School of Occupational Therapy

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    Feng Shui elements and life areas approach for older persons in a nursing care facility
    (2004-05-31) Sit, William; Reid, Cynthia; Schultz, Sally; Schocken, Monica
    The main purpose of this series of studies is to explore, compare, and apply the Feng Shui approach to older persons in a nursing care facility who often need to adapt to a new environment away from home. This research includes both qualitative and quantitative studies. A questionnaire about the harmony of the residents' environment was established through literature review. interviews, and observations. A correlation between the Occupational Environment Harmony Questionnaire (OEHQ) and a physical symptom inventory was established. The questionnaire was used as a screening tool for measuring imbalance within the occupational environment of the residents in a nursing care facility before the F eng Shui approach was given. The first phase of this research emphasized expanding the knowledge about a subsystem of occupational environment through interviews and observations of the residents in a nursing home. The aim of the study was to explore the phenomena of energy flow within the context of Feng Shui elements and life areas. The results showed the elements and life areas ofFeng Shui were meaningful and important to residents, even though some of them reported a lack of current experience with some elements. The second phase of this study focused on investigating the correlation between the Wahler Physical Symptom Inventory (WPSD and OEHQ, which was created according to Feng Shui life areas and essential themes of the results from the first phase. The results showed a high correlation indicating the residents wbo bad the most symptomatic complaints also had greater imbalance among the Feng Shui elements and life areas. The third phase of this study focused on the clinical practice of a Feng Sbui approach. The aim of this study was to demonstrate how the sensory stimulation modalities according to Feng Simi elements were associated with a decrease of physical symptoms. Residents in the Feng Shui treatment group lessened their perception of physical symptoms significantly more than those in the control group. In summary, the elements and life areas of a Feng Shui approach related to the physical symptoms of the older persons in a nursing care facility.
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    Applying the standards of education of the World Federation of Occupational Therapists to selected occupational therapy educational programs in the United States
    (2007-05) Amerih, Husny
    In higher education, accreditation has been used to maintain the quality of education at universities and their schools by setting standards of education. Both the World Federation of Occupational Therapists and the Accreditation Council of Occupational Therapy Education set standards of occupational therapy (OT) education so that educational programs can graduate practitioners with the needed “tools” for effective practice in OT. To explore the issue of differences and commonalities between the ACOTE and the WFOT standards of education, and how they may affect graduating therapists, three studies were conducted. The first study consisted of a literature review related to: higher education in the United States, occupational therapy standards of education in the US, the World Federation of Occupational Therapists’ standards of education, the cross-countries challenges and adaptation of foreign healthcare workers. The Second Study applied the WFOT Revised Standards of occupational therapy education to a selected sample of OT schools in the US, to investigate to what extent do OT schools in the US meet the WFOT Standards? And to what extent do OT curricula in the US emphasize the substantial knowledge, skills and attitudes outlined in the WFOT Revised Standards? Five OT Schools in the US participated. On average, all the universities covered 87% of the WFOT competencies at the Knowledge, Skills, and Attitude levels, ranging from 77% to 90%. The universities combined coverage to Knowledge was 88%, Skills was 85%, and Attitudes was 80%. The third study explored the challenges and adaptation of occupational therapists who practice in foreign countries; the perceptions of occupational therapists to their readiness to practice OT in a different country. Seven occupational therapists were interviewed. Three main themes emerged from analyzing the interviews, they were: general challenges while working in a foreign country; OT-related challenges; and issues related to occupational therapy education, several subthemes emerged as well. This dissertation contributed to OT literature by comparing standards of education of the ACOTE and the WFOT. Also by bringing attention to the challenges that occupational therapists face when moving to foreign countries and how they adapt to these challenges.
