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Human development through occupation: theoretical frameworks in contemporary occupational therapy practice, part 1.

In 1968, the report of a conference sponsored by the American Occupational Therapy Association called for the development of an integrated theory of occupational therapy. A review of the practical problems faced by therapists today, contrasted with major developments in the art and science of the field during the past decade, suggests that this goal has not been attained. However, three major theoretical frameworks for therapy have evolved through the work of Fidler and Mosey, Wilbarger, and Llorens, who participated in the conference on theory. Reilly and associates developed a fourth framework of significance. Through analysis of theoretical constructs, generic concepts that characterize occupational therapy can be identified. Theoretical constructs and research validation of the four approaches to occupational therapy are discussed in this article. A second article to appear in a subsequent issue of AJOT illustrates the use of the four theoretical frameworks to derive a philosophical basis for practice and a model of the practice process called "human development through occupation."

Human Development

[Prognosis of occupational bronchial asthma after change of occupation and elimination of antigen (author's transl)].

In order to eliminate the antigen, 168 patients with metal dust allergy made a complete change of occupation, The number of those who were rehabilitated after change of occupation was in inverse proportion to the duration of exposure to the antigen. Subjects with persistent bronchial asthma showed an increase in the complaints which corresponded to the antigen exposure. So as to be able to detect secondary developments deriving from the allergic changes in the mucous membrane, a few parameters were examined after the change of occupation for their relationship to the duration of exposure. Such relationships were found for secondary inflammatory processes in the airways (detection of pathogenic organisms in the sputum, concomitant sinusitis and pleural residues from inflammatory processes). The duration of exposure to the antigen also affects the frequency of persistently increasing bronchospastic irritability after change of occupation.

Asthma

[Occupational and extra-occupational stresses during pregnancy subjectively assessed by the gravida and their significance in relation to other perinatal risks for the newborn infant].

6780 mothers postpartaly were asked how they assess their occupational employment. We made following groups: the work is physically very strain, middle strain or not strain, the work is mentally very exert, middle exert or not exert. We selected 2/3 or all cases to have high risk in pregnancy or neonatal period. We found statistical coherences between the subjective judgement and the social status. The correlations between the subjective judgement of the occupational employment and the risk factors of the perinatal period were loose. The correlations between the perinatal risk factors and the objective social dates (trade, number of children, age of the mother etc.) are better than between perinatal dates and subjective assessment of their occupational employment by the mother.

Adult

Occupational therapy and occupational medicine-a merger.

A working model for occupational therapy intervention in an industrial setting is presented. The model addresses both preventive and problem-solving aspects of practice. An overview of relevant industrial sociology, a discussion of the model, and implications for the therapist are given as well as the viability and benefits of a merger despite the disparate value systems associated with industry and the health services.

Humans