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Biomedical subjects

G Kielhofner

Publications and source records attributed to G Kielhofner.

At least 19 recordsLinked to original sources
PubMed2000

Definitions of allied health services in urban community contexts: consumer perspectives.

This study, as part of a larger project designed to increase allied health services to underserved urban community agencies, focussed on understanding how consumers defined the services provided in community agencies. Consumers were asked to describe what they defined as service and what constituted good service provision. Qualitative methods were used to conduct key-informant interviews and focus groups with consumers and staff at six community agencies representing different underserved populations, including ethnic and racial minority groups, the homeless, and individuals with disabilities living in the community. Four major themes emerged across the data: 1) the struggle to maintain a stable life with a chronic illness or disability; 2) services need to help solve life challenges; 3) the challenge of accessing and maintaining services; and 4) the need for a peer community. Data analysis revealed that services are difficult to access within and outside community agencies, services need to address short-term as well as long-term issues, and services in the community are still driven by a professional or expert model despite the availability of peer models. Recommendations for health professionals working in community settings are provided.

Activities of Daily Living↗
PubMed1999

Occupational Case Analysis Interview and Rating Scale. An examination of construct validity.

The Occupational Case Analysis Interview and Rating Scale (OCAIRS) was developed based on the Model of Human Occupation with the intention of assessing patients' occupational adaptation. Several studies examining the quality of this instrument have been completed; however, none have discussed the internal validity of the instrument or the appropriateness of the rating scale. The purpose of this study is to validate the internal validity of the OCAIRS and to test the quality of the rating scale. The results indicate that the OCAIRS is a valid measure of occupational adaptation. Each item was shown to have its own rating scale structure, however, all items together still shared the same five-point rating scale.

Adaptation, Psychological↗
PubMed1998

Meaning and misunderstanding in occupational forms: a study of therapeutic goal setting.

OBJECTIVE: This study examined occupational therapists' use of the occupational form of goal setting as therapy and its impact on clients. METHOD: The study method was qualitative, using participant observation and interviewing as the main source of data. RESULTS: The findings illustrated that therapists work both to give substance to the occupational form and to create the context of an implied narrative that imbues it with particular meanings. Simultaneously, clients' experience of meaning is influenced by a personal volitional narrative. When the two narratives do not coincide, therapists' efforts to maintain the occupational form intensify as they encourage clients toward attitudes and performances that do not resonate with the clients' experience of reality. CONCLUSION: The findings underscore the importance of recognizing that occupational forms are embedded in social processes and perspectives that inevitably come into play when occupational forms are used as therapy.

Adult↗
PubMed1997

Anticipating retirement: the formation of narratives concerning an occupational transition.

OBJECTIVE: This study is the first part of a longitudinal investigation of the retirement process. This stage of the inquiry concerned how older persons anticipate their retirement. METHOD: Thirty-two workers were randomly selected from all workers age 63 years in a suburb of Stockholm. They participated in semistructured interviews about their work and their expectations for retirement. RESULTS: The participants narratives illustrated the complex work of interpreting the past and expected meaning in one's occupational life. The narratives, which anticipated widely different future trajectories, revealed many of the challenges and dilemmas of anticipating retirement and the close association of work experience to expectations for retirement. In particular, the narratives highlighted the participants' concerns about maintaining the quality of experience in activity. The findings also demonstrate the process by which persons anticipate and make choices about life change. CONCLUSIONS: People anticipate retirement through volitional narratives in which they link together past, present, and future. Understanding this volitional process of interpreting, anticipating, and making choices is important to understanding how people adapt to life changes.

Adaptation, Psychological↗
PubMed1996

Metaphor and meaning in a clinical interview.

This study examined the narrative features of 20 life histories gathered from psychiatric patients with the Occupational Performance History Interview. The aim was to identify how narrative features were present in the patient interview responses and to illustrate how such narrative features can be located. We found that the patients organized their interview responses with deep metaphors that served to "emplot," or give meaning to, the life story. This article illustrates how patients used the deep metaphors to both circumscribe and frame possible solutions to the problems in their lives. Deep metaphors are consistent, recurring images of a life story that give coherence to, and aid in, the interpretation of the events of that life. Moreover, we explored how metaphors can be located in patient life histories and their implications for occupational therapy.