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    A phenomenological exploration of caregivers of children with disabilities: Challenges and adaptation
    (2007-12) Washington, Fermond Leon; Hersch, Gayle Ilene; Candler, Catherine; Schultz, Sally; Penzerro, Rose Marie
    This dissertation is a compilation of three studies related to understanding the caregiver's lived experiences of caring for a child with a disability. The research examined possible associated contextual factors that may lead to child maltreatment. These factors included stress brought on by such things as financial strain, social isolation, and limited education. The purpose of the three interrelated studies was to create an opportunity for a group of caregivers to share their personal perspectives of caring for a child with a disability. In the first study (Chapter Three) seven caregivers of children with moderate to severe disabilities shared their personal perspectives and identified occupational challenges related to their caregiving experiences. Themes that emerged from the data were stress, emotional issues, views on occupation, and adaptation. The purpose of the second study (Chapter Four) was to explore issues caregivers faced when caring for his or her child. In this contextual analysis, the same seven caregivers from the first study completed a questionnaire, were interviewed individually, and assisted the researcher in constructing an ecomap of their current living environment. Content from the interviews was analyzed. Themes that emerged from the data were relationships and context. The third study (Chapter Five) employed a focus group format. The intent of this study was particularly important as it related not only to understanding the caregiver's perspective, but how various challenges often result in increased stress. The same seven caregivers were interviewed using semi-structured open-ended questions. Content from the interviews were analyzed to develop the following prominent themes: images of support, challenges, adaptation, and spirituality. Chapter Six (discussion and implications) explains the significance of this research to occupational therapy in understanding the caregiver's perspective and provides implications for prevention of abuse and neglect of children with disabilities. The results from this research revealed that caregivers of children with disabilities are faced with many challenges and stressors. Increased stress may lead to child abuse and neglect. Further research is needed in occupational therapy on the prevention of child abuse and neglect.
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    Exploration of parent perspectives and adaptation to shaken baby syndrome: An occupational therapy approach
    (2007-12) Poskey, Gail; Hersch, Gayle; Fannin, Ron; Candler, Cathy; Spencer, Jean
    Shaken Baby Syndrome is a violent and deadly form of child abuse. However, it is a preventable tragedy. Infant crying is the major precipitating factor that causes an adult to shake an infant or small child. The purpose of this research was to examine from an occupational therapy perspective current prevention strategies of Shaken Baby Syndrome (SBS) and to explore adaptive strategies used by parents in response to inconsolable infant crying. The first study provided a program evaluation of a parent education class. The parent education class was developed to address infant crying and the dangers of SBS and provided primary prevention for parents and caregivers with infants in a neonatal intensive care unit. The study established that the participants did perceive the class to be an effective method of addressing infant crying and conveying the dangers of SBS. The second study included a qualitative inquiry utilizing a phenomenological tradition to explore the parent's perspective on the lived experience of infant crying. In-depth interviews with six parents who had directly experienced the phenomenon of infant crying were conducted. The themes of: longing for answers, heightened emotions and coping strategies emerged from the data. A discussion of these themes along with clinical implications for practice and future research are presented. Caregiving with an infant is considered a co-occupation, thus the infant and parent's response to infant crying is viewed as a co-occupation. The parent's thoughts, feelings, behaviors and actions in response to infant crying were explored in the third study by using a qualitative research approach of participant observations, a questionnaire and field notes. The results of the analysis identified three major themes: the immediate response to crying, routines, and utilizing movement as a coping strategy. Lastly, Chapter 6 offers a summary of the key findings from the three research studies. This section of the dissertation provides a synthesis of the studies, suggestions for future research, and implications for occupational therapy practice in SBS prevention programs.
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    Creative thinking in schools: Finding the "Just Right" challenge for students
    (SAGE, 2011) Fletcher, Tina
    Spurred on by explosive technological developments and unprecedented access to information, leaders in the fields of business, industry, and education are all calling for creative, innovative workers. In an atmosphere of high-stakes testing and global competitiveness, educators around the world are examining their teaching methods to determine best practices for producing learning environments that develop and nurture creativity, characterized by divergent thinking, innovative solutions to problems, and fresh, new ideas. In light of their responsibilities to teach an ever-expanding knowledge base, how can school personnel also foster creative thinking in students?
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    Predictive effects of malnutrition indicators for morbidity and mortality among blood and marrow transplantation recipients: A retrospective chart review
    (Elsevier, 2011-02) Lecagoonporn, S.; Watson, M.; Popat, U.; Langford, R.; Cesario, Sandra; Young, A.
