Identifying occupational performance issues is an essential component of the occupational therapy process. Little attention has been paid to therapists’ management of this aspect of geriatric practice.
Purpose
This study explored therapists’ approach to identifying occupational performance issues (OPI) with older adults.
Methods
Information gathered from semi-structured interviews was analyzed using Polkinghorne's (1995) analysis of narrative method.
Findings
The study demonstrated how therapists prepare clients to engage in the OPI identification process; use interviewing strategies to build trust; and tap into client narratives to foster hope in occupational possibilities.
Implications
Findings suggest that therapists require a complex set of highly skilled strategies to engage clients in OPI identification through tapping into aspects of the client's motivational influences, occupational histories, therapy expectations, and generational attitudes about aging. Further study is required to identify ways to overcome structural barriers to more occupational and narrative-based approaches to identifying occupational performance issues.
AllshouseK. D. (1993). Treating patients as individuals. In GerteisM., Edgmean-LevitanS., DaleyJ., & DelbancoT. M. (Eds.), Through the patients eyes. Understanding and promoting patient-centered care (pp. 19–44). San Francisco: Jossey-Bass Publishers.
2.
AtchleyR. C. (1999). Continuity and adaptation in aging: Creating positive experiences.Baltimore: Johns Hopkins University Press.
3.
BaileyD. (1997). Research for the health professional: A practical guide (2nd ed.). Philadelphia: F. A. Davis Publishing.
4.
Canadian Association of Occupational Therapists. (2002). Enabling occupation: An occupational therapy perspective (Rev. ed.). Ottawa, ON: CAOT Publications ACE.
5.
CrepeauE., & CohnE. (2009). Narrative as a key to understanding. In CrepeauE. B., CohnE. S., & Boyt SchellB. A. (Eds.), Willard & Spackman's occupational therapy (11th ed., pp. 98–104). Philadelphia: Lippincott Williams & Wilkins.
6.
DeberR. (1994). The patient-physician partnership: Changing roles, and the desire for information. Canadian Medical Association Journal, 151, 171–176.
7.
DugganR. (2005). Reflection as a means to foster client-centred practice. Canadian Journal of Occupational Therapy, 72, 103–112.
8.
EganM., & TownsendE. (2005). Countering disability-related marginalization using three Canadian models. In KronenbergF., AlgadoS. S., & PollardN. (Eds.), Occupational therapy without borders: Learning from the spirit of survivors (pp. 197–212). Edinburgh, UK: Elsevier Churchill Livingstone.
9.
EschenfelderV. (2005). Shaping the goal setting process in occupational therapy. Physical and Occupational Therapy in Geriatrics, 23(4), 67–81.
10.
FearingV. G., & ClarkJ. (2000). Individuals in context: A practical guide to client centred practice.Thorofare, NJ: SLACK, Inc.
11.
FrankG. (1996). Life histories in occupational therapy clinical practice. American Journal of Occupational Therapy, 50, 251–264.
12.
GageM. (2003). Sense of doing- The impact of occupational restoration in the home. OT Now, 5. Retrieved March 5, 2009, from http://www.caot.ca/default.asp?pageid=695.
HobsonS. J. (2006). Client centred practice with older adults. In SumsionT. (Ed.), Client-centred practice in occupational therapy: A guide to implementation (2nd ed., pp. 91–106). London: Elsevier Health Sciences.
15.
IwamaM. (2005). Situated meaning: An issue of culture, inclusion, and occupational therapy. In KronenbergF., AlgadoS. S., & PollardN. (Eds.), Occupational therapy without borders: Learning from the spirit of survivors (pp. 213–231). Edinburgh, UK: Elsevier Churchill Livingstone.
16.
KielhofnerG. (2002). Model of Human Occupation (3rd ed.). Philadelphia: Lippincott Williams & Wilkins.
17.
KielhofnerG., MallinsonT., CrawfordC., NowackM., RigbyM., HenryA. (1997). A user's guide to the Occupational Performance History Interview II (OPHI-II) (version 2.0). Chicago: Model of Human Occupation Clearinghouse, Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago.
18.
KinsellaE. A. (2001). Examining your philosophy of practice: A reflective approach to professional development. OT Now, 3(3), 10–12.
19.
KirshB., TrenthamB., & ColeS. (2006). Diversity in occupational therapy: Experiences of consumers who identify themselves as minority group members. Australian Occupational Therapy Journal, 53, 302–313.
20.
Laliberte-RudmanD. (2006). Positive aging and its implications for occupational possibilities in later life. Canadian Journal of Occupational Therapy, 73, 188–192.
21.
LawM. (2000). Identifying occupational performance issues. In FearingV. G., & ClarkJ., (Eds.). Individuals in context: A practical guide to client centred practice (pp. 31–44). Thorofare, NJ: SLACK, Inc.
22.
