Reconstructing meaning through occupation after the death of a family member: accommodation, assimilation, and continuing bonds.

Reactions to death have been studied extensively from psychological, behavioral, and physiological perspectives. Occupational adaptation to loss has received scant attention. Qualitative research was undertaken to identify and describe occupational responses in bereavement. The constant comparative approach was used to analyze and interpret the occupational responses. Adaptive strategies of occupational accommodation and assimilation were used after the death of a family member. Desire to sustain bonds with the deceased motivated specific occupational engagements. These occupational responses served to reconstruct meaning after the death of a family member. These findings contribute to understanding adaptation after death by adding an occupational perspective to previous theories. Occupational therapists' abilities to support clients after loss can be enhanced through appreciation of occupational accommodation and assimilation and the role of continuing occupational bonds after the death of a loved one.

Lessons in living and dying from my first patient: an autoethnography.

BACKGROUND: This study examines the challenges and rewards of a fieldwork student's first encounter with death in a clinical setting and describes occupational interventions that affirm the life of a client preparing for death. PURPOSE: To explore meanings, challenges, and lessons of end-of-life care for an occupational therapy fieldwork student. METHODS: A qualitative format, autoethnography, was used to develop a narrative that reveals the lived experience of a fieldwork student. FINDINGS. Findings include a description of what a fieldwork student was and was not able to accomplish in end-of-life care. The paper describes using self-care activities to normalize and cede control of end-of-life care to the client and developing a vision of how to help clients find closure. IMPLICATIONS: The study carries implications for students and therapists working in end-of-life care. Therapists and educators can draw from this study to better understand and support new therapists when patients die.

Developing an honor statement for university students in graduate professional programs.

Student and faculty in our graduate professional programs in physical and occupational therapy recently acted on their concerns regarding an upsurge in behaviors that were contrary to those associated with academic integrity (e.g., cheating, plagiarism, etc.). To address this issue, student leaders and faculty members met to consider ideas on how to reverse this negative trend, which ultimately led to the development of an honor statement for the department and establishment of a process for addressing issues related to academic integrity. We used a Delphi method to guide the process of collecting and distilling information, which involved a series of meetings, online surveys, and electronic voting. This article describes the process of formulating and refining that honor statement.

Understanding occupational therapy students' attitudes, intentions, and behaviors regarding community service.

Community-based practice has always been a central domain of occupational therapy, and evidence supporting its increasing importance is growing. Preparing occupational therapy students for community practice has received considerable attention in professional literature, but students' voices have seldom been heard concerning this issue. This study sought to investigate attitudes, intentions, and behaviors regarding community service among occupational therapy students enrolled in one professional program using the Community Service Attitudes Survey. We present the Theory of Planned Behavior as a conceptual framework linking students' attitudes and intentions with behaviors. Results indicate that these occupational therapy students' attitudes and intentions regarding community service tended to be more strongly positive than those of their counterparts in other allied health disciplines; however, the community service behaviors of occupational therapy students were not significantly different from those of other allied health students, possibly because occupational therapy students perceived high costs to community service.

A course in autoethnography: fostering reflective practitioners in occupational therapy.

This paper describes an academic course designed to lay the foundation for reflective practice in occupational therapy. In this course, students conduct highly personalized research based on experiences in Level II fieldwork that leads to writing an autoethnography. The paper describes autoethnography, details its use in occupational therapy literature, and discusses the design and outcomes of the course. Students' experiences with this autobiographical genre of qualitative research are illustrated. In the writing process, students find clinical stories that must be told and learn to "move around" in their stories. The outcomes of the course include integration of personal and professional experiences, closure to academic preparation, and deep reflection about what it means to be an occupational therapist.

Factors associated with college student intent to engage in community service.

Many universities in the United States highlight service as an integral component to their mission. Additionally, a growing pedagogical focus highlights the importance of community service as an integral component of student development. The current study was an investigation of the factors associated with college student intentions to engage in volunteer community service. University students (N = 403) at a comprehensive university located in the southern plains completed an anonymous Web-based questionnaire to assess community service attitudes and intentions. Subsequent to testing for statistical assumptions, results from multiple regression analysis suggest that a sense of community connectedness, cost and benefit considerations, and the seriousness of community needs are significant variables in explaining variance in the intent to engage in community service.

Meanings and purposes of caring for a family member: an autoethnography.

Engagement in two interlinked areas of occupation, familial social participation and caring for my father at the end of his life, led to a journey of self-discovery. A qualitative research methodology, autoethnography, is used to develop a narrative that examines engagement in these two occupations before, during, and after my father's illness and death. I discuss meanings and purposes of familial social participation and caregiving, suggesting that transforming fear of death to awareness of death is a central purpose of caregiving. Implications for therapists and caregivers include considerations about the value of occupation, discussion of a continuum of caregiving, examination of boundaries when caring for a parent, thoughts about the roles of altruism, love, anger, and "bad faith" in caregiving, and analysis of sons as caregivers for fathers. Further research on meanings and purposes of caregiving is proposed.

