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PubMed2004

Occupational justice and client-centred practice: a dialogue in progress.

BACKGROUND: This paper describes an ongoing, international dialogue about the relationship between occupation, justice, and client-centred practice, prompted by the question: How do occupational therapists work for justice? METHODS: The authors critically reflect on their own dialogue and culturally situated interests, dialogues with workshop participants, and a literature review. RESULTS: Four cases of occupational injustice are proposed: occupational alienation, occupational deprivation, occupational marginalization, and occupational imbalance. The naming of these occupational injustices suggests four occupational rights: to experience meaning and enrichment in one's occupations; to participate in a range of occupations for health and social inclusion; to make choices and share decision-making power in daily life; and to receive equal privileges for diverse participation in occupations. PRACTICE IMPLICATIONS: Since silence implies compliance with the status quo, the authors encourage occupational therapists to develop their own dialogue about occupational injustices in order to address them openly with others. Dialogue about occupational justice is timely as occupational therapists around the world articulate what distinguishes this numerically small, rather invisible profession and its contributions to individuals, populations, and societies.

Canada↗
PubMed1987

The recruitment of occupational therapy students: a national survey.

This national survey was designed to study selected characteristics of entry level occupational therapy students and to compare recruitment variables in technical and professional students. The survey encompassed 116 programs with 1,843 students responding. Major findings include the following: the median age of professional students was 1 to 2 years older than that of technical students; the technical students had the larger percentage of older students; professional level students chose occupational therapy at an earlier age than did technical students; the majority of minority students were enrolled in technical programs; and students' initial exposure to occupational therapy differed between the technical and professional students: Technical students reported that their earliest contacts with the profession most often came from family friends, college and junior college contacts, high school counselors, and occupational therapy students, in that order. Professional level students reported that their most common initial contact came from occupational therapy students, family friends, parents, a volunteer or employment experience in the field, or health personnel in the field, in that order. Survey data form the basis for a discussion of potential expansion of recruitment strategies.

Adult↗
PubMed1991

Providing access to blacks and Hispanics in dietetics education.

To increase the number of blacks and Hispanics in dietetics and three other health professions, the Health Sciences Recruitment and Retention Program was developed and implemented in 1985 by the College of Health at Florida International University in Miami. The coordinated undergraduate program assisted in a federal grant to accomplish the objectives of recruiting and retaining minority students. High school and community college students were recruited using a slide/tape presentation featuring black and Hispanic professionals. In addition, the college offered a summer course entitled "Perspectives of the Health Sciences Professions" to students entering their senior year in high school. In this course, students learned how dietitians, medical laboratory scientists, and physical and occupational therapists treat various disease states. Field trips and site visits provided additional exposure to the professions. A summer orientation and tutorial program was established to retain minority students enrolled in the coordinated undergraduate program. We recommend that this program be considered as a model for dietetics educators to use in developing other programs to increase the number of minorities in the profession.

Black or African American↗
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↗
PubMed1999

Occupational health practice in New Zealand.

On the basis of the national un-funded liability for work injuries and illnesses, and comparisons of health outcome and cost data to a benchmark, it can be concluded that occupational health practice in New Zealand is deficient. This deficiency persists despite recent legislative reforms and is due to a combination of Accident Rehabilitation and Compensation Insurance Corporation, health professional and industrial factors. It is clear that a comprehensive corrective strategy is needed to attend to: the up-skilling of health case managers and the medical profession in concert; and, to encouraging employers to introduce comprehensive occupational health programmes.

Benchmarking↗
PubMedDate not supplied

Women in the labor force.

Unlike the rate for men, the labor force participation rate for women has increased significantly over the past three decades or so. This trend is expected to continue at least through 2005. Among the reasons for the growing role of women in the labor market are higher levels of educational attainment, improved employment opportunities, changing values in society, and economic pressures and aspirations that require women to assume dual careers as homemakers and family income producers. By the year 2005, it is estimated that women workers will number about 72 million, with more than 63 percent of all women age 16 and over either working or actively looking for work. While traditional occupations such as secretarial and clerical administrative support and professions such as nursing and teaching still predominate, about 4 million women are now in executive, administrative and managerial positions in the private sectors of the economy. As for the types of industry in which women are employed, service industries clearly predominate. Projections suggest that women workers of the future will be older on average, with the fastest growth occurring in the 45-64 age cohort. They will also be a more diverse group as the number of black, Asian and Hispanic women workers grows more rapidly than the number of white non-Hispanic labor force participants.

Adult↗
PubMed2004

Psychiatric occupational therapy service--quality assurance.

