British Journal of Occupational Therapy

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Editorial
Restricted accessEditorialFirst published August, 2013pp. 345-345
Occupational Therapy in Europe — ‘Visible and Valued’
Tina Gericke
Research article
Restricted accessResearch articleFirst published August, 2013pp. 346-354
The Elizabeth Casson Memorial Lecture 2013: Transformational Leadership in Occupational Therapy — Delivering Change through Conversations
Elaine P Hunter
Research article
Restricted accessResearch articleFirst published August, 2013pp. 355-361
Does a Structured Gardening Programme Improve Well-Being in Young-Onset Dementia? A Preliminary Study
Peter HewittClaire WattsJacqueline Hussey
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Abstract
Introduction:
Young-onset dementia affects about 1 in 1500 people aged under 65 years in the United Kingdom (UK). It is associated with loss of employment, independence and an increase in psychological distress. This project set out to identify the benefits of a 2 hours per week structured activity programme of gardening for people with young-onset dementia.
Method:
A mixed methods (qualitative and quantitative) study of therapeutic gardening for people with young-onset dementia, measuring outcomes for both participants with young-onset dementia and their carers, was used. Twelve participants were recruited from a county-wide mental health service for older adults, based on onset of dementia being before the age of 65 years (range 43–65 years). Of these, two participants dropped out and one died during the project. Measures included the Mini Mental State Examination (MMSE), Bradford Well-Being Profile, Large Allen Cognitive Level Screen (LACLS) and Pool Activity Level (PAL).
Findings:
Over a 1-year period the carers of the people with young-onset dementia found that the project had given participants a renewed sense of purpose and increased well-being, despite cognitive functioning continuing to decline during this period.
Conclusion:
This study suggests that a meaningful guided activity programme can maintain or improve well-being in the presence of cognitive deterioration.
Research article
Restricted accessResearch articleFirst published August, 2013pp. 362-369
The Social Impact of Living with Developmental Coordination Disorder as a 13-year-old
Sally PayneGillian WardAndrew Turner
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Abstract
Introduction:
Children with developmental coordination disorder are frequently referred to an occupational therapist. However, while there is a growing body of research about developmental coordination disorder, there is a paucity of research from the perspective of adolescents living with the condition.
Purpose:
The purpose of this study was to investigate the experience of teenagers living with developmental coordination disorder from their own perspective. This article presents findings from interviews with teenagers aged 13 years.
Method:
The research adopted an interpretive phenomenological approach. Semi-structured interviews were carried out to examine the personal experiences of six individuals diagnosed with developmental coordination disorder. Interviews were audio-recorded, transcribed and analysed using in-depth ideographic, inductive and interrogative techniques.
Findings:
All participants felt that the visible and hidden effects of their condition had an impact on their relationships with peers and family members. Three sub-themes emerged: (1) relationships with peers; (2) relationships with parents and (3) relationships with siblings.
Conclusion:
Participants described how their personal attributes, shared interests and the attitudes of others affected their relationships and social participation at home, at school and in the community. Understanding the issues that matter to teenagers with developmental coordination disorder will help occupational therapists to offer advice and meaningful interventions that increase teenagers' social confidence and participation.
Abstract
Restricted accessAbstractFirst published August, 2013pp. 369-369
Thesis Abstracts
Review article
Restricted accessReview articleFirst published August, 2013pp. 370-378
The Experience of Engaging in Occupation following Stroke: A Qualitative Meta-Synthesis
Shoshannah WilliamsCarolyn Murray
Abstract
Introduction:
A meta-synthesis is a means of extracting data from multiple qualitative studies about the same topic, re-analysing the findings and bringing them together as a collective whole. Data from six qualitative studies that investigated the experience of engaging in occupation following a stroke were extracted and reanalysed with the purpose of gaining a greater understanding of the subjective experience to inform occupational therapy practice.
Methods:
Six databases were systematically searched for literature published in English during 1990–2011. Seven studies were appraised using the Critical Appraisal Skills Programme tool; six of these were included in the meta-synthesis.
Findings:
Five conceptual themes regarding occupational engagement emerged from the review: an emotional response, impact on identity, role of significant others, community access and the process of occupational adaptation.
Conclusion:
Engagement in occupation following a stroke is linked to self-identity and an emotional response; both of these, in turn, have an impact on capacity for occupational adaptation. Individuals are situated within a context of significant others and community. These findings give occupational therapists greater insight into the experience of older people following stroke in community settings.
Research article
Restricted accessResearch articleFirst published August, 2013pp. 379-383
Managing Waiting Times and Providing Equitable,Family-Centred Care: A Description of Four Key Initiatives from NHS Fife Child Health Occupational Therapy Service (2006–11)
Fiona MillarMaria DohertyGladys Forster
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Abstract
Equity, timeliness and family-centredness are key dimensions of high-quality occupational therapy service delivery. This practice analysis reflects on practice-based initiatives to achieve these.

In 2006, the National Health Service Fife Child Health Occupational Therapy Service, in the United Kingdom, had extensive waiting times, which varied across the region, and high levels of service user dissatisfaction related to these. To address this, the service investigated ways to make better use of the existing resources and adopted the Care Aims framework, culminating in quality improvement initiatives. Key initiatives were: triaging new referrals, health promotion, care agreements with service users and extending the health care support worker's role. The main challenges encountered were staff anxiety and the expectations of both service users and other professionals. Important facilitators were dynamic leadership and well-motivated staff.

Following implementation, waiting times were reduced and are, at the time of writing, consistently less than 12 weeks. Anecdotal evidence suggests that service user satisfaction has improved.
Research article
Restricted accessResearch articleFirst published August, 2013pp. 384-386
Time to Wake Up: Bridging the Gap between Theory and Practice for Sleep in Occupational Therapy
Christina FungCatherine Wiseman-HakesMary Stergiou-Kita
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Abstract
Sleep plays an essential role in physical, cognitive and emotional functioning, and in occupational performance and participation; it is now considered within the scope of occupational therapy practice. However, since sleep is not routinely assessed and addressed in standard practice, a practice gap exists. Interventions are available to optimize sleep and cope with the consequences of sleep disorders, but occupational therapists may overlook the effect of sleep on function, so missing opportunities to provide relevant management strategies. This opinon piece argues the benefits of including sleep within occupational therapy practice and provides suggestions to facilitate its inclusion within practice, education and research.

Volume 76, Issue 8, August 2013