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PubMed2004

Dimensions of meaning in the occupations of daily life.

BACKGROUND: According to the existential philosophers, meaning, purpose and choice are necessary for quality of life. Qualitative researchers exploring the perspectives of people who have experienced health crises have also identified the need for meaning, purpose and choice following life disruptions. Although espousing the importance of meaning in occupation, occupational therapy theory has been primarily preoccupied with purposeful occupations and thus appears inadequate to address issues of meaning within people's lives. PURPOSE: This paper proposes that the fundamental orientation of occupational therapy should be the contributions that occupation makes to meaning in people's lives, furthering the suggestion that occupation might be viewed as comprising dimensions of meaning: doing, being, belonging and becoming. Drawing upon perspectives and research from philosophers, social scientists and occupational therapists, this paper will argue for a renewed understanding of occupation in terms of dimensions of meaning rather than as divisible activities of self-care, productivity and leisure. PRACTICE IMPLICATIONS: Focusing on meaningful, rather than purposeful occupations more closely aligns the profession with its espoused aspiration to enable the enhancement of quality of life.

Disease↗

PubMed1992

Occupational therapists in private practice.

Although increasing numbers of occupational therapists are choosing to work in private practice, little data exist describing this sector of the profession. In the present study, experienced occupational therapists were asked about their moves into private practice, including (a) their motivation, (b) their preparation, and (c) their perceptions of the move's risks and benefits before and after the move. A survey was sent to a national random sample of 105 occupational therapists, 74 of whom responded. According to the survey, autonomy was the most important motivating factor for occupational therapists moving into private practice. However, once they were in private practice, the occupational therapists noted that increased income was a major benefit. These occupational therapists had planned for the risks of reimbursement, referral sources, and overhead but had not anticipated problems with staffing shortages. Incomes increased for occupational therapists who moved into private practice. The survey compared the incomes of occupational therapists before and after they entered private practice. It also compared their income and educational levels. Other comparisons included income and work experience, income and work role, and income and geographic location. Autonomy and financial considerations appear to be the overriding issues for occupational therapists choosing careers in private practice. Almost unanimously, the survey respondents said that private practice was a good career choice.

Adult↗

PubMed1993

Occupation as a risk identifier for breast cancer.

OBJECTIVES: Breast cancer mortality may be reduced if the disease is detected early through targeted screening programs. Current screening guidelines are based solely on a woman's age. Because working populations are accessible for intervention, occupational identification may be a way of helping to define and locate risk groups and target prevention. METHODS: We used a database consisting of 2.9 million occupationally coded death certificates collected from 23 states between 1979 and 1987 to calculate age-adjusted, race-specific proportionate mortality ratios for breast cancer according to occupation. We performed case-control analyses on occupational groups and on stratifications within the teaching profession. RESULTS: We found a number of significant associations between occupation and frequency of breast cancer. For example, white female professional, managerial, and clerical workers all had high proportions of breast cancer death. High rates of breast cancer in teachers were found in both proportionate mortality ratio and case-control analyses. CONCLUSIONS: These findings may serve as in an aid in the effective targeting of work-site health promotion programs. They suggest that occupationally coded mortality data can be a useful adjunct in the difficult task of identifying groups at risk of preventable disease.

Adult↗

PubMed1985

Professions as the conscience of society.

Ethics is no less of a science than any other. It has its roots in conflicts of interest between human beings, and in their conflicting urges to behave either selfishly or altruistically. Resolving such conflicts leads to the specification of rules of conduct, often expressed in terms of rights and duties. In the special case of professional ethics, the paramount rule of conduct is altruism in the service of a 'noble' cause, and this distinguishes true professions from other trades or occupations. If professional ethics come into conflict with national laws, the professional today can test the legitimacy of such laws by reference to internationally agreed legal standards in the field of human rights, and so help to perform the role of 'professions as the conscience of society'.

Codes of Ethics↗

PubMed1997

Venous insufficiency in male workers with a standing profession. Part 1: epidemiology.

