Changing Rooms: the Impact of Adaptations on the Meaning of Home for a Disabled Person and the Role of Occupational Therapists in the Process

Accessible housing is crucial both to enable the implementation of community care and to assist in giving disabled people equal rights to independent living. In order to meet these demands, occupational therapists often play a key role in recommending adaptations to the home environment. Although there can be important benefits in this process, the meaning of home to the disabled person and his or her family can be overlooked and compromised by the changes that occur to it.

It is suggested that in order to redress this balance, the social model of disability should be applied to the assessment process. This would result in a more holistic view of the environmental barriers faced by the disabled person within his or her home and a deeper understanding of the wider meaning of home to the disabled person and the family. The provision of adaptable housing, such as Lifetime homes, is also considered as a way of minimising the need for home adaptations in the longer term. A broader role for the occupational therapist within the framework of the social model is discussed.

Focal Points and Relationships: A Study of Clinical Reasoning

This article reports on a single case study of an occupational therapist working in a plastic surgery unit at an Australian public hospital. A phenomenological approach was used to explore the therapist's clinical reasoning in depth. Data were gathered over a 3–week period through semi-structured interviews with the informant and through participant observation of therapy sessions with patients and associated activities engaged in by the informant. The resulting narrative data were analysed inductively. The focus of this discussion is on the aspects of personal interactions that influence clinical reasoning. The article examines how such constructs as power, responsibility, caring and competence combine to influence clinical reasoning.

Can Disability Studies Contribute to Client-Centred Occupational Therapy Practice?

Occupational therapists frequently cite a ‘client-centred’ approach as a fundamental aspect of their practice. However, there are many examples in the narratives of disabled people that suggest that the health and social care services they experience do not quite meet this aspiration. The authors propose that an understanding of disability from disabled people's perspectives is elemental to client-centred practice and that knowledge of the academic discipline of disability studies can contribute to authentic client-centred occupational therapy.

Understanding ‘Independence’: Perspectives of occupational therapists

PURPOSE

The purpose of this study was to understand how the term independence is used in rehabilitation. In particular, we asked occupational therapists in Canada and Japan to interpret the term independence in terms of people with disabilities. In rehabilitation, independence has long been a key concept. A review of the literature shows that the term's meaning has shifted throughout the past century. However, despite its significance, the word's meaning has never been deeply analysed, and it is left to the interpretation of the individual practitioner; consequently, there is a conceptual confusion surrounding the term. Furthermore, no studies have been conducted from an inter-cultural viewpoint that included non-Western societies.

METHOD

A qualitative interpretive study was conducted, based on semi-structured interviews with 18 occupational therapists. Nine Canadian and nine Japanese therapists were interviewed in depth and their perspectives analysed for themes and categories corresponding to their working definition of independence.

RESULTS

Therapists' interpretation of the term independence consisted of three perspectives: "Independence as competence,""Independence as autonomy," and "Independence as psychological qualities". These perspectives were typically combined into two patterns of dealing with independence in practice. Differences between Canadian and Japanese perspectives were explored.

CONCLUSIONS

The study's findings confirm some ideas about independence that have been pointed out in the professional literature, but they also add several important ideas - the idea of psychological characteristics as key to independence, and the notion of a cultural overlay on the definition and application of the concept independence. This study's findings should contribute to the ongoing discussion in the professional literature about the virtues and limitations of pursuing independence as the ultimate goal in rehabilitation.