    The purpose of this study was to identify complications related to the blood and marrow transplantation (BMT) process, the presence of malnutrition among patients who received myeloablative allogeneic BMT, and the predictive effects of malnutrition indicators to the outcomes of BMT. Four research questions related to malnutrition were investigated: (a) malnutrition indicators and outcomes of BMT; (b) body mass index (BMI) and incidences of transplant related mortality; (c) degree of mucositis and its relationship to transplant related infections; and (d) predictive ability of BMI and serum albumin levels and infection incidences during 100 days post BMT. The conceptual framework chosen for this study is based on the pathways of cancer aggression (1977) which demonstrate how cancer interferes with multiple organs and function leading to host depletion, morbidity, and mortality. This study is a retrospective chart review from 110 electronic medical records of patients diagnosed with Acute Myeloid Leukemia (AML) or Myelodysplastic Syndrome (MDS), who received the same regimen of myeloablative, allogeneic BMT from one cancer institution during August 2005 to June 2008. Findings revealed that there were subjects who experienced weight loss (68%) and had hypoalbuminemia (97.3%), indicating malnutrition among 110 post-allogeneic BMT recipients during the 100 days post-BMT. Weight loss was not related to transplant mortality but it significantly contributed to an increase in transplant related infections. Hypoalbuminemia was significantly related to both transplant related mortality and infection especially when serum albumin dropped below 3 gm/dL. The body mass index was not related to transplant related mortality during 100 days post BMT. Although the majority of subjects (71.8%) experienced mucositis to the point that it interfered their eating and swallowing solid food, severity in mucositis did not contribute to transplant related infection. Both BMI and hypoalbuminemia were significant predictors to transplant related infection during 100 days post BMT.
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    Gist-reasoning in adults with traumatic brain injury
    (International Brain Injury Association, 2012) Vas, Asha; Chapman, Sandra B.
    One remarkable capacity of the human brain is its adeptness in extracting ‘gist’ from information that we encounter everyday (Bartlett, 1932, Chapman, Sparks, Levin et al., 2004; Reyna & Brainerd, 1995). Researchers refer to gist as global meanings gleaned from verbal or auditory information (e.g., Kintsch, 1994; vanDijk & Kintsch, 1983). For example, the gist of a movie may include a general sense of the story line or the relation between the key characters and events in the movie. Chapman and colleagues (2004) extend this notion of gist to introduce a construct labeled ‘gist-reasoning’ that denotes the ability to form novel and abstract level meanings than conveyed by the concrete details. That is, gist-reasoning involves combining the explicit input/details of the movie through complex reasoning to construct deeper level interpretations. In essence, gist reasoning is a perfect example of the adage ‘the whole is more than the sum of its parts”. The metric of gist-reasoning has proven sensitive in characterizing deficiencies in abstracting meanings from complex information in adolescents with TBI, who had near normal IQ as compared to their non-injured peers (Chapman, Gamino, Cook et al., 2006). Furthermore, improvements in gist-reasoning ability have been associated with increased performance on measures of immediate memory, working memory, inhibition, and switching (Anand, Chapman, Rackley et al., 2010; Vas, Chapman, Cook et al., 2011). However, training of basic cognitive processes such as memory and attention did not improve higher-level gist-reasoning (Gamino, Chapman, Hull et al., 2010). Thus, gist-reasoning could be best understood as a complex task that is positively associated with cognitive control processes (e.g. working memory, inhibition, switching) and immediate memory.
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    A natural approach in mental health practice: Occupational adaptation revealed
    (Taylor & Francis, 2012-06-08) Adami, Amber M.; Evetts, Cynthia L.
    A single case study of the stories told by one occupational therapist about her clients in mental health settings is presented. Qualitative analysis revealed key concepts of the role of the occupational therapist as defined by occupational adaptation theory, along with unique perspectives of occupational therapy in mental health settings. The outcome of this study is a demonstration of the unique insight occupational therapy brings to addressing client recovery in mental health settings, specifically from an occupational adaptation perspective. This insight should enlighten others as to the necessity of skilled occupational therapy in mental health settings.
