RESUMO
The emergence of managed care has resulted in a practice environment buffeted by rapid and sweeping changes. Shifts in philosophy and approach to payment for health care affect the nature of the service and the method of its delivery. The occupational adaptation frame of reference is used to illustrate the challenges imposed by the physical, social, and cultural components of the changing occupational environment. Perceptions, observations, and concerns of middle level occupational therapy, physical therapy, social work, and nursing managers illustrate the impact of this new environment. Therapists are challenged to understand their own changing work setting and to apply the same effort to mastering its challenges as they would to examining the context of their patient's occupational performance and to designing and implementing an appropriate clinical intervention.
Assuntos
Prática Institucional , Programas de Assistência Gerenciada , Terapia Ocupacional , Necessidades e Demandas de Serviços de Saúde , Local de TrabalhoRESUMO
This paper presents the Comprehensive Occupational Therapy Evaluation Scale (COTE Scale) for use by occupational therapists in short-term, acute-care psychiatric facilities. The scale defines 25 behaviors that occur in and are particularly relevant to the practice of occupational therapy. The scale is used as an initial evaluation, as a record of patient progress, and as a means of communicating the evaluation, progress, and treatment to other hospital departments. Ratings of patients that indicate improvement and readiness for discharge are supported by the evaluations of other disciplines.