A service learning is a perfect fit for occupational and physical therapy education.

Service learning provides invaluable contributions to the education of occupational and physical therapy students by allowing them to contribute to the community while simultaneously optimizing their professional preparation. This report explores the application of five principles in occupational and physical therapy service-learning experiences: placement quality, application between classroom and community, reflection, diversity, and listening to the community's voice.

When a child dies the world should stop spinning: an autoethnography exploring the impact of family loss on occupation.

The death of a loved one disrupts family-members' occupational lives. This paper explores the role and course of occupation during a time when my nephew died. A qualitative research methodology, autoethnography, is used to develop the narrative. I found that familiar occupations lost meaning during this time and even seemed absurd. Paradoxically, occupation helped forge a vital pathway back to health and reconstruction of meaning. Four stages of occupation during a family crisis are proposed: maintenance, dissolution, ambivalence, and restoration and adaptation. Reflections on occupational therapists' role during family crises are discussed, as are implications for further research.

Elements of instruction in allied health: do faculty and students value the same things?

The purposes of this study were to determine the importance placed on 15 elements of instruction in allied health by students and faculty and to identify similarities and differences in students' and faculty's views. A total of 145 students and 55 faculty in the College of Allied Health at the University of Oklahoma participated in an on-line survey. Focus groups subsequently were conducted to discuss areas of agreement and disagreement between students and faculty. Four common elements were contained in the top-five list of both groups: (1) the teacher's ability to relate course material to clinical situations, (2) the teacher's communication skills, (3) the teacher's preparation and organization, and (4) the teacher's knowledge of the subject. Five of the 15 items were significantly different: (1) the teachers' friendliness and respect for students, (2) the teacher's ability to motivate students, (3) the teacher's ability to challenge students intellectually, (4) the teacher's encouragement of discussion, and (5) the teacher's ability to use a number of teaching techniques. Results of this study will further understanding between allied health faculty and students concerning similarities and differences in instructional values.

Environmental effects on the assessment of people with dementia: a pilot study.

OBJECTIVE: The purpose of this pilot study was to use a standardized assessment of independent living skills to explore the effects of environment on functional performance of individuals with dementia. METHODS: Twelve participants (6 males, 6 females), diagnosed with dementia, were given the Structured Assessment of Independent Living Skills (SAILS), a standardized assessment of functional motor, cognitive, instrumental, and social performance. Participants were assessed in their homes, in an adult day-services facility they regularly attended, and in an occupational therapy clinic. RESULTS: Data were analyzed using repeated measures analysis of variance (ANOVA). There was no evidence of a learning effect from repeated assessments. Participants' performances did not differ among the home, clinic, and adult day-services settings on the total SAILS score (F = 1.22; df = 2,20; p = 0.3176), nor on three of its subscales: cognitive score (F = 0.80; df = 2,20; p = 0.4648), instrumental activities (F = 1.37; df = 2,20; p = 0.2777), and social interaction (F = 0.34; df = 2,20; p = 0.7147). However, participants' performance on the SAILS motor score was significantly higher in the home than in the clinic (t = 2.925, df = 11, p = 0.0138). CONCLUSION. Participants' motor performance was significantly better at home than in an unfamiliar environment. Effects of environment on motor performance, and absence of effects on cognitive, instrumental, and social performances, can be explained through ecological theory. These results suggest that the ability to adapt movement to an unfamiliar environment may decline with the onset and progression of dementia.

The effects of collaborative goal-focused occupational therapy on self-care skills: a pilot study.

OBJECTIVE: This pilot study examined collaborative, goal-focused therapy to determine its effects on performance of self-care activities, including eating, grooming, bathing, upper body dressing, lower-body dressing, and toileting. METHOD: Thirty-one patients at a rehabilitation hospital, divided between control and experimental groups, comprised the sample. Participants' performances on self-care activities were measured using the Functional Independence Measure (FIM) at admission to therapy and again at a 2-week follow-up. Attainment of goals was not emphasized in the control group. In the experimental group, new goals and achievement of previously set goals were regularly discussed and documented. Comparisons were made between 2-week FIM scores of the control and experimental groups, and data were analyzed by the Mann-Whitney U test. RESULTS: The experimental group demonstrated greater gains on FIM scores when compared to the control group on all self-care activities, but only upper-body dressing met levels of statistical significance. CONCLUSION: Findings support the efficacy of collaborative, goal-focused occupational therapy in the treatment of deficits in upper-body dressing, but did not support this approach with toileting, eating, grooming, bathing, and lower-body dressing. Further study, with a larger sample, is recommended.