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    Literacy and graphic communication: Getting the words out
    (2012-09-04) Fletcher, Tina; Sampson, Mary Beth
    Although it may seem logical to assume that giftedness automatically equates with high academic achievement, research has shown that assumption is not always true especially in areas that deal with the communication of understanding and knowledge of a subject. If problems occur in graphic output venues that include handwriting, intervention programs do not typically meet the unique needs of the gifted learner. Therefore, this article explores ways to enhance the total literacy development of the gifted student through a discussion of varieties of graphic outputs and strategies.
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    Stop waiting and start creating: Service learning with an outpatient bone marrow transplant unit art cart program
    (Association of Schools of Allied Health Professions, 2013) Fletcher, Tina; Bayer, Christina; Bayer, Emily; Gonzales, Jessica; Ralston, Ashley; Yount, Phyllis
    This paper examines how master of occupational therapy students, their occupational therapy instructor, and a community-based licensed clinical social worker collaborated in a service learning art cart program on an outpatient bone marrow transplant unit. As they progressed through the phases of Kolb's model of service learning, occupational therapy students, their occupational therapy instructor, and the licensed clinical social worker were all able to meet mutual goals of serving a unique patient population, increasing knowledge of best practices, and building and fostering university/community relationships.
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    Evaluating the effectiveness of reasoning training in military and civilian chronic traumatic brain injury patients: Study protocol
    (BMC, 2013) Krawczyk, Daniel C.; de la Plata, Carlos Marquez; Schauer, Guido F.; Vas, Asha K.; Keebler, Molly; Tuthill, Stephanie; Gardner, Claire; Jantz, Tiffani; Yu, Weikei; Chapman, Sandra B.
    Background: Individuals who sustain traumatic brain injuries (TBIs) often continue to experience significant impairment of cognitive functions mediated by the prefrontal cortex well into chronic stages of recovery. Traditional brain training programs that focus on improving specific skills fall short of addressing integrative functions that draw upon multiple higher-order processes critical for social and vocational integration. In the current study, we compare the effects of two short-term, intensive, group-based cognitive rehabilitation programs for individuals with chronic TBI. One program emphasizes learning about brain functions and influences on cognition, while the other program adopts a top-down approach to improve abstract reasoning abilities that are largely reliant on the prefrontal cortex. These treatment programs are evaluated in civilian and military veteran TBI populations.
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    International occupational therapists continuing education needs and opportunities: A survey
    (Western Michigan University, 2013) Amerih, Husny
    Occupational therapists (OTs) are expected to maintain up-to-date knowledge and clinical competence by engaging in continuing professional education (CPE). The objective of this research was to obtain information on CPE needs and opportunities in developed and developing countries. A survey was created and emailed to 520 OTs in various countries, asking questions about CPE requirements, opportunities, and the avenues of CPE available to OTs. One hundred-nineteen OTs from 17 different countries responded. Of the 119 OTs, 28 practice in developing countries and 91 practice in developed countries. Thirty-nine percent of the OTs in developing countries stated that they have certain requirements for CPE. In developed countries 73% of the OTs indicated such requirement were necessary to practice. In developed countries 67% of OTs reported that CPE was easily available, whereas in developing countries only 25% of OTs reported that CPE was easily available. Therapists in developed countries are more likely to participate in CPE activities, whereas their counterparts in developing countries are not. International OT stakeholders need to explore avenues to make CPE more available to OTs in developing countries and remote areas.
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    Toward a Classification of Neonatal Brachial Plexus Palsy Intervention
    (Texas Woman s University, 2013-01-01) Shierk, Angela
    This dissertation resulted in a taxonomy-driven classification defining the process of care for patients with neonatal brachial plexus palsy (NBPP) using practice-based evidence (PBE) methodology. The comprehensive taxonomy-driven classification categorized and defined patient characteristics, evaluations, and interventions for patients with NBPP. This dissertation was comprised of three interrelated studies. Based on a retrospective medical record review, study one identified patient characteristics, evaluations, and interventions documented by an interdisciplinary team treating patients with NBPP in a pediatric, orthopedic hospital as a first step toward developing the taxonomy-driven classification. Study one resulted in comprehensive categories of patient characteristics, types of imaging used, and surgical interventions. Study two completed the taxonomy-driven classification by further categorizing and defining evaluation guidelines and therapeutic interventions for patients with NBPP. Study two also developed documentation, based on the classification, for systematic data collection. Study three identified the taxonomy-driven classification as a feasible and reliable method to document the process of care for patients with NBPP in a pediatric, orthopedic hospital setting.