Adult↗
PubMed1994

Volition as narrative: understanding motivation in chronic illness.

This paper expands the current concept of volition in the Model of Human Occupation. The present version views personal causation, values, and interests as traits that determine choices to engage in occupations. Through a detailed investigation of the life histories of two persons with psychiatric disorders, this paper illustrates how volition is embedded in a personal narrative. Two features of narratively organized volition are highlighted: (a) how narrative places decisions and actions within a plot, thus giving them meaning in the context of a whole life, and (b) how the personal narrative motivates the person by serving as a context for choosing and action. Thus, the paper illustrates how persons seek to narrate their lives and live their life narratives.

Chronic Disease↗
PubMed1994

Volitional narratives and the meaning of therapy.

OBJECTIVES: Occupational therapy literature has long recognized meaning as central to therapy. By focusing almost exclusively on how the therapy process influences the experience of meaning, the literature has neglected to examine how the patient's experiences before therapy influence the creation of meaning in therapy. METHOD: Building on a previous study of how patients discover and recount the meaning of their own lives in volitional narratives, we investigated the effect of those narratives on the experience of therapy. RESULTS AND CONCLUSION: Our examination of the therapeutic experiences of two patients enrolled in a psychiatric day hospital program reveals how they assigned meaning to therapy as an episode within their larger volitional narrative.

Adult↗
PubMed1989

Research values of occupational and physical therapists.

A national survey was conducted to determine occupational and physical therapists' values toward research. While members of both professions were found to have similar research-related values, therapists identified as researchers held somewhat more positive views of research than did clinicians. The primary differences between clinicians and researchers related to values regarding the relationship between research and professional status, and to the relationship between research and clinical practice.

Adult↗
PubMed1988

Development and investigation of the occupational performance history interview.

This article describes the development of the Occupational Performance History Interview, an instrument designed to gather an accurate and clinically useful history of an individual's work, play, and self-care performance from psychosocially and/or physically disabled adolescents, adults, and older persons. Following the identification and validation of content and the development of format, the instrument was field-tested and revised. An examination of reliability across time and raters indicated that although part of the instrument ratings met or exceeded levels of acceptable stability, further development and testing is indicated.

Adolescent↗
PubMed1986

Examining reliability and validity of the Preschool Play Scale with handicapped children.

This study examined the reliability and validity of the Preschool Play Scale (PPS), a measure of the developmental level of play, on a sample of 60 handicapped children. Results demonstrated acceptable reliability and validity for the scale as a whole. However, the need for some refinement of the scale was revealed by the findings. Categories of play that can be observed only infrequently need to be reconsidered. The data also suggest that the criteria for deciding whether a behavior is absent or whether there was no opportunity to observe the behavior need to be spelled out more clearly for the scale.

Affective Symptoms↗
PubMed1986

The assessment of occupational functioning: a screening tool for use in long-term care.

This paper describes the development of the Assessment of Occupational Functioning (AOF), a screening tool designed to assess the functional capacity of residents in long-term treatment settings who have physical and/or psychiatric problems. The assessment is based on six variables of the Model of Human Occupation. A study of 83 community and institutionalized elderly subjects was conducted to examine the AOF's dimensionality, test-retest reliability, interrater reliability, concurrent validity, and ability to discriminate between healthy and institutionalized adults. Item analysis suggests that ratings tend to correspond with components of the theoretical model. Both test-retest reliability and interrater reliability correlations for total test scores were above accepted minimum levels. Correlations of the screening tool with scores on the Life Satisfaction Index-Z, a concurrent validity measure, yielded positive correlations. Correlations of the screening tool score with another concurrent validity measure, the Geriatric Rating Scale score, yielded mixed results. Discrimination results indicated that the instrument can distinguish between the adaptive performance of normal and institutionalized populations.

