Class 4A OT425 2017
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This document discusses key concepts in occupational therapy including occupation, areas of occupation, and the Occupational Therapy Practice Framework. It defines occupation as everyday activities that are meaningful and purposeful. The framework views people as occupational beings who engage in activities critical to their health, well-being, and social participation. It outlines the domains of occupation including activities of daily living, instrumental activities, rest, education, work, play, and social participation. Performance skills, patterns, context, and environments are described as influences on occupational performance. The overall goal of occupational therapy is supporting health through engagement in meaningful occupations.
Class 4A OT425 2017
- 1. Session 4A
- 2. Engagement Occupation Intervention
- 3. Many occupations are ordinary, part daily living; and are often taken for granted. Occupations can be special when they happen infrequently or when they carry important symbolic meaning.
- 4. OTs base their work on understanding of occupation and its role in health. OTs can know occupation by - • Looking inward – examining its form, function, and meaning • Looking outward – with observation through an “occupational lens”
- 5. Language for Occupational Therapy
- 6. Uniform Terminology for Occupational Therapy
- 7. The Occupational Therapy Practice Framework (OTPF) A “summary of interrelated constructs that define and guide occupational therapy practice” AOTA, 2008, p. 625
- 8. The Occupational Therapy Practice Framework (OTPF) Starts with OCCUPATION
- 10. Occupational Therapy Lingo Domain - The areas in which OT’s have an established body of knowledge and expertise: • Everyday life activities that people find meaningful and purposeful • Defines the focus of OT Process - actions that OT practitioners take when providing services that are client-centered and focused on engagement in occupation • Defines the delivery of OT. • Evaluating + Intervening + Targeting Outcomes Occupation remains central throughout process, with collaboration w/ client in each aspect of service delivery.
- 11. The Occupational Therapy Practice Framework (OTPF) Aspects of Occupational Therapy’s Domain (AOTA, 2008)
- 12. Areas of Occupation 1. Activities of Daily Living (ADL) 2. Instrumental Activities of Daily Living (iADL) 3. Rest and Sleep 4. Education 5. Work 6. Play 7. Leisure 8. Social Participation Aspects of Occupational Therapy’s Domain
- 13. Areas of Occupation: Activities of Daily Living (ADLs) • Bathing & showering • Toileting & toilet hygiene • Dressing • Swallowing/Eating • Feeding • Functional mobility • Personal device care • Personal hygiene & grooming • Sexual activity
- 14. Areas of Occupation: Instrumental Activities of Daily Living (iADLs) • Care of others • Care of pets • Child rearing • Communication management • Driving & Community Mobility • Financial management • Health management & maintenance • Home establishment & management • Meal preparation & cleanup • Religious observance & spiritual activities & expression • Safety & emergency maintenance • Shopping
- 15. Areas of Occupation: Rest and Sleep • Rest • Sleep preparation • Sleep participation
- 16. Areas of Occupation: Education • Formal educational participation • Informal personal educational needs or interests exploration • Informal personal education participation
- 17. Areas of Occupation: Work • Employment interests & pursuits • Employment seeking & acquisition • Job performance • Retirement preparation & adjustment • Volunteer exploration • Volunteer participation
- 18. Areas of Occupation: Play and Leisure • Play exploration • Play participation • Leisure exploration • Leisure participation
- 19. Areas of Occupation: Social participation • Community • Family • Peer & friend
- 20. Occupational Therapy Lingo (con’t) Occupational Performance: A client’s ability to carry out activities of daily living Occupational Choices: The client’s decision to participate in certain occupations Occupations: Everyday things that people do and that are essential to one’s identity The overarching goal of OT is: “supporting health and participation in life through engagement in occupation” (O&H, p. 81).
- 21. Disruption in Occupational Performance Video – “Because of Occupational Therapy” https://www.youtube.com/watch?v=Ud5Fp279g4Y
- 22. Occupational Therapy Lingo (con’t) Client Factors: specific capabilities, characteristics, or beliefs that reside within a person and that often influence and/or are influenced by a person’s engagement in occupation Performance Skills: Goal-directed actions that are observable as small units that play a major role in successful participation in daily life occupations. • Learned and developed over time and are situated in specific contexts and environments • The client’s demonstrated abilities
- 23. Occupational Therapy Lingo (con’t) Performance Patterns: habits, routines, roles, and rituals used in the process of engaging in occupations or activities Environment: • Physical – Natural or man-made surroundings in which daily life occupations occur • Social – Relationships with and expectations of persons, groups, and populations with whom a client has contact Context: Elements within and surrounding a client that are often less tangible than environments but still have a strong influence on performance
- 24. Occupational Therapy Lingo (con’t) Occupational Profile: Summary of a client’s background and experiences, patterns of daily living, interests, values, and needs
- 25. The Occupational Profile • Obtained through interview and conversation with client and/or caregiver(s) • An opportunity to begin to establish a therapeutic relationship • Leads to an individualized approach in the rest of the OT process Next step: The OT reviews the info and develops a working hypothesis about why the problems identified may be occurring.