LawM., BaptisteS., McCollM. A., OpzoomerA., PolatajkoH., & PollockN. (1990). The Canadian Occupational Performance Measure: An outcome measure for occupational therapy. Canadian Journal of Occupational Therapy, 57, 82–87.
23.
LawM., BaumC., & DunnW. (2005). Measuring occupational performance: Supporting best practice in occupational therapy (2nd ed.). Thorofare, NJ: Slack Inc.
24.
LawM., CooperB., StrongS., RigbyP., & LettsL. (1996). The person-environment-occupation model: A transactive approach to occupational performance, Canadian Journal of Occupational Therapy, 63, 9–23.
25.
LysackC. L., & SeipkeH. L. (2002). Communicating the occupational self: A qualitative study of the oldest-old American women. Scandanavian Journal of Occupational Therapy, 9, 130–139.
26.
MathesonL. N. (1998). Engaging the person in the process: Planning together for occupational therapy intervention. In LawM. (Ed.), Client-centred occupational therapy (pp. 107–122). Thorofare, NJ: Slack.
27.
MattinglyC. (1998). Healing dramas and clinical plots: The narrative structure of experience.Cambridge, UK: Cambridge University Press.
28.
McCollM. (1998). What do we need to know to practice occupational therapy in the community. American Journal of Occupational Therapy, 52, 11–18.
29.
McKinstryB. (2000). Do patients wish to be involved in decision making in the consultation? A cross sectional survey with video vignettes. British Medical Journal, 321, 867–871.
30.
MelvilleL. L., BalticT. A., BettcherT. W., & NelsonD. L. (2002). Patients’ perspectives on the Self-Identified Goals Assessment. American Journal of Occupational Therapy, 56, 650–659.
31.
NeistadtM. E. (1995). Methods of assessing clients’ priorities: A survey of adult physical dysfunction settings. American Journal of Occupational Therapy, 49, 428–436.
32.
PentlandW., & DrummondH. (2004). Coaching: What does it offer you and your clients?OT Now, 6(4), 10–12.
33.
PolatajkoH. J., CraikJ., DavisJ., & TownsendE. A. (2007). Canadian Practice Process Framework. In TownsendE. A., & PolatajkoH. J., Enabling occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation (p. 233). Ottawa, ON: CAOT Publications ACE.
34.
PolkinghorneD. E. (1995). Narrative configuration in qualitative analysis. In HatchA. J. (Ed.), Life history and narrative (1st ed., pp. 5–24). London: Falmer Press.
35.
PollockN., & McCollM.A. (1998). Assessment in client-centred occupational therapy. In LawM. (Ed.), Client-centered occupational therapy (pp. 89–106). Thorofare, NJ: Slack Inc.
36.
RebeiroK. L. (2000). Client perspectives on occupational therapy practice: Are we truly client-centred?Canadian Journal of Occupational Therapy, 67, 7–14.
37.
RestallG., RipatJ., & SternM. (2003). A framework of strategies for client-centred practice. Canadian Journal of Occupational Therapy, 70, 103–112.
38.
SpencerJ., DavidsonH., & WhiteV. (1997). Helping clients develop hopes for the future. American Journal of Occupational Therapy, 51, 191–198.
39.
StadnykR. (2006). Community-dwelling spouses of nursing home residents: Activities that sustain identities in times of transition. Topics in Geriatric Rehabilitation, 22, 283–293.
40.
SternM., RestallG., & RipatJ. (2000). The use of self-reflection to improve client-centred processes. In FearingV., & ClarkJ. (Eds.), Individuals in context: A practical guide to client-centred practice (pp. 145–158). Thorofare, NJ: Slack.
41.
SumsionT. (2005). Facilitating client-centred practice: Insights from clients. Canadian Journal of Occupational Therapy, 72, 13–20.
42.
SumsionT., & LawM. (2006). A review of evidence on the conceptual elements informing client-centred practice. Canadian Journal of Occupational Therapy, 73, 153–162.
43.
SumsionT., & SmythG. (2000). Barriers to client-centredness and their resolution. Canadian Journal of Occupational Therapy, 67, 15–21.
44.
TownsendE. A. (1998). Good intentions overruled: A critique of empowerment in the routine organization of mental health services.Toronto, ON: University of Toronto Press.
45.
TownsendE. A, PolatajkoH. J., CraikJ., & DavisJ. (2007). Canadian Model of Client-centred Enablement. In TownsendE. A., & PolatajkoH. J., Enabling occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation (p. 110). Ottawa, ON: CAOT Publications ACE.
46.
TownsendE. A., TrenthamB., ClarkJ., Dubouloz-WilnerC. J., PentlandW., DobleS. (2007). Enabling individual change. In TownsendE. A., & PolatajkoH. J., Enabling occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation (pp 135–151). Ottawa, ON: CAOT Publications ACE.