Aged↗
PubMed1986

The relationships between volition, activity pattern, and life satisfaction in the elderly.

This study examines the relationships between the volition subsystem, activity pattern, and life satisfaction of 60 elderly individuals. The volition subsystem includes an individual's interests, values, and personal causation. The Occupational Questionnaire (OQ) was developed to measure volition subsystems and activity patterns, and it was pilot tested for reliability and validity. Scores on the OQ were compared with measures of subjects' life satisfaction. Results of the study identified several aspects of the subjects' occupations that were related to their level of life satisfaction. The most important findings were the positive correlations between the degree of interest, value, and personal causation in occupation and life satisfaction. Time spent in work and leisure was found to be correlated more highly with high levels of life satisfaction than was time spent in daily living tasks and rest. Although further verification of these results is needed, these findings indicate that occupational therapists may enhance the life satisfaction of their elderly patients by emphasizing interests, values, personal causation, work, and leisure in their treatment programs.

Aged↗
PubMed1986

Beliefs, perspectives, and activities of psychosocial occupational therapy educators.

This article reports on descriptive survey study designed to provide information on the content of psychosocial occupational therapy courses, the professional beliefs of instructors, and relationships between their beliefs and decisions regarding course content. All currently accredited professional programs were surveyed; the data analysis was based on 64% of these programs. The survey found that despite a prevalent endorsement of occupational behavior theory, teaching practices were eclectic in terms of theoretical and skill emphases. This eclecticism appeared inconsistent with educators' perceptions that a major problem facing practice in mental health is a lack of a unifying theory to define the direction of occupational therapy practice.

Attitude of Health Personnel↗
PubMed1986

The reliability of a historical interview with physically disabled respondents.

This study investigated the reliability of a historical interview with 20 respondents with physical disabilities. An existing interview, the Occupational Role History, was modified and a companion rating scale was developed. Analysis of the test-retest and interrater reliabilities suggest that a stable clinical judgment can be formed from data gathered in a historical interview.

Adolescent↗
PubMed1986

Organized activity and the adaptive status of nursing home residents.

This study examined one aspect of the hypothesis that the environment influences the adaptive status of elderly people. Specifically, it looked at the relationship between the amount of organized activities offered in three nursing homes and 44 residents' perceptions of their roles in the present and future and their future time perspective. No relationship was found between future time perspective and the amount of activity offered; however, positive relationships existed between present and future roles and the amount of activity. The study supports the premise that when activity is available, individuals are likely to form and maintain images of themselves as actively engaging with their environment.

Adaptation, Psychological↗
PubMed1985

The demise of diffidence: an agenda for occupational therapy.

Professionalization of occupational therapy will require a number of activities which have previously not been incorporated systematically into occupational therapists' view of themselves and their professional obligations. This paper presents a conceptualization of professional activities as three layers of necessary labor which include, but go well beyond, clinical practice. The implications of this conceptualization of occupational therapy's necessary activities and related agenda to effect professionalization are discussed. These implications include a need for clarification of the nature of the occupational therapy service, increased clinical and basic research, identification and support for the basic values of the profession, and organization of the knowledge-base of the field around a single unifying concept of occupation.

Canada↗
PubMed1985

An occupational therapy approach to assessing psychiatric patients' adaptive functioning.

This study focused on the relative utility of the model of human occupation for occupational therapy assessment of persons having mental disorders. The organizational status of the human system and its relationship to adaptive level of functioning and degree of symptomatology were examined in a sample of 30 adult psychiatric patients. We used a six-test assessment battery developed for this study, which was based on the model of human occupation, to measure the organizational status of the following components of the human system: locus of control, goals, temporal orientation, interests, roles, and skills. Subtests of the American Association on Mental Deficiency (AAMD) Adoptive Behavior Scale and the Modified Brief Psychiatric Rating Scale were used to measure adaptive level functioning and symptomatology, respectively. When we compared organizational status with psychiatric diagnosis and symptomatology, we found organizational status to be the more significant index of adaptive level of functioning.

Adaptation, Psychological↗