Editor's Notes
- #2: 9-9:20 Final Era presentation (make-up due to student absence on 2/23) Intro to OTPF Areas of occupation Client factors Perf. Skills Required reading: O&H Ch. 9 and W&S Ch. 19
- #3: This client-centered process is dynamic and interactive in nature. Context is considered as an overarching, embedded influence. Requires understanding occupation and careful analysis of several factors Eval involves careful attn to – Strengths/supports What client wants (needs) to be able to do How personal and contextual factors affect performance (Barriers)
- #4: Occupation is a biological imperative, evident in human evolutionary history current behaviors of primate relatives survival needs are met through occupation Humans also have occupational needs beyond survival
- #5: Specific meaning of an occupation is known only to the individual engaged in the occupation Occupations take place in context, including: time; physical space; past experiences; and social and cultural contexts Person, occupation, and context are inseparable But, contexts may be changeable OT interventions cannot be context free. Categorization of occupations is often problematic - distinction between work and leisure is not always clear Individuals may experience the same occupation in very different ways
- #6: OT uses terminology that has evolved to reflect specific concerns of the profession.
- #7: In 1979 - AOTA developed Uniform Terminology for OT, which provided a unified language for the profession Helped practitioners “speak the same language” Did not provide info on the process of providing occupation-based intervention Revisions: 1989 1994
- #8: In 2002 - AOTA replaced Uniform Terminology for OT with the Occupational Therapy Practice Framework A “summary of interrelated constructs that define and guide OT practice” AOTA, 2008, p. 625 Purpose – Establish common language among OT practitioners Improve standard of communication for what OTs do to the public, as well as to other health care professionals Focus more on occupation-centered practice Guide evaluation, intervention, and outcomes Convey OT’s scope of practice to payer sources, legislative bodies, and licensing boards Align with language used by the World Health Organization (WHO) which had a purpose of shifting the focus from the cause of disability to the impact of the disability (The WHO developed the International Classification of Diagnosis - ICD billing codes – standard diagnostic tool for epidemiology, health management and clinical purposes, commonly used for coding and billing. Current version as of Oct. 2015: ICD-10) The WHO system that classifies health and health-related domains: International Classification of Functioning, Disability, and Health
- #9: What type of approach does the Occupational Therapy Practice Framework use? Top-down OT evaluates areas of performance and occupations in which client hopes to engage first – followed by an analysis of client factors or performance skills interfering with performance. (p. 83)
- #10: The Scope of Practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license. It includes the Domain and the Process of OT services which are intertwined.
- #11: Domain – in general, a specified sphere of activity or knowledge For us – it’s an area “controlled” by OT, the areas in which OT’s have an established body of knowledge and expertise *All aspects of the domain – occupations, client factors, perf skills, perf patterns, and context & environment – are of equal value, and together they interact to affect the client’s occupational identity, health, and participation in life. Within their domain of practice, OTs consider the occupations in which the client engages the performance skills and patterns he uses, the contexts and environments influencing engagement, the features and demands of the activity, and the client’s body functions and structures.
- #12: Five areas across the bottom are “determinants of occupation” – factors that affect/impact occupation: In orange – person (or client) linked determinants In green – environment or activity linked determinants Consequences (outcomes or goals) of OT intervention: Health Well-being Social participation Community integration or engagement Simply put: the goal is to increase ability of client to participate in everyday activities. Eval and intervention may address 1 or more aspect of the domain that influence occupational performance.
- #13: Note: Occupation – life engagements constructed of multiple activities Often shared and done with others. Those that typically involve 2+ people may be termed co-occupations Example: child care
- #14: Aka “BADLs” [basic] Self-care Measurement of a person’s functional status Rehabilitation vs. habilitation
- #15: Not necessary for fundamental functioning – but usually for independent living in a community AOTA has identified 12 types May also be performed as a co-occupation with others
- #20: Susie cleans her hearing aids and replaces the battery. Which answer best describes Susie’s occupation? Personal device care Personal hygiene and grooming Safety and emergency maintenance Communication management Don enjoys biking to work everyday. Which answer best describes Don’s occupation? Leisure participation Safety and emergency maintenance Job performance Driving and community mobility
- #21: Eval OT develops occupational profile, analyzes client’s ability to carry out occupations, and determines client’s occupational needs, problems, and priorities for intervention Intervention = planning and implementing OT services Involves therapeutic use of self, activities, and occupations Considers consultation, education, and advocacy as part of treatment Outcome of OT intervention = determine future actions with the client Include client’s occupational performance, adaptation, health & wellness, participation, prevention, quality of life, role competence, self-advocacy, and occupational justice initiatives
- #22: Worksheet based on characters on video and have students identify which area of occupation has been disrupted https://www.youtube.com/watch?v=Ud5Fp279g4Y
- #23: CF – affected by presence or absence of illness, disease, deprivation, disability, and life experiences May need to be present in whole or in part for a person to complete a skill used in the execution of an occupation Categorized as: Values Beliefs Spirituality Body Functions Body Structures PS – Categorized as: Motor skills Process Skills Social Interaction Skills
- #24: PP – can support or hinder occupational performance Develop over time and are influenced by other aspects of the OT domain Can be related to an individual client, a family or other group, or a community or population Context & environ – often used interchangeably in literature Included in OTPF to show importance of considering the wide array of interrelated variables influencing performance Can serve to support or present barriers
- #25: Provides insight into the client’s perspective and motivations Tells us – Who is the client? Why is he/she seeking services? Concerns relative to engaging in occupations and daily life activities? In what occupations does client feel successful, and what barriers are affecting success? Occupational history (life experiences) Daily life roles Patterns of engagement in occupations – now and in the past Client’s priorities, values, interests and future goals related to occupational performance, prevention, participation, role competence, health and wellness, quality of life, well-being, and occupational justice?
- #26: Reasons could include impairments in client factors, perf skills, and perf patterns or barriers w/I the context and environment OTPF Song: https://m.youtube.com/watch?v=s9xwTMTLpg4 https://prezi.com/ev8q7wfto0ih/otpf-concept-map/