued. The article encourages the reader to consider how increased access to activity can promote well-being and to consider challenging the occupational injustices behind asylum policy.
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Affiliation(s)
- Helen Claire Hart
- School of Health & Life Sciences, Teesside University, Southfield Road, Middlesbrough TS1 3BX, UK
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Thurman WA, Harrison TC, Garcia AA, Sage WM. The social construction of disability and the capabilities approach: Implications for nursing. Nurs Forum 2019; 54:642-649. [PMID: 31559644 DOI: 10.1111/nuf.12389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PROBLEM Improving the health and well-being of people with disabilities (PWD) should be included https://plato.stanford.edu/cgi-bin/encyclopedia/archinfo.cgi?entry=justice-distributivein any strategies aimed at eliminating health disparities and achieving health equity in the United States. However, practitioners and policymakers often overlook disability when considering health equity. This is problematic because structural injustices including social and environmental barriers frequently worsen health for PWD. A commitment to social justice, however, dictates that everyone should have equitable opportunities to participate in chosen aspects of life to the best of their abilities and desires. METHODS We use a critical commentary to provide suggestions for the nursing discipline. Specifically, we 1) position the disparities in health and well-being experienced by PWD as matters of equity and social justice, 2) describe Amartya Sen's capabilities approach, and 3) provide suggestions for incorporating tenets of the capabilities approach into nursing practice, research, and policy. CONCLUSION The capabilities approach can provide a useful framework to guide nursing practice, research, and policy in order to advance social justice for PWD.
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Affiliation(s)
- Whitney A Thurman
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, Texas
| | - Tracie C Harrison
- Center for Excellence in Aging Services and Long-Term Care, The University of Texas at Austin School of Nursing, Austin, Texas
| | - Alexandra A Garcia
- Division of Community Engagement and Health Equity, Department of Population Health at Dell Medical School, The University of Texas at Austin School of Nursing, Dell Medical School, Austin, Texas
| | - William M Sage
- School of Law, Dell Medical School, The University of Texas at Austin, Austin, Texas
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Toro-Hernández ML, Mondragón-Barrera A, Múnera-Orozco S, Villa-Torres L, Camelo-Castillo W. Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach. Int J Equity Health 2019; 18:18. [PMID: 31155006 PMCID: PMC6545726 DOI: 10.1186/s12939-019-0923-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite representing 70 million people in Latin America, access to comprehensive rehabilitation and participation in the community remains a challenge for persons with disability (PWDs) in the region. Through enactment of the Disability Law, Colombia has made improvements to recognize and address some of the barriers for PWDs, including access to comprehensive rehabilitation. However access remains limited with significant disconnect between perspectives of various stakeholders and the needs of the population. We examined the unique perceptions on access to comprehensive rehabilitation services and participation of PWDs. We also explored the perspective of caregivers of PWDs, rehabilitation professionals, and other stakeholders on the experiences of PWDs. Our goal was to identify gaps in the implementation of comprehensive rehabilitation programs, and barriers to access resources for comprehensive rehabilitation or services that would impact participation of PWDs. METHODS Qualitative study conducted in 2017. Data was collected from a purposive sample of adults with physical disability, aged 18-44 years, who had received rehabilitation services at a local partner organization and with different backgrounds and experiences with disability. Purposive sampling was also conducted with caregivers, rehabilitation professionals, and other stakeholders. Socio-demographic information was collected and semi-structured interviews were conducted by a research team member, recorded, transcribed and analyzed using a thematic analysis method to identify main themes related to our aim. CES University ethical review board approved this study. RESULTS Thirty-two participants were interviewed: eight were male, 42.1 ± 11.1 years old, and 44% (n = 14) were PWDs. Three main themes were identified among all the participants: the meaning of rehabilitation, challenges to access services, and participation. Challenges to access services had three sub-themes: barriers to personal mobility, perceptions and knowledge on disability, and navigating the system. CONCLUSION The main focus of rehabilitation as perceived by stakeholders is still on functional rehabilitation. If healthcare personnel is better trained on disability and if those with disabilities are actively involved in the developing these programs, the focus may evolve to a comprehensive and equitable rehabilitation process that fosters full participation.