During the last few decades, quality assurance has been a central issue in the societies, both in, for example the industrial area and in healthcare. It is a tool to measure the outcomes of product or service provided. A review of the literature during the last 17 years with respect to quality assurance work in psychiatric occupational therapy indicates that few articles have been published in the area and that their scientific quality is questionable. The studies show many methodological shortcomings, which result in difficulty drawing any conclusion from the studies. The number of publications is also decreasing. Furthermore, a survey to investigate quality assurance work in psychiatric occupational therapy service shows that the occupational therapists do not work with quality assurance methods to a great extent. The methods they use most are interviews with patients and patient questionnaire. Both these methods require documentation in order to offer the patient a suitable service. Quality assurance work will be difficult to implement if no documentation is available. Documentation is central to communicating with other professions and with the client. This study points out that occupational therapists need to improve practice as well as research concerning quality assurance in order to ensure that they offer the patient a high-quality service.

Documentation↗
PubMed1987

Gender bias in an occupational therapy text.

Willard and Spackman's Occupational Therapy does not create an awareness and understanding of the role of women in the field of occupational therapy. Nor does the text include general policy statements or reflections on how gender bias affects our work. What is our true consciousness as women therapists? Maria Mies (1983) wrote that women consent to their own oppression or subordination through silence. "Only when there is a rupture in the 'normal' life of a woman, a divorce, an end of a relationship, is there a chance for her to become conscious of her true condition which had been unconsciously submerged in a patriarchal system" (p. 125). True consciousness occurs in occupational therapy when practitioners avoid the use of activities or occupation in therapy. This is our "rupture". I believe the profession needs to develop a policy statement discussing gender concerns in our theory and practice linked to the progress made by women scientists in anthropology, psychology, sociology, history, and literature. It is critical to good treatment that the gender role factor be included in our research on the generic impact of activity on the individual and small group. As female occupational therapists we have the opportunity to make a significant imprint on a gender-based understanding of the health value of activities in our daily lives.

Books↗
PubMed1988

Allied health applicant pools and employment opportunities--1987.

This study sought information relative to student capacity and enrollment, quality of applicants, numbers in the applicant pool, and program directors' estimates of the job market and salaries, as well as overall impressions of their respective professions in six allied health disciplines: medical technology, physical therapy, radiologic technology, occupational therapy, dietetics/nutrition, and medical record administration. Of 105 four-year colleges and universities surveyed, 252 programmatic responses were received from 83 institutions (79% response rate). Generally, the status of these six allied health professions appeared very good, with a 2 to 1 overall ratio of applicants to graduates, and an almost 6 to 1 ratio in physical therapy. The average GPA for incoming allied health students was 3.01. Job opportunities were considered plentiful, and 93% of program directors rated the overall outlook for their respective professions as good to excellent. However, there were four areas that program officials may wish to examine more closely: excessive length of some professional programs, numbers of minorities in the institutions surveyed, entry-level salaries for several professions, and a somewhat less positive atmosphere in medical technology as compared to the other five disciplines.

Allied Health Personnel↗
PubMed1992

Medicine and the health professions: issues of dominance, autonomy and authority.

Medical dominance of health care has traditionally been the organising principle in health care delivery. Medical power is manifested through the professional autonomy of doctors, through their pivotal role in the economics of health services, through dominance over allied health occupational groups, through administrative influence, and through the collective influence of medical associations. Using Friedson's four factor definition of medical dominance, a structured interview schedule was developed to examine one aspect of medical dominance, that is, doctors' control over the allied health professions. Ninety interviews were carried out with a sample of nurses, physiotherapists, occupational therapists, speech pathologists and psychologists working in various health care settings in metropolitan Sydney, seeking their perceptions on the way in which the medical profession interacts with their occupational group. The findings indicate that a significant proportion (73%) of health professionals did not feel regarded as professional equals by doctors. Nor did they feel that doctors had an adequate knowledge and understanding of their professions (73%). However, the majority (74%) felt that they had sufficient autonomy and were able to discuss doctors' instructions and offer advice or suggestions to doctors. Length of service significantly contributed to perceptions of professional autonomy amongst allied health professionals. These results support the view that the increased autonomy of the allied health professions has not impinged on medical dominance in the health care delivery system. Recommendations for further research and the training of medical and allied health professionals are made.

Allied Health Personnel↗
PubMed1992

Environmental hazards and public health: lessons for the practice of medicine and for public policy.

The separation of occupational and environmental disease from the mainstream of medical practice has deep roots in the culture of the profession. Medical practice centered on individual patient care as nineteenth-century science yielded the therapeutic triumphs of the twentieth century. Social issues seemed remote to medical practitioners as the rewards of scientifically based therapies upstaged the unglamorous aspects of preventive medicine. Public health was left to politicians and bureaucrats. Victorian ambivalence toward the less successful members of society reinforced the isolation of medicine from public policy. As a consequence, physicians are largely ignored in contemporary debates about environmental hazards, to the detriment of both society and the profession.

Environmental Exposure↗
PubMed2002

Communication. Improving RNs' organizational and professional identification in managed care hospitals.