BACKGROUND: Chronic venous insufficiency (CVI) in the occupational population is often poorly recognized. The dimensions of this problem have never been thoroughly investigated in the Netherlands. OBJECTIVE: To study the epidemiology and risk factors of CVI in males with a standing position at work. To develop a simple diagnostic instrument for screening an (occupational) population for CVI. METHODS: 387 male workers with a standing profession were examined by means of a questionnaire, physical examination, Doppler ultrasound investigation, light reflection rheography and optical leg volume measurements. RESULTS: CVI was present in 29% of the subjects and correlated with age, weight and duration of standing work. Complaints of the legs were reported by 81% of the individuals with CVI but also by 63% of the persons without CVI. The questionnaire had a predictive value of 80% in detecting CVI. CONCLUSION: CVI was a major problem because of the quantity (29%) and the accompanying complaints. Neither the questionnaire nor other investigative measures proved to be as efficient in diagnosing CVI as physical examination in combination with Doppler ultrasound investigation.

Adolescent↗

PubMed1987

Occupational health nursing as a component of baccalaureate nursing education.

Much can be gained by the nursing profession and by society by having well-prepared, professional occupational health nurses. Furthermore, conceptual knowledge about occupational health will better prepare the non-specialized nurse for her or his nursing practice. Lastly, knowledge about the hazards and risks that may accompany one's occupation will increase the nurse's awareness of the hazards that she/he may face in her/his own occupational setting. For these reasons the incorporation of occupational health content in the baccalaureate nursing programs would be a singular achievement for the nursing profession. It is clear that work-related injuries and illnesses pose a major challenge to today's health care providers. Most occupational health problems are preventable. It is fitting and indeed imperative that members of the nursing profession be leaders in a concerted effort to reduce the many risks in the workplace. The U.S. Public Health Service (1983) states that it is their goal that "by 1990 at least 70% of primary health care providers should routinely elicit occupational health exposures as part of the patient (health) history and should know how to interpret the information in an understandable manner." It is only through the introduction of important occupational health concepts in baccalaureate schools of education that this goal will be accomplished. Knowledge about occupational health nursing is fragmented. Furthermore, an occupational health curriculum, when it does exist, is varied in its content and its emphasis. this stems in part from a dearth of knowledge and experience by educators in the field of occupational health.(ABSTRACT TRUNCATED AT 250 WORDS)

Curriculum↗

PubMed1992

Antineoplastic drug handling protection after OSHA guidelines. Comparison by profession, handling activity, and work site.

Although Occupational Safety and Health Administration (OSHA) issued antineoplastic drug handling guidelines in 1986, literature reports indicated that use of protection in the early 1980s did not meet OSHA standards. This study investigated the use of protection by pharmacy and nursing staff in a national sample of facilities participating in the National Surgical Adjuvant Breast and Bowel Project collaborative clinical trials network of the National Cancer Institute. Extent of handling, handling activity, and use of protection are compared by work setting and profession. Use of protection by the study sample in 1988 to 1989 is compared with their past use, with use of protection in previous studies, and with OSHA guidelines. In general, pharmacists are better protected than are nurses, and hospital staff are better protected than staff in outpatient settings who also tend to handle more drugs. Although improving over time, protective garment use does not meet OSHA guidelines, particularly among nurses when administering agents or handling patient excreta.

Antineoplastic Agents↗

PubMedDate not supplied

Occupational non-melanoma skin cancer.

Non-melanoma skin cancer is historically known to be associated with certain professions. Reporting is mandatory in Denmark when occupational exposure is suspected. In a retrospective register-based study of all cases of suspected occupational non-melanoma skin cancer reported to the Directorate of National Labour Inspection and the National Board of Industrial Injuries in Denmark in the period January 1, 1984 to December 31, 1994, we assessed the extent to which occupational exposures today are of importance in the occurrence of non-melanoma skin cancer. A total of 74 individuals (11 women and 63 men) aged 32-82 years (median 58 years) had been reported. Of these, 15 cases (20%) were approved as being occupational, 37 (50%) were rejected and 22 (30%) were either shelved or could not be further clarified. Most commonly approved were exposures such as asphalt, tar, and the like, and ionizing radiation, and localization on the arms or multiple tumours. Unexpected occupational exposure could not be identified but continued reporting is recommended in order to follow this in the future.

Adult↗

PubMed2004

Therapy outcome measures for allied health practitioners in Australia: the AusTOMs.