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Affiliation(s)
| | | | | | - Laura Villa-Torres
- Department of Social Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Wendy Camelo-Castillo
- Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland Baltimore, Baltimore, USA
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Using the ICF to Identify Contextual Factors That Influence Participation of Persons With Deafblindness. Arch Phys Med Rehabil 2019; 100:2324-2333. [PMID: 30986411 DOI: 10.1016/j.apmr.2019.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 02/04/2019] [Accepted: 03/02/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify and describe the contextual factors that influence the participation of people with deafblindness in India. DESIGN Qualitative study, using directed content analysis approach and the International Classification of Functioning, Disability and Health (ICF) as a framework to analyze the data. SETTING Community and social participation settings. PARTICIPANTS Community-dwelling individuals with deafblindness (N=16). Age ranges from 18-45 years. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Personal and environmental factors that influence the participation of individuals with deafblindness using the ICF framework. RESULTS Results indicate that the age of onset and nature of impairment (deafblindness) and willingness to explain the condition (functional consequences of deafblindness) emerged as important personal factors. Access to resources such as assistive technology, social support, and deafblind-specific services were found to be enablers of participation. Lack of services, systems, and policies specific to deafblindness along with negative societal attitude toward disability were highly perceived environmental barriers that influence participation of people with deafblindness in India. CONCLUSIONS Professionals must acknowledge aspects of the environment in conducting assessments and delivering interventions and understand the dynamic interactions between environment of the individual and his/her concurrent vision and hearing impairments. Approaches to enable participation require rehabilitation professionals to work with those with deafblindness to advocate for removal of environmental barriers and ensure provision of appropriate resources from the government to facilitate their participation. Social policy and government must ensure emphasis on awareness about deafblindness, access to deafblind-specific services, positive societal attitude, and opportunities for full participation for people with deafblindness in society.
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Nhunzvi C, Langhaug L, Mavindidze E, Harding R, Galvaan R. Occupational justice and social inclusion in mental illness and HIV: a scoping review protocol. BMJ Open 2019; 9:e024049. [PMID: 30852534 PMCID: PMC6429853 DOI: 10.1136/bmjopen-2018-024049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Mental illness and HIV remain prevalent as chronic and stigmatised conditions and a global public health concern. Disability-adjusted life-years due to comorbid neuropsychiatric conditions and HIV are rising. Occupational justice and social inclusion emphasise the importance of equity and the utility of resources and opportunities for all to engage in diverse, healthy and meaningful activities. However, succinct conceptualisation of social inclusion and occupational justice, including the relationship between these concepts is still limited. This hampers their effective utilisation in research and practice. Here, we present our scoping review protocol to appraise literature to describe and explain the state of conceptualisation of occupational justice and social inclusion in relation to mental illness and HIV. We are aiming to review the definitions, current utilisation and relationships between occupational justice and social inclusion to inform further theorisation and practice application. METHODS AND ANALYSIS This scoping review protocol follows existing guidelines for scoping reviews in occupational therapy with particular attention on Arksey and O'Malley's (2005) scoping review framework. We iteratively developed a search strategy and carried out our search using the following databases: PubMed, Scopus, Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, Africa-Wide Information, Humanities International Complete, Web of Science, PsychInfo and SocINDEX. To enhance the comprehensiveness of our search and capture all relevant information, we will also search a variety of grey literature sources. Two reviewers will independently screen eligible studies for inclusion. Bibliographic data, abstract content and aspects of the study design and findings will be extracted and thematically analysed. ETHICS AND DISSEMINATION As secondary analysis, this scoping review does not require ethics approval. Results will summarise and disseminate existing research related to occupational justice and social inclusion in mental health and HIV/AIDS care, describing the conceptualisation, relationships between concepts and identifying gaps for further research and practical application. We will disseminate the results through peer-reviewed journals and conferences, targeting clinicians, academics, researchers and policy makers.
