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Foundations of OT (2011) by Mind Map: Foundations of OT (2011)
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Foundations of OT (2011)

3 types of knowledge to support OT practice

Paradigms

New Emerging Paradigm (1980s-today)

Crisis (1970s)

Mechanistic Paradigm (1960s)

Crisis (1950s)

Paradigm of Occupation (1900-1940s)

Moral Treatment (18th-19th centuries)

Conceptual Practice Models

Why use conceptual (theoretical) practice models? Sound philosophical base for the profession Provide link between theory and practice Professional unity and common vocabulary Guidelines for OT in defining and focusing on their areas of interest Framework for assessment, intervention and evaluation.  

PEO

CMOP-E

Kawa

MOHO

PEOP

Ecological Systems Model, Macrosystem, Exosystem, Mesosystem, Microsystem

Related Knowledge

Anatomy

Psychology

Neuroscience

Social Work

General Medicine

PEO Model

Person

Motor

Cognitive

Communication/Interaction

Spirituality

Environment

Physical

Social

Socioeconomic

Cultural

Institutional & Organisational

Occupation

Activities of Daily Living (ADL)/Self Care, Personal Activities of Daily Living (PADL), Instrumental Activities of Daily Living (IADL), Electronic Aids to Daily Living (EADL)

Productivity/Work

Leisure/Play

Occupational Performance

the doing of occupation the outcome of the transaction of the person, the environment and the occupation the ability to choose, organize, and satisfactorily perform meaningful occupations that are culturally defined and age appropriate for looking after one-self, enjoying life, and contributing to the emotional, social and economic fabric of the community    

Occupationl fit

Application Framework

  List the strengths and difficulties individual is experiencing under the three headings of: Person (performance components of motor, process, communication/interaction) Environment (physical, social, socioeconomic, cultural, institutional) Occupation (productivity, self care, leisure) Using these three headings can you list any OT assessments you may have know about? Using these three headings can you list any OT interventions you may know about?  

Canadian Practice Process Framework (CPPF)

Enter/initiate

Set the stage

Assess/evaluate

Agree on objectives

Implement/plan

Monitor/modify

Evaluate outcomes

Conclude/exit

APA Referencing

Reflective Practice

Kolb's Learning Cycle

Active Experimentation

Concrete Experience

Reflective Observation

Abstract Conceptualisation

Strands of Reflection

Factual Strand

Retrospective Strand

Sub-stratum Strand

Connective Strand

Learning & Teaching Strategies

Learning Styles

Active vs Reflective

Sensing vs Intuitive

Visual vs Verbal

Sequential vs Global

Best practices

Teach in presence of natural cues

Instructional aids (behavioural strategies) to assist learning, Discrimination, Generalisation, Shaping, Forward Chain, Reverse Chain, Total Task Chain, Interrupted behaviour, Prompts, Hierarchy, Physical, Modelling, Gestural, Directive (verbal), Non-directive (verbal), Best practices, Start at the bottom of hierachy, System of least prompts, System of prompts and prompt fading, Reinforcement, Natural cues, Primary reinforcement, Secondary reinforcement, Positive/Negative reinforcement

Provide feedback

Errorless learning

More committed. Give lots of prompts in the beginning (start at the top of the prompts ladder). Reduce prompts gradually as learners progress. Errors are avoided or minimized...this approach allows participants to experience success during the learning process Proposes that learning occurring in the absence of errors is stronger and more durable Positive reinforcement    

Assessments

Semi-structured interview

SOLER, Squarely face, Open posture, Lean slightly, Eye contact, Relaxed posture (non-verbal)

Active listening, Joining by preparing, Joining by attending, Following skills, Reflecting skills, Drawing to a conclusion

Open-ended questions

Occupational Story

Narrative process, Restitution narrative, Chaos narrative, Quest narrative

Canadian Occupational Performance Measure (COPM)

Step 1: Identifying occupational performance issues (semi-structured interview), Self-care, Personal care, Functional mobility, Community management, Productivity, Paid/unpaid work, Household management, School, Play, Leisure, Quiet recreation, Active recreation, Socialisation

Step 2: Rate importance for each issue

Step 3: Choose most important items

Step 4: Rate performance and satisfaction

Step 5: Calculate total performance and satisfaction scores

Activity Analysis/Occupational Performance Analysis

Activity summary

Procedural task analysis (Yuen), Identify task, Identify criterion for completion of task, Construct the contents & steps, Validate contents & steps, Tailor for individual needs

Performance skills & Client Factors (PERSON)

Performance Patterns & Contexts (ENVIRONMENT)

Performance Areas (OCCUPATION)

Precautions/Contraindications

Grading and Adapting, Person, Environment, Occupation

Clinical Reasoning

Scientific Reasoning

Diagnostic

Procedural

Narrative Reasoning

Understanding the person. What is it like to have this diagnosis.

Pragmatic Reasoning

Practical issues (e.g. finances, who referred client and why)

Ethical Reasoning

What 'should' be done? What is the right thing to do? (morally defensible actions)

Interactive Reasoning

Ethics

Definitions

House of Professional Practice, Law, Technical Competence, Ethics, Human Rights

Values

Normative Ethics, Deontology (decree), Teleology (outcomes), Virtue Ethics (intentions)

Bioethics

Bioethical Principles

Autonomy

Non-maleficence

Beneficence

Justice

Bioethical rules

Derived from one or more principles (autonomy, non-maleficence, beneficence, justice) but with specific application. Prima facie (interlinked; not one rule takes precedence from another)  

Veracity

Confidentiality

Ethical Grid

Evidence-based Practice

Why evidence-based practice? To help OTs find the most effective interventions (supported by research) by taking into consideration of: best research evidence our clinical expertise and reasoning as OTs client’s unique values and circumstances  

Practice cycle

Identify problem (clinical question)

Gather evidence

Appraise/evaluate evidence

Communicate evidence

Implement and Review

Good sources of evidence

McMaster University (School of Rehabilitation Science)

OT Seeker

Cochrane Collaboration

Types

Research & Clinical Expertise, Levels, Level 1:Randomised controlled trials, Level II-1: Non-randomised trials, Level II-2: Non-randomised trials (with historical or location controls), Level II-3: Case series without controls, Level III: Opinions (authorities, studies, expert committees), Categories, Descriptive, Assessment, Effectiveness, Responsiveness

Clients' beliefs & values

Clients' clinical assessments

Clients' preferences

Client-centered Practice

Person-centered

Person in at the hub Person is regarded as the expert on their lives Not used under the medical model. Person is not necessarily sick or in need of medical attention (e.g. person with a disability like cerebral palsy) Used in the disability area (e.g. Disability Services) Core principles: Listening Sharing power Respinsive action Connecting with citizenship (i.e. rights, self-determination, independence)

Client-centered

  Client is at the hub Client is paying for health care services Often used in the medical model (e.g. hospitals are client or patient centered) Client usually in need of some care or medical attention (more dependent on the service provided). Premise of client centered: people who are in need of medical attention often do better when they collaborate with their healthcare practitioners.  

Therapeutic relationship

Develop rapport

Establish trust

Develop a collaborative partnership

Sustain the therapeutic relationship

Enduring relationship

Best practices

Understand and respect clients and their diversity Collaborate with clients to achieve their occupational goals Use interventions that are supported by research (evidence-based practice)    

Barriers

Clinician barriers Client barriers Client-clinician relationship barriers Context or environmental barriers