British Journal of Occupational Therapy

There is an increasing awareness that people with dementia should have their spiritual needs addressed. The aim of this study was to investigate health professionals' understanding of spirituality within dementia care and their perceptions of how patients' spiritual needs are met and by whom. A phenomenological approach was used, with semi-structured interviews undertaken with four nurses, two occupational therapists, two physiotherapists, two doctors and one speech and language therapist (n = 11).

All the health professionals found defining ‘spirituality’ difficult, although common terminology was used. They agreed that spirituality was not solely related to religion. Chaplaincy staff were associated with the provision of spiritual care, but 10 of the health professionals identified themselves as staff who should address such spiritual needs. The majority (n = 10), however, reported a lack of confidence with spiritual care and agreed that training would be valuable.

The findings indicate that all health professionals should address the spiritual needs of patients with dementia. A working definition of ‘spirituality’ is needed and further research is also warranted into the type of training needed by health professionals with regard to the spiritual care of patients.

Older adults with low vision present unique challenges to occupational therapists because they are generally independent in self-care but limited in leisure, productivity and instrumental activities of daily living. This paper presents a review of the needs of older adults with low vision and proposes a model for occupational therapists.

A comprehensive MEDLINE search (1990–2009) of the literature on the interaction between low vision and intrinsic and extrinsic factors was performed. Titles and abstracts were reviewed and all relevant full articles were selected. Additionally, manual searches were conducted of related occupational therapy literature.

The literature review found that low vision rehabilitation focuses on technology and modifying the physical environment, but that there is a great impact on older adults with low vision by intrinsic and extrinsic issues such as cognition, psychology, physiology, spirituality and the social environment. The model proposes expanding occupational therapy with low vision clients to focus comprehensively on participation and integration in the home and community. A sample measurement model for occupational therapy evaluation is provided.

This paper examines the views of staff about the environments of two residential homes: one representative of a homely environment and the other more reminiscent of a hotel. A qualitative study using in-depth semi-structured interviews was conducted with a purposive sample of 21 staff. Emerging themes in the data from the first facility related to kinship, recognition of history, individuality and meaningful relationships in the homely environment. This contrasted with a more conscious awareness of the tone of the second facility, the need for correct behaviours and a bureaucratic organisation in the hotel-like home.

The findings showed that the meanings attached to a residential home and its press for occupational behaviours are shaped by cultural, social and historical experiences. Such meanings are strongly influenced by management, with staff and residents adjusting to expectations as indicated by the social and physical environment. There is very little in the literature that reflects how one should conceptualise a residential home, yet it is the very nature of this perception that is crucial to the development of an atmosphere that indicates expectations for actions – for both staff and residents.

PDOT (Parkinson's Disease Occupational Therapy) was a pilot randomised controlled trial investigating occupational therapy for people with Parkinson's disease (PD) exhibiting difficulties with activities of daily living (ADL). This article describes the process undertaken to design and record the intervention.

Intervention development was informed by the current evidence base and practice consensus. An expert steering group synthesised this information to develop an intervention framework. A recording tool was identified from a previous occupational therapy trial and adopted for PDOT. This was completed for all participants receiving the intervention, capturing the dose and content of therapy delivered.

Nineteen participants received occupational therapy. A mean number of 5.7 visits was delivered over 60.3 days, with the initial visit lasting 60 minutes (median) and subsequent visits lasting 50 minutes (median). The intervention log demonstrated that a large proportion of therapist visits involved equipment provision/environmental adaptation, mobility/transfers/ADL training, review/discussion, and the teaching of techniques/provision of education.

The intervention developed was found to be feasible and acceptable, and the findings of PDOT have been used to inform a phase III rehabilitation trial (PD REHAB). The intervention log has been revised in light of the findings and will be used within this trial.

Professional doctorates in occupational therapy and physiotherapy in the United Kingdom offer a practice-based qualification equivalent in status to a PhD. Their aim is to develop professional practice and contribute to professional knowledge. Two doctorate journeys illustrate how applied research added both to each profession's knowledge base and to practice. Their learning was enhanced by interprofessional peer support. It is argued that the professional doctorate is an attractive option for a senior practitioner in clinical practice, management or higher education who wants to influence practice.