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Affiliation(s)
- Clement Nhunzvi
- Rehabilitation, University of Zimbabwe, College of Health Sciences, Harare, Harare, Zimbabwe
- Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Lisa Langhaug
- African Mental Health Research Initiative (AMARI), Department of Psychiatry, University of Zimbabwe College of Health Sciences, Harare, Harare, Zimbabwe
| | - Edwin Mavindidze
- Occupational Therapy, Ingutsheni Central Hospital, Bulawayo, Bulawayo, Zimbabwe
| | - Richard Harding
- Dept of Palliative Care and Policy, Kings College London, London, UK
| | - Roshan Galvaan
- Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
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Baron H, Hawrylyshyn N, Hunt SS, McDougall J. Understanding quality of life within occupational therapy intervention research: A scoping review. Aust Occup Ther J 2019; 66:417-427. [PMID: 30746712 DOI: 10.1111/1440-1630.12570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION There is little consensus regarding the meaning of quality of life (QOL) within occupational therapy literature. Measurement of QOL has varied in both research and practice. This scoping review explored the definitions and measures used within occupational therapy quantitative intervention research to evaluate QOL as an outcome. METHODS The review was completed by searching six databases using occupational therapy-related and QOL-related terms. Data were extracted from each article and authors performed descriptive statistics to establish trends for both definitions and measures. RESULTS Eighteen publications met the inclusion criteria. Seven articles included a definition of QOL. Most authors defined QOL as a multidimensional construct, comprised of varying domains. Fourteen different standardised measures and two non-standardised measures were utilised. CONCLUSIONS A clear conceptualisation of QOL that incorporates occupational therapy values such as client-centredness and holism is needed to advocate for the profession's role in health care and to encourage the development of suitable outcome measures.
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Affiliation(s)
- Haley Baron
- School of Occupational Therapy, Elborn College, Western University, London, ON, Canada
| | - Natalie Hawrylyshyn
- School of Occupational Therapy, Elborn College, Western University, London, ON, Canada
| | - Samantha S Hunt
- School of Occupational Therapy, Elborn College, Western University, London, ON, Canada
| | - Janette McDougall
- School of Occupational Therapy, Elborn College, Western University, London, ON, Canada.,Thames Valley Children's Centre, London, ON, Canada
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Babulal GM, Selvaratnam A, Taff SD. Existentialism in Occupational Therapy: Implications for Practice, Research, and Education. Occup Ther Health Care 2018; 32:393-411. [PMID: 30580655 DOI: 10.1080/07380577.2018.1523592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
As the profession of occupational therapy enters a second century, its growth in an increasingly complex and globalized world requires an adaptive and diverse philosophical foundation. The existentialist school of thought offers a complementary focus, which enhances existing philosophical foundations of the profession and supports two major tenets: (1) humans as self-making beings always in the process of becoming and (2) emotions and feelings as foundations for being-in-the-world. This article explores these two themes both in the context of existentialism and occupational therapy, and then provides an examination of existentialist utility in occupational therapy practice, research, and education.
