Biomedical subjects

M B Holm

Publications and source records attributed to M B Holm.

27 records · Page 2Linked to original sources

PubMed1993

American Occupational Therapy Association Accreditation Committee Reliability Study.

The purpose of the study was to augment the previous CAHEA and AOTA Commission on Education validity and reliability studies with a reliability study focused on the accrediting activity processes within AOTA in conjunction with CAHEA. The three objectives of the study were to establish (1) the internal consistency of AC, RAE, and AMA raters; (2) interrater reliability among AC, RAE, and AMA raters; and (3) accuracy of AC, RAE, and AMA raters. Overall, the RAE raters were most internally consistent in their ratings (.94), followed by the AC (.93), and the AMA (.88). Because many of the RAE raters have participated recently in the new AOTA accreditation orientation workshop, it is not unusual that their ratings would have the least variability and be so closely matched to those of the AC raters. On the basis of these results, the raters in this study (44.5% of the total population of raters) could be expected to be highly consistent as they evaluate Essentials that are usually in compliance, many times out of compliance, and those in-between. Interrater reliability among all raters for all five Essentials and all four decision points was established at .93 with percent agreement with absolute concordance. Interrater reliability among AC and RAE raters only achieved .95 percent agreement. As more data were available (i.e., at Decision 3 and Decision 4), rater concordance increased. By Decision 4, the most critical decision point because these data constitute the Report of On-Site Evaluation (ROSE), percent agreement ranged from .83 to .96 for all three rating groups, and .86 to 1.00 for the AC and RAE raters.(ABSTRACT TRUNCATED AT 250 WORDS)

Accreditation↗

PubMed1992

Assistive technology device use in patients with rheumatic disease: a literature review.

Occupational therapists often prescribe assistive technology devices (ATDs) to assist persons with disabilities in performing daily living tasks. Estimates suggest that although most ATDs are used, a substantial proportion are never used or are discarded shortly after they are obtained. A review of the literature on ATDs was carried out to identify factors that contribute to ATD use and disuse. The review focused on persons with osteoarthritis and rheumatoid arthritis, because such persons are frequent users of ATDs. Although the literature review highlighted person-, environment-, and ATD-related factors as relevant to ATD use, it also underscored the dearth of scientific study of the prescription, provision, and use of ATDs. A model is proposed to guide empirical research aimed at identifying non-device users from the outset of treatment so that interventions to improve ATD use may be initiated or alternative interventions implemented. The variables comprising the model pertain to the patient, the patient's living environment, the therapist prescribing the device, and the device itself.

Activities of Daily Living↗

PubMed1991

Occupational therapy diagnostic reasoning: a component of clinical reasoning.

The occupational therapy process involves the assessment and treatment of problems in occupational status. Assessment entails the sensing and defining of patients' problems and is accomplished through diagnosis. As a process, diagnosis involves the creation of a clinical image of the patient through cue acquisition, hypothesis generation, cue interpretation, and hypothesis evaluation. This sequence of cognitive activities is called diagnostic reasoning. As a product, diagnosis summarizes a patient's occupational deficits in terms of occupational role performance, occupational performance, and the components of occupational performance. To serve adequately as a basis for planning intervention, the occupational therapy diagnosis describes the problem, explains the potential cause of the problem, gives the cues whereby the problem is recognized, and names the pathologic agent. Occupational therapy assessment is broader than diagnosis and includes a delineation of the patient's assets as well as deficits. In the resolution of problems in occupational status, assets may be used to offset deficits. The clinical image represents a balanced view of occupational status by reflecting assets and deficits.

Clinical Competence↗

PubMed1983

Video as a medium in occupational therapy.

In 1977, Daniels (18) reported that more than 50 percent of the centers surveyed in her study owned and produced videotapes. Videotape materials considered most vital were about evaluation, treatment, and the occupational therapy process. This article focused on the use of video as a "selected task" for treatment and as an audiovisual record of patient performance. The article was intended to stimulate thinking about the use of video as an effective medium in occupational therapy, and also to suggest several ways video could be used for patient treatment or education. Video has the capability of being the preferred "medium" in many situations because of its familiarity, believability, intimacy, immediacy, cost-effectiveness, availability for use in the home, ability to portray motion, and its proven effectiveness.

Humans↗

PubMedDate not supplied

Development and consumer validation of the Functional Evaluation in a Wheelchair (FEW) instrument.