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    Functional improvement in older adults after a falls prevention pilot study
    (Western Michigan University, 2013-02) Chang, Pei-Fei J.; Kuo, Yang-Fang
    Falls are a costly, disabling, and life-threatening risk in the elderly. Improvements in physical function, balance, lower extremity strength, and health-related quality of life are hypothesized to help mitigate fall risk. In this pilot study, six women and men with an average age of 81 years participated in a 6-week exercise and education program created to reduce risk of falls. Evaluations were made at baseline and at 6 weeks on four tests: the Functional Status Questionnaire, the Berg Balance Scale (BBS), the Six-minute Walk Test, and the World Health Organization Quality of Life–BREF 26-question test. Scores indicated significant improvement in functional physical status (activities of daily living), balance, distance walked in 6 min, and quality of life in the physical health domain. The size of this study limits the generalizability of its findings, but its evidence warrants undertaking a larger trial.
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    Using distance education in teaching orthotic fabrication to occupational therapy students
    (Scientific Research, 2013-05-01) Amerih, Husny; Nazzal, Mohammad S.; Elsalloukh, Hassan
    Occupational therapy (OT) education requires educators to provide students with entry level skills in orthotic fabrication. These skills have been taught in a traditional face-to-face classroom and labs. The concept of distance education (DE) has evolved over the years with the advancement of the technology. DE started with print media, radio broadcasting, and progressed to utilizing video conferencing. Currently DE relies heavily on using the internet to deliver quality, cost-effective and convenient education. DE Literature focused on teaching basic knowledge, however, no research was found that compared DE to traditional education in teaching skills or the application of knowledge. This pilot study investigated the effectiveness of using DE pedagogy in teaching OT students the skills of splint making, and to compare effectiveness of DE to that of traditional classroom. Forty OT students participated in the study, they self-selected to be in the experimental, or control group. The experimental group received training on splint making via the Blackboard?, while the control group received similar training the traditional way. The quality of splints was evaluated; Mann-Whitney concluded that the difference between the means of the two groups was no significant, indicating that the quality of the splints were equivalent.
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    Motion tracking and electromyography-assisted identification of mirror hand contributions to functional near-infrared spectroscopy images acquired during a finger-tapping task performed by children with cerebral palsy
    (Society of Photo-optical Instrumentation Engineers (SPIE), 2014) Hervey, Nathan; Khan, Bilal; Shagman, Laura; Tian, Fenghua; Delgado, Mauricio R.; Tulchin-Francis, Kirsten; Shierk, Angela; Roberts, Heather; Smith, Linsley; Roberts, Dahlia; Clegg, Nancy J.; Liu, Hanli; MacFarlane, Duncan; Alexandrakis, George
    Recent studies have demonstrated functional near-infrared spectroscopy (fNIRS) to be a viable and sensitive method for imaging sensorimotor cortex activity in children with cerebral palsy (CP). However, during unilateral finger tapping, children with CP often exhibit unintended motions in the nontapping hand, known as mirror motions, which confuse the interpretation of resulting fNIRS images. This work presents a method for separating some of the mirror motion contributions to fNIRS images and demonstrates its application to fNIRS data from four children with CP performing a finger-tapping task with mirror motions. Finger motion and arm muscle activity were measured simultaneously with fNIRS signals using motion tracking and electromyography (EMG), respectively. Subsequently, subject-specific regressors were created from the motion capture or EMG data and independent component analysis was combined with a general linear model to create an fNIRS image representing activation due to the tapping hand and one image representing activation due to the mirror hand. The proposed method can provide information on how mirror motions contribute to fNIRS images, and in some cases, it helps remove mirror motion contamination from the tapping hand activation images.