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Affiliation(s)
- Ganesh M Babulal
- a Department of Neurology , Washington University School of Medicine , St. Louis , MO , USA
| | - Arun Selvaratnam
- b Program in Occupational Therapy , Washington University School of Medicine , St. Louis , MO , USA
| | - Steven D Taff
- b Program in Occupational Therapy , Washington University School of Medicine , St. Louis , MO , USA
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Ólafsdóttir LB, Egilson ST, Árnadóttir U, Hardonk SC. Child and parent perspectives of life quality of children with physical impairments compared with non-disabled peers. Scand J Occup Ther 2018; 26:496-504. [PMID: 30457392 DOI: 10.1080/11038128.2018.1509371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Life quality has become a widely used concept within rehabilitation and occupational therapy practice. AIM This study explored child and parent perspectives of life quality of children with physical impairments compared with a group of non-disabled children. METHOD Data were collected with the Icelandic self- and proxy-reported versions of the KIDSCREEN-27. For children with physical impairments, reports from 34 children and 40 parents were included in the analyses, and in control group reports from 429 children and 450 parents were included. RESULTS Children with physical impairments evaluated their life quality within the average range on four out of five life quality dimensions. The lowest scores were within the physical well-being dimension. Self-reported scores of children with physical impairments were higher than those of their parents on all dimensions except autonomy and parent relations. Thus, the parents considered more environmental and personal factors to negatively influence their child's life quality than children did themselves. CONCLUSION Children with physical impairments experience their life quality similarly to non-disabled children. SIGNIFICANCE Focus on life quality can help occupational therapists to identify what circumstances positively or negatively influence client well-being and to focus more on contextual factors that contribute to disablement.
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Affiliation(s)
- Linda Björk Ólafsdóttir
- a Centre of Disability Studies, School of Social Sciences , University of Iceland , Reykjavík , Iceland
| | - Snaefrídur Thóra Egilson
- a Centre of Disability Studies, School of Social Sciences , University of Iceland , Reykjavík , Iceland
| | - Unnur Árnadóttir
- b The State Diagnostic and Counselling Centre , Kópavogur , Iceland
| | - Stefan C Hardonk
- a Centre of Disability Studies, School of Social Sciences , University of Iceland , Reykjavík , Iceland
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Godoy-Vieira A, Soares CB, Cordeiro L, Campos CMS. Inclusive and emancipatory approaches to occupational therapy practice in substance-use contexts. The Canadian Journal of Occupational Therapy 2018; 85:307-317. [PMID: 30428689 DOI: 10.1177/0008417418796868] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND. Occupational therapy practice is enhanced through clear understanding of its epistemological foundations. In the area of substance use, practices are strongly functionalist. PURPOSE. This study unearths epistemologies through analyzing practices addressing the social needs of clients with problematic substance use. METHOD. This study used an exploratory qualitative approach and was based on Marxist philosophies. Qualitative interviews were conducted with nine occupational therapists experienced in working with substance users. Data were analyzed through a dialectic approach to content analysis based on the Marxist theory of labour process. FINDINGS. The occupational therapy practices were found to follow common principles: clients are agents of transformation in health processes; creativity is a strong element of practice and underlies the whole therapeutic process; and conditions of social reproduction compose the object of occupational therapy (i.e., what is transformed through occupational therapy practices). Two different approaches using these principles were uncovered according to the labour-process purposes: inclusive and emancipatory. IMPLICATIONS. Systematization of practices based on epistemological foundations strengthens occupational therapists' ability to link actions to theories.
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Reed KS, Meade M, Jarnecke M, Aust R, Krause JS. Perceptions of policies and programs and their impact in supporting employment among individuals with spinal cord injury. JOURNAL OF VOCATIONAL REHABILITATION 2018. [DOI: 10.3233/jvr-180948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Karla S. Reed
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Michelle Meade
- Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Melinda Jarnecke
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Richard Aust
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - James S. Krause
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
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Gustafsson S, Hörder H, Hammar IO, Skoog I. Face and content validity and acceptability of the Swedish ICECAP-O capability measure: Cognitive interviews with 70-year-old persons. Health Psychol Res 2018; 6:6496. [PMID: 30596153 PMCID: PMC6247011 DOI: 10.4081/hpr.2018.6496] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 10/04/2017] [Accepted: 11/13/2017] [Indexed: 11/22/2022] Open
Abstract
This study is part of a project that aims to culturally adapt the Investigating Choice Experiments for the Preferences of Older People-CAPability Index (ICECAP-O) for use in research and health and social care in Sweden. The objective was to evaluate face and content validity and acceptability. Eighteen 70-year-old community-dwelling persons participated in cognitive interviews. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants' perceptions of included attributes and experiences of completing the measure. The results show that three participants (18%) had problems completing ICECAP-O, and that judged problems occurred for five (6%) of participants responses in the standardized classification scheme. Most participants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O seems to measure what it is supposed to measure, quality of life (QoL) with a capability approach, and acceptability is satisfactory. ICECAP- O has potential for becoming a valuable addition to the supply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older persons.