PURPOSE: The purpose of the study is to develop an outcome measurement tool to investigate functional performance of consumers using seating and wheelchair systems as their primary seating and mobility device. The instrument is undergoing systematic development in three phases. The results of Phase 1 will be reported. METHOD: Manual and power wheelchair users were interviewed using a modified version of a client-centred outcome measure. An item bank was derived based on the interview data. Subjects were then asked to validate item categories of the new instrument, and finally to self-administer the first version of the instrument. RESULTS: Subjects reported 154 self-care, productivity, and leisure occupational performance issues related to their current seating-mobility system. Based on their input, 10 categories (i.e. transfers, reach, accessing task surfaces, transportation-portability, human-machine interface, architectural barriers, transportation-accessibility, transportation-securement, natural barriers and accessories) were validated for inclusion in the new outcome measure, Functional Evaluation in a Wheelchair (FEW). CONCLUSION: The items on the FEW focus on the interaction between the consumer, the technology, and the milieu. Consumers viewed the overall importance of FEW categories for seating-mobility system users differently than when they self-administered the FEW.

Adult↗

PubMedDate not supplied

The use of low-load prolonged stretch devices in rehabilitation programs in the Pacific northwest.

OBJECTIVE: This retrospective study examined the use of low-load prolonged stretch (LLPS) orthoses for contracture management. METHOD: The records of 17 patients from skilled nursing facilities, hand clinics, and hospitals were reviewed. There was a total of 18 contractures (2 wrist, 12 elbow, 4 knee) secondary to neurological and orthopedic pathologies. Chart review focused on patient demographic information, range of motion (ROM) and functional outcomes, and wear schedules. RESULTS: The use of LLPS orthoses significantly increased ROM for the whole sample, which in turn significantly improved the subjects' functional outcomes. When the sample was divided into two pathology groups to compare a predominately geriatric population with neurological pathologies to a somewhat younger population with a history of musculoskeletal pathology, both groups showed a significant gain in ROM with the use of the LLPS orthoses. CONCLUSION: Use of LLPS orthoses for contractive management can mediate the losses in ROM and function that occur with joint contractures.

Adolescent↗

PubMedDate not supplied

Critical pathway development: an integrative literature review.

OBJECTIVE: The purpose of this integrative literature review was to summarize and analyze the methods used to develop critical pathways. METHOD: Relevant articles published in occupational therapy, physical therapy, nursing, and medical journals between 1992 and 1997 were reviewed to extract various methods and the steps or criteria used for each method. RESULTS: Nine approaches to critical pathway development and the steps or criteria involved in each method are presented in tabular format. The most detailed approach was used as a gold standard, and the other approaches were compared to it. CONCLUSION: This review should assist occupational therapy practitioners working with various diagnostic populations to understand the methods used, and steps involved, in the development of critical pathways. It should also serve as a resource for practitioners who have the opportunity to participate in critical pathway development.

Critical Pathways↗

PubMedDate not supplied

Effectiveness of everyday occupations for changing client behaviors in a community living arrangement.

OBJECTIVE: This study examined the effect of three occupations-based interventions for reducing the frequency of dysfunctional behaviors (disruptive vocalizations, distraction of others, withdrawal from appropriate social interactions) in two women with dual (i.e., developmental, psychiatric) conditions. Additionally, the duration of time spent appropriately engaged was examined. METHOD: A single-subject, multiple baseline, across-subjects design, with two dually diagnosed residents in a Community Living Arrangement (CLA), was used to evaluate change in four behaviors under three alternating conditions. Condition 1 was CLA (morning and evening combined) compared with the school and sheltered workshop, Condition 2 was CLA morning, and Condition 3 was CLA evening. Intervention consisted of engagement in everyday occupations associated with the school-workshop and CLA settings as well as a positive reinforcement program. RESULTS: Using occupations-based interventions and a behavior modification program, 5 of 6 behaviors improved significantly in the school-and-workshop setting compared to the CLA, under Condition 1. Under Condition 2, the morning occupations-based intervention in conjunction with positive reinforcement for active participation significantly improved 4 of 6 behaviors for the two residents. Similarly, under Condition 3--the evening occupations-based intervention--4 of the 6 targeted behaviors improved significantly. CONCLUSION: The use of everyday occupations as interventions, in conjunction with positive reinforcement for active participation, was effective for decreasing dysfunctional behaviors and increasing functional behaviors in two women with dual conditions who resided in a CLA.

Adolescent↗

PubMedDate not supplied

The 2000 Eleanor Clarke Slagle Lecture. Our mandate for the new millennium: evidence-based practice.

The health care environment of the past quarter century went through numerous evolutionary processes that affected how occupational therapy services were provided. The last iterations of these processes included requests for the evidence that supported what we were doing. This year's Eleanor Clarke Slagle Lecture (a) examines the strength of the evidence associated with occupational therapy interventions--what we do and how we do it--(b) raises dilemmas we face with our ethical principles when some of our practices are based on limited evidence, and (c) proposes a framework of continued competency to advance the evidence base of occupational therapy practice in the new millennium.

Adult↗