Virtual reality in the assessment of selected cognitive function after brain injury.

OBJECTIVE: To assess selected cognitive functions of persons with traumatic brain injury using a computer-simulated virtual reality environment. STUDY DESIGN: A computer-simulated virtual kitchen was used to assess the ability of 30 patients with brain injury and 30 volunteers without brain injury to process and sequence information. The overall assessment score was based on the number of correct responses and the time needed to complete daily living tasks. Identical daily living tasks were tested and scored in participants with and without brain injury. Each subject was evaluated twice within 7 to 10 days. A total of 30 tasks were categorized as follows: information processing, problem solving, logical sequencing, and speed of responding. RESULTS: Persons with brain injuries consistently demonstrated a significant decrease in the ability to process information (P = 0.04-0.01), identify logical sequencing (P = 0.04-0.01), and complete the overall assessment (P < 0.01), compared with volunteers without brain injury. The time needed to process tasks, representing speed of cognitive responding, was also significantly different between the two groups (P < 0.01). CONCLUSION: A computer-generated virtual reality environment represents a reproducible tool to assess selected cognitive functions and can be used as a supplement to traditional rehabilitation assessment in persons with acquired brain injury.

The 1999 Eleanor Clarke Slagle Lecture. Defining lives: occupation as identity: an essay on competence, coherence, and the creation of meaning.

This article presents a view of occupation as the principal means through which people develop and express their personal identities. Based on a review of theory and research, it proposes that identity is instrumental to social life because it provides a context for deriving meaning from daily experiences and interpreting lives over time. The article proposes that identity also provides a framework for goal-setting and motivation. It is asserted that competence in the performance of tasks and occupations contributes to identity-shaping and that the realization of an acceptable identity contributes to coherence and well-being. Within this framework, it is postulated that performance limitations and disfigurement that sometimes result from illness or injury have identity implications that should be recognized by occupational therapy practitioners. By virtue of their expertise in daily living skills, occupational therapy practitioners are well positioned to help address the identity challenges of those whom they serve. In so doing, they make an important contribution to meaning and well-being.

Occupations and well-being: a study of personal projects.

OBJECTIVE: The purpose of this study was to explore the relationship between occupation and subjective well-being (SWB). METHOD: A convenience sample of 120 adults completed a personal projects analysis, a method of rating their current goal-directed pursuits. They also completed measures of SWB (Affect Balance Scale, Life Satisfaction Index Form A) and personality traits (Myers-Briggs Personality Inventory). Characteristics of personal projects were correlated with SWB scores. Multiple regression analysis was used to investigate possible predictors of well-being from among the characteristics of personal projects, personality traits, and demographic variables. RESULTS: The stress associated with personal projects was significantly and inversely correlated with well-being, as was project difficulty. Perceived progress in completing projects was significantly positively correlated with well-being. The strongest predictors for well-being were the composite project factors of stress and efficacy. Two personality traits, sensing and extraversion, interacted with the project dimension of stress to emerge as significant predictors of well-being. Together, these four variables explained 42% of the variance in well-being scores. CONCLUSION: These findings are consistent with assumptions that attributes of meaningful occupations are significantly related to people's perceived well-being.

Personal projects: a useful approach to the study of occupation.

A comprehensive and useful understanding of human occupation requires research methods that capture its individual dimensions while permitting analyses within and across groups. In this article we describe the construct of personal projects and the research method of personal projects analysis. Both have their origins in studies of personality and have been used successfully to link individual traits and context-based, goal-directed behavior to well-being and other variables. The appropriateness and relevance of this approach for studies of occupation and occupational therapy are considered.

The scholarly productivity of occupational therapy faculty members: results of a regional study.

A study of the scholarly activities of 66 occupational therapy faculty members at selected academic health centers was conducted through a mailed survey. An analysis of the responses showed that (a) the respondents' primary scholarly activities were reporting research findings in refereed journal articles and presenting papers at professional meetings and (b) only a small percentage of the respondents had directed extramurally funded projects. In addition, the level of scholarly productivity of the occupational therapists was significantly lower than that of their allied health colleagues. The majority of the respondents indicated that their own academic preparation was the primary factor that encouraged their scholarly pursuits and that heavy teaching responsibility was the primary discouraging factor. The respondents indicated also that faculty scholarly activities are, and will continue to be, important considerations in academic promotion decisions.

Cardiopulmonary disease in newborns: a study in continuing medical education.

A film emphasizing the importance of tachypnea as an early manifestation of congenital heart disease was shown to physicians and nurses at 27 hospitals as part of their regular continuing medical education activities. To evaluate the effects of the program, investigators developed a pretest-posttest design which included a nonequivalent control group. Pretest and posttest data were obtained through chart audit of referrals from subjects in experimental and control groups. Dependent variables used to test the hypothesis included the age at which infants were referred and the age at which tachypnea was noted. Analysis of the data yielded significant gain scores for the experimental group, while changes in the control group were not significant. The findings indicate that a need-oriented educational program can have a measurable impact on improving the quality of patient care.

Perceived ability versus actual ability: a problem for continuing medical education.

Physicians attempting to rationally select appropriate Continuing Medical Education programs or conferences to attend are faced with an unending barrage of brochures, letters and other advertisements regarding available CME experiences. If they make their choice on the basis of felt needs rather than convenience, then the accuracy of this perception is of considerable importance.

The effects of a geographic continuing education program on physician referral behavior: an unobtrusive study.

This study reports on an unobtrusive study of changes in physician referral behavior after a need-oriented continuing medical education program.

Measuring empathy in occupational therapy students.

Empathy is one interpersonal skill dimension that contributes to the occupational therapy process. This paper explores the concept of empathy and briefly recapitulates some of the assessment devices used in an attempt to measure the skill. It further describes an investigation involving 23 occupational therapy students in a basic master's program. The students were administered the Hogan Empathy Scale, and scores were correlated with peer and faculty empathy ratings. The results revealed a significant correlation between measured empathy and perceived ability to empathize. Possibilities are discussed for using the Hogan Empathy Scale in occupational therapy education.

Attitudes of graduates toward occupational therapy education.

Recently graduated occupational therapists were surveyed to determine their perceptions of the adequacy of their professional training. Through a mailed questionnaire, therapists evaluated their undergraduate professional preparation based upon their clinical experiences since graduation. Additional suggestions were solicited regarding possible areas of curriculum change, and the survey gave special attention to the area of interpersonal skill development. Responses were examined for areas of commonality and possible use in curriculum planning and modification. Results indicated that recent graduates see a need for more and earlier patient contact, increased attention to the development of administrative and managerial skills, and courses designed to facilitate skills necessary for effective interpersonal relationships.