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Affiliation(s)
- Susanne Gustafsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy
- Centre for Ageing and Health (AgeCap)
| | - Helena Hörder
- Centre for Ageing and Health (AgeCap)
- Department of Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Isabelle Ottenvall Hammar
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy
- Centre for Ageing and Health (AgeCap)
| | - Ingmar Skoog
- Department of Neuropsychiatric Epidemiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
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Sterman JJ, Naughton GA, Bundy AC, Froude E, Villeneuve MA. Planning for outdoor play: Government and family decision-making. Scand J Occup Ther 2018. [DOI: 10.1080/11038128.2018.1447010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Julia J. Sterman
- School of Allied Health, Australian Catholic University, North Sydney, NSW, Australia
| | | | - Anita C. Bundy
- Faculty of Health Science, The University of Sydney, Lidcombe, NSW, Australia
- Faculty of Occupational Therapy, Colorado State University, Fort Collins, CO, USA
| | - Elspeth Froude
- School of Allied Health, Australian Catholic University, North Sydney, NSW, Australia
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Pereira RB. Towards inclusive occupational therapy: Introducing the CORE approach for inclusive and occupation-focused practice. Aust Occup Ther J 2017; 64:429-435. [DOI: 10.1111/1440-1630.12394] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Robert B. Pereira
- Hospital Admission Risk Program; Barwon Health; Geelong Victoria Australia
- Discipline of Occupational Therapy; School of Public Health and Nutrition; Faculty of Health; University of Canberra; Canberra Australia
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Martin Ginis KA, Evans MB, Mortenson WB, Noreau L. Broadening the Conceptualization of Participation of Persons With Physical Disabilities: A Configurative Review and Recommendations. Arch Phys Med Rehabil 2017; 98:395-402. [DOI: 10.1016/j.apmr.2016.04.017] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/14/2016] [Accepted: 04/23/2016] [Indexed: 11/26/2022]
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Currency and Competence of Occupational Therapists and Consumers with Rapidly Changing Technology. Occup Ther Int 2017; 2017:5612843. [PMID: 29097973 PMCID: PMC5612714 DOI: 10.1155/2017/5612843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 12/12/2016] [Indexed: 11/17/2022] Open
Abstract
Assistive technology was once a specialised field of practice, involving products designed for populations with specific impairments or functional goals. In Australia, occupational therapists have, at times, functioned as gatekeepers to public funding, prescribing products from a predefined list. An expanding range of accessible mainstream products available via international and online markets has changed the meaning and application of assistive technology for many people with disability. In the policy context of consumer choice and cost-effectiveness, have occupational therapists been left behind? This paper describes the change in context for access to assistive technology resulting in expanded possibilities for participation and inclusion. A case study of environmental control systems is used to explore the overlap of mainstream and assistive products and the funding and services to support their uptake. The analysis describes a future policy and practice context in which assistive technology includes a spectrum of products decoupled from access to independent advice and support services. A broader scope of occupational therapy practice has potential to enhance the occupational rights of people with disability and the efficiency and effectiveness of assistive technology provision.