Nurse administrators are searching for an expanded repertoire of strategies to attract and retain qualified nursing staff in today's managed care environment. This study examined hospital registered nurses' interpretations of managed care and the effects of those views on nurses' identification with their employing organization and the nursing profession. Findings show that nurses held greater identification with their occupation than their organization. Significant factors influencing nurses' attachment to both of these reference groups included uncertainty about managed care changes, information received about managed care changes, and effects of managed care on the nursing role. Communication principles and strategies are presented to nurse leaders for use in fostering a stronger organizational affiliation among staff nurses while maintaining a strong identification with the nursing profession.

Attitude of Health Personnel↗
PubMed1990

[Psychological adaptation of older workers to occupational conditions].

As a result of ergometric investigation of labour activity of 187 workers of mass professions (machine-operators, metal craftsmen, fitters), involved in physical labour of medium heaviness, the following age patterns in behavioral self-regulation of activity were detected in people of 20-79 years of age: reduction of the occupation in the major jobs and increase in the occupation in the auxiliary, less tense jobs, decrease in the density of work time, changing in the activity strategy, reduction of the duration of continuous work and increase of the duration of the subsequent rest, dividing of the alloted volume of work into parts. Physiological rationalization of labour of older workers based on the established patterns of their behavioral adaptation to labour is a sufficiently effective measure for labour rehabilitation and lengthening of the period of active life.

Adaptation, Psychological↗
PubMed2003

[Research in occupational therapy: postgraduate training program in Brazil].

BACKGROUND: This paper presents an analysis of the postgraduate training process of occupational therapists in Brazil. It also describes a study of the training process' impact on the areas of research, teaching, clinical work and on the professional profile of these occupational therapists. METHOD: In order to obtain information regarding the choices made by the occupational therapists enrolled in a postgraduate program, a questionnaire was mailed to all occupational therapy educators in Brazil. RESULTS: From the data, it was possible to identify the reasons for their choices, the expectations of the professionals towards the training, the perspectives of the profession and the impact of the training on the profiles of the occupational therapy students and future professionals in this field. PRACTICE IMPLICATIONS: The results of the analysis should lead to the implementation of a national postgraduate program designed for occupational therapists.

Brazil↗
PubMedDate not supplied

Occupational therapy's dance with diversity.

As the demographics of the United States continue to change and we become a more pluralistic society, the increased diversity of the occupational therapy workforce and our consumers calls for an examination of the profession's stance on multiculturalism and diversity. Using the metaphor of dance, this article identifies the dance partners as the organization's leaders and its members. A historical review of the profession from the 1940s to the present traces the partners' steps to determine which led the dance of diversity during the profession's development. In this review, I discovered that the period when the profession most effectively and productively explored issues of diversity was during the early- to mid-1990s--a time when the organization and its members worked in harmony. At that time, occupational therapy's dance with diversity flowed with rhythm and synchronicity.

Cultural Diversity↗
PubMed1986

[Analysis of the risk of backache in the occupational environment].

In a cross-sectional, and one year retrospective study low back pain risk was analysed in a sample of 1812 subjects stratified by five professions: nurses, industrial workers, truck drivers, construction workers and white collar workers. Data were collected by occupational physicians during annual systematic examinations. Relative risks were significantly higher in nurses and industrial worker occupations than in the control group of white collar employees. Multivariate analysis points out that heavy or light handling, bad postures, non-sitting jobs and exposure to vibration or inclemency are the prevalent occupational factors of low back pain. Housekeeping among females and gardening or odd jobs in males are less but significant extra-professional factors. Prevention should include instruction in lifting techniques and improvement in work conditions.

Adult↗
PubMedDate not supplied

Health reform, professional identity and occupational sub-cultures: the changing interprofessional relations between doctors and nurses.

Recent literature on health reform describes advantages of a collaborative approach to the management of health organizations. However, it is important for the managers of health organizations, including nurse managers, to understand that occupational groups adapt to organizational change and policy reform in different ways. These differences to change may have an effect on health reform initiatives, in particular, by potentially limiting the development of collaboration, team work and inter-professional practice. This paper presents fieldwork from a study on health reform and professional identities. Data from focus group discussions are used to discuss the dynamics of reform, the tensions between occupational subcultures and the organization, and changing relations within and between diverse occupational and professional groups. As opposed to much of the literature on professional identity, data for this research suggests that professional identities are changing under the strain of environmental changes to the health system, and associated cultural changes. Professions are not static. In addition, this research found that cultural differences are not limited to occupational groups of doctors, nurses and others, and include differentiation within the medical profession that is based upon specialization, generation, educational background, employment status and feelings of [non]association with the organization. These differences have resulted in cultural ambiguity of sustained and non-sustained fragmentation of occupational and professional groupings that, if not fully understood, are potentially complicating the implementation of change.

Attitude of Health Personnel↗