OBJECTIVE: The aim of this study was to develop a valid and reliable measure of therapy outcome for three allied health professions in Australia: speech pathology, occupational therapy, and physiotherapy. The Australian Therapy Outcome Measures (AusTOMs) enable measurement of the differences in client profiles and patterns of services provision across health care settings. In this paper we describe phase 1 of the study: the development and preliminary validation of the AusTOMs. METHOD: The UK TOMs, developed by Enderby, were scrutinized by the research team. A pilot core scale was developed, based on the structure of the TOM. Focus groups of expert clinicians for each profession, across the state of Victoria in Australia, analysed and refined the scales further. A mail-out survey was then sent to therapists across Australia to assess both face and content validity of the AusTOMs. MAIN RESULTS: A new tool, the AusTOM, was developed and tailored to the needs of each profession, with input from specialist clinicians and allied health researchers. The face and content validity of the new scales were assessed, and good consensus was obtained for the wording and content validity of the scales. The discriminative validity, concurrent validity, and reliability of the tool are now being evaluated. CONCLUSION: We have produced an outcome measure in the Australian context for speech pathology, physiotherapy, and occupational therapy. There are six speech pathology scales, nine physiotherapy scales, and 11 occupational therapy scales in the AusTOMs. A clinician chooses the relevant scale(s) for the client (based on the goals of therapy) and makes a rating across all domains for each scale. Further papers will report on the reliability, validity, and clinical usefulness of the AusTOMs.

Australia↗

PubMed1992

Occupational adaptation: toward a holistic approach for contemporary practice, Part 2.

This paper introduces a practice model based on the occupational adaptation frame of reference (Schkade & Schultz, 1992). The occupational adaptation practice model emphasizes the creation of a therapeutic climate, the use of occupational activity, and the importance of relative mastery. Practice based on occupational adaptation differs from treatment that focuses on acquisition of functional skills because the practice model directs occupational therapy interventions toward the patient's internal processes and how such processes are facilitated to improve occupational functioning. The occupational adaptation practice model is holistic. The patient's occupational environments (as influenced by physical, social, and cultural properties) are as important as the patient's sensorimotor, cognitive, and psychosocial functioning and the patient's experience of personal limitations and potential is validated. The integration of these concepts drives the treatment process. Through a description of treatment with a variety of patients, this paper presents the model's diversity and illustrates the relationship between the concepts. The occupational adaptation practice model reflects the uniqueness of occupational therapy and integrates the profession's historical practice with contemporary interventions and methods.

Activities of Daily Living↗

PubMed1998

A statistical profile of physical therapists, 1980 and 1990.

BACKGROUND AND PURPOSE: To plan for future needs, human resource analysts require demographic data. In this research, US census data were used to develop a profile of physical therapists. SUBJECTS: Data were extracted from the Public Use Microdata Samples of the US censuses of population from 1980 and 1990. Samples of 3,112 physical therapists from 1990 and 1,530 therapists from 1980 were obtained. METHODS: A profile was generated by use of descriptive statistics to examine geographic distribution, social characteristics, employment characteristics, and income. Linear regression was used to determine factors that influence income. RESULTS: During the 1980s, physical therapy demonstrated remarkable growth, with trends in physical therapist location, gender, age, and place of employment. Even as the profession aged, it stayed an occupation composed predominantly of women, but one less concentrated in hospitals. Geographically, physical therapists remained clustered in the Northeast and along the Pacific Coast. Income generated by physical therapists was predicted by social and geographic characteristics. CONCLUSION AND DISCUSSION: This study presents a new data source to examine physical therapist characteristics. It provides information necessary for health care planners and analysts to better understand the nature of the profession and those who practice.

Adult↗

PubMed1976

Accreditation of occupational health programs: development and validation of criteria.

Defined standards and a mechanism for evaluation of performance can help promote new and improve existing occupational health programs. Criteria must be based on sound principles, be comprehensive, discriminating and attainable. They should apply to small and large establishments with varying hazards. A successful program requires a multi-disciplinary effort involving physicians, nurses, industrial hygienists, health physicists, safety professionals, managers, technicians and labor. Assessment by on-site peer review is necessary. The criteria and process for their use must be accepted by the professions, labor and management. The Occupational Health/Safety Programs Accreditation Commission plans to use the document entitled Standards, Interpretations and Audit Criteria for Performance of Occupational Health Programs in its accreditation activities. The development and validation of this document and its use are described.

Accreditation↗

PubMed1985

Sexual identity and anticipated occupation of male and female allied health and medical students.

The general purpose of this study was to help delineate the relationship among sex-stereotypic attributes, gender, and occupational choice in the health professions. Specifically, the study attempted to determine if there were differences in perceptions of sex-stereotypic attributes among four groups of individuals: male medical students, female medical students, male allied health students, and female allied health students. It was found that there were significant differences among the four previously described groups on their sex-role perceptions as measured by the Bem Inventory. This variance can be attributed to the main effect of gender. Occupation was found not to be a significant variable in explaining variance among the four groups on their masculinity, femininity, and androgyny scores. Likewise, androgyny scores did not distinguish individuals in traditional careers from those in non-traditional careers.