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Larsson-Lund M, Nyman A. Participation and occupation in occupational therapy models of practice: A discussion of possibilities and challenges. Scand J Occup Ther 2016; 24:393-397. [PMID: 27996336 DOI: 10.1080/11038128.2016.1267257] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Occupation has been the focus in occupational therapy practice to greater or lesser degrees from a historical viewpoint. This evokes a need to discuss whether concepts that are added to our field will enhance or blur our focus on occupation. AIM To explore how the concept of participation in the International Classification of Functioning, Disability and Health (ICF) is related to the concept of occupation by reviewing and comparing its use in three models of practice within occupational therapy. The aim was also to generate discussion on possibilities and challenges concerning the relationship of participation and occupation. METHOD The models reviewed were The Model of Human Occupation (MOHO), the Canadian Model of Occupational Performance and Engagement (CMOP-E) and the Occupational Therapy Intervention Process Model (OTIPM). RESULTS The concept of participation was related to occupation in different ways in these models. Based on the review some challenges and considerations for occupational therapy were generated. CONCLUSION Relating the concept of participation from the ICF to the concept of occupation in models of practice can be challenging. At the same time, relating the concepts can be a resource to develop occupational therapy and the understanding of occupational issues in society.
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Affiliation(s)
- Maria Larsson-Lund
- a Department of Health Science, Occupational Therapy , Luleå University of Technology , Luleå , Sweden
| | - Anneli Nyman
- a Department of Health Science, Occupational Therapy , Luleå University of Technology , Luleå , Sweden
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King E, Okodogbe T, Burke E, McCarron M, McCallion P, O'Donovan MA. Activities of daily living and transition to community living for adults with intellectual disabilities. Scand J Occup Ther 2016; 24:357-365. [PMID: 27707082 DOI: 10.1080/11038128.2016.1227369] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND As adults with intellectual disability (ID) in Ireland move to the community from residential settings, the changed environment is intended to increase opportunities for occupational engagement, autonomy and social relationships. It is important to consider how increased resources and opportunities available within the community can be optimized to promote engagement and quality of life. AIMS This paper investigates if and how ADL and IADL performance of people ageing with ID is related to place of residence. METHODS ADL and IADL performance of adults with ID in Ireland across different living situations was analyzed using descriptive and bivariate analysis of data collected from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS TILDA). RESULTS Greater ability to perform ADL and IADL was noted in those living in independent or community group home settings when compared to traditional residential settings. Place of residence was strongly related to ADL and IADL performance. CONCLUSION AND SIGNIFICANCE Given that people with ID will likely require physical and social supports to complete ADL and IADL when transitioning to community living from residential settings, an occupational justice perspective can inform occupational therapists working with people with ID, facilitating successful transitions to community living.
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Affiliation(s)
- Eilish King
- a School of Nursing and Midwifery , Trinity College Dublin , Ireland
| | - Theresa Okodogbe
- b School of Social Work and Social Policy , Trinity College Dublin , Ireland
| | - Eilish Burke
- c School of Nursing and Midwifery , Trinity College Dublin , Ireland
| | - Mary McCarron
- d Faculty of Health Sciences , Trinity College Dublin , Ireland
| | - Philip McCallion
- e Centre for Excellence in Aging and Wellness, University of Albany , NY , USA
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Angell AM, Frank G, Solomon O. Latino Families' Experiences With Autism Services: Disparities, Capabilities, and Occupational Justice. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2016; 36:195-203. [PMID: 27585604 PMCID: PMC5332377 DOI: 10.1177/1539449216666062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article examines six cases of publicly funded Applied Behavior Analysis (ABA) therapy for Latino children with autism spectrum disorder (ASD) to contribute to thinking about occupational justice. In this ethnographic study of six Latino families of children with ASD in Los Angeles County, all families were offered ABA for their children, but five families experienced occupational challenges leading them to insist on modifications of ABA or to opt out of the service. We consider in each case (a) how the families' experiences can be understood occupationally, (b) how ABA affected the functionings and capabilities of the children and their families, and (c) how the parents' accounts relate to occupational justice. Applying the capabilities approach can help operationalize the concept of occupational justice as a tool to evaluate social policy across cases.
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Affiliation(s)
- Amber M Angell
- 1 University of Southern California, Los Angeles, CA, USA
- 2 University of Illinois at Chicago, IL, USA
| | - Gelya Frank
- 1 University of Southern California, Los Angeles, CA, USA
| | - Olga Solomon
- 1 University of Southern California, Los Angeles, CA, USA
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Hammell KRW. Empowerment and occupation: A new perspective. The Canadian Journal of Occupational Therapy 2016; 83:281-287. [DOI: 10.1177/0008417416652910] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. The idea of empowerment permeates the occupational therapy literature yet has received little critical reflection from occupational therapy’s theorists. Purpose. This paper aims to explore the concept of empowerment and highlight a recent definition that resonates with occupational therapists’ core values. Key Issues. Empowerment is generally understood to be a process of bestowing power and giving ability to someone deficient in both. However, a new definition provides a framework for understanding how empowerment might enhance people’s capabilities. Implications. The World Bank’s depiction of empowerment fits well with occupational therapists’ beliefs in the importance of the ability and opportunity to “do,” providing a framework for action. This framework focuses on people’s capabilities: their freedom—or opportunity—to choose what they wish to do and to be and their ability to act on these wishes. Moreover, the World Bank’s assertion that empowered people have freedom of both choice and action suggests empowerment is a relevant concept for occupational therapists.
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Hammell KRW, Beagan B. Occupational injustice: A critique. The Canadian Journal of Occupational Therapy 2016; 84:58-68. [DOI: 10.1177/0008417416638858] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Although the idea of occupational injustice pervades the occupational therapy literature, there has been little scholarly debate concerning this construct or the parameters of the five identified forms of occupational injustice. Purpose. The aims of this paper are to highlight conceptual confusions, foreground some inherent questions that have been neither acknowledged nor addressed, and question the theoretical and practical utility of five manifestations of occupational injustice. Key Issues. Few theorists have contributed to the occupational injustice literature. Significant definitional confusion exists concerning the five forms of occupational injustice with some forms described as subsets of others. The inherent problems of judging occupational injustice have not been addressed. Implications. If occupational injustice were understood as a violation of occupational rights—human rights to achieve well-being through occupation—many of the problems of identifying a situation of occupational justice or injustice would be resolved. Using the capabilities approach to human rights would facilitate this endeavour.
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Hammell KRW. Critical reflections on occupational justice: Toward a rights-based approach to occupational opportunities. The Canadian Journal of Occupational Therapy 2016; 84:47-57. [PMID: 27402705 DOI: 10.1177/0008417416654501] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Occupational justice is cited throughout the occupational science and occupational therapy literatures despite little scholarly attention either to its definition or to how situations of occupational justice are identifiable. PURPOSE This paper aims to contribute a critique of occupational justice, explore the concepts of justice and (occupational) rights, and support a capabilities approach to inform rights-based occupational therapy practices. KEY ISSUES No clear definition of occupational justice or differentiation from social justice exists despite the longevity of the concept, and theorists frequently confuse the concepts of justice and rights. A rights-based focus provides an unambiguous mandate for occupational therapists, with the capabilities approach offering a cross-disciplinary framework to inform rights-based practices. IMPLICATIONS The concept of occupational rights is consistent with the rights-based focus advocated by the disabled people's movement, articulated by the United Nations' Convention on the Rights of Persons With Disabilities, and affirmed by the World Federation of Occupational Therapists' position on the centrality of occupation to health, well-being, and human rights.
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Kirsh BH. Transformer les valeurs en action: La défense des intérêts en tant qu'impératif professionnel. Can J Occup Ther 2015; 82:E1-E13. [PMID: 26502024 DOI: 10.1177/0008417415602681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hocking C, Townsend E. Driving social change: Occupational therapists’ contributions to occupational justice. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2015. [DOI: 10.1179/2056607715y.0000000002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hammell KW. Occupational rights and critical occupational therapy: rising to the challenge. Aust Occup Ther J 2015; 62:449-51. [DOI: 10.1111/1440-1630.12195] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Karen Whalley Hammell
- Department of Occupational Science and Occupational Therapy; Faculty of Medicine; University of British Columbia; Vancouver British Columbia Canada
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