Allied Health Personnel↗

PubMed1992

Occupational therapy and education: a shared vision.

This paper describes the visions that the educational progressives and founders of occupational therapy expressed for their respective professions, and it examines the thematic ideas that each held in common. These shared themes centered on humanistic values, a belief in occupation, and the promotion of scientific research. The parallels in thinking found within the two groups are examined, and the possible influence of the progressive education movement on the development of occupational therapy is suggested. This analysis is placed within the context of the progressive period of American history, 1900 to 1920.

Education↗

PubMed1993

A future for occupational health nursing: Part 3.

Ruth Alston's two previous articles have indicated how some of the current developments occurring in the educational provision for nurses and other health and safety practitioners may affect the practice of occupational health nursing. In this final article she asks whether OHNs are able and willing to respond to the challenges facing their profession and survive in increasingly competitive occupational settings.

Economic Competition↗

PubMed1989

[Psychosocial and socio-medical problems in the medical profession].

Under conditions of contemporary highly developed medicine and allied disciplines of the new scientific concept of health care it is essential that doctors and other health workers should be harmoniously developed personalities. One of the main characteristics of such a personality is the overall health potential. Doctors should not only propagate a healthy lifestyle but should in this respect serve as an example. Unfortunately in many instances paradoxical behaviour in relation to their own health is found. The problem of health protection of doctors must be conceived comprehensively not only in conjunction with the general social environment but also in conjunction with his specific working environment. In the contemporary medical literature in the world we encounter in connection with investigations of health protection, and in particular the morbidity of doctors and other health workers, the term morbus medicus. This involves a complicated and specific complex of factors ensuing from the complexity of the medical profession and its risks which does not cause specific but nevertheless increased sequelae in certain areas of morbidity. At present the majority of occupations is associated with neuropsychic stress. In the medical profession neuropsychic stress is much greater than in other occupations. Therefore prevention of negative stress in the medical profession must ensue from an endeavour to neutralize these negative factors - i.e. to create optimal working conditions and optimal interpersonal relations, and from improving the standard of the personality profile of doctors.

Czechoslovakia↗

PubMed1991

Meaning ascribed to major professional concepts: a comparison of occupational therapy students and practitioners in the United States and Israel.

A number of concepts related to human performance, such as occupation, purposeful activity, function, work, doing, and play/leisure, are widely used in occupational therapy. Because these concepts are essential to the profession, we seek to understand their meaning. Many theorists in occupational therapy define and attribute different levels of importance to each of these concepts. The present study examines the professional (student vs. practitioner) and universal (American vs. Israeli) meanings of the six concepts named above. Four statistical methods were used: (a) a multivariate analysis of variance, (b) t tests and a sign test to analyze the Osgood semantic differential, and (c) Individual Differences in Multidimensional Scaling (Carroll & Chang, 1970). The results indicate that the American occupational therapists ascribed higher affective meanings than did all of the other groups to the concepts of purposeful activity, function, doing, and work. No difference was found for occupation and hobby, which rated high for all groups. Differences in the dimensions underlying the concepts between American and Israeli subjects suggest a cultural and linguistic influence on the meaning ascribed to the concepts.

Analysis of Variance↗

PubMed2006

Effects of workplace policy on continuing professional development: the case of occupational therapy in Nova Scotia, Canada.

BACKGROUND: Continuing professional development is essential for professionals to remain competent, and for effective recruitment and retention. PURPOSE: This paper reports a qualitative study of the effects of workplace policy on continuing professional development on a small, dispersed profession in a resource-challenged province, using the case example of occupational therapy in Nova Scotia. METHODS: The study used a multi-methods design, theoretically based on institutional ethnography. Methods were critical appraisal of the literature, interview and focus group data collection with 28 occupational therapists and 4 health services administrators, and a review of workplace policy. RESULTS: The study identified a policy wall. Notable policies were those which defined who is responsible for continuing professional development, and which limited employee benefits and work flexibility options for those with family duties. It appears that a female-dominated profession, such as occupational therapy, may also face gender-based challenges. PRACTICE IMPLICATIONS: Suggestions are offered for workplace policy makers, unions, provincial regulatory organizations, and health professionals. The findings are generally applicable to any small, dispersed health profession operating in resource-challenged conditions.

Anthropology, Cultural↗