Occupational therapy students' perceptions of their cultural awareness and competency.

Occupational therapy students' perceptions of cultural awareness and their self-rated level of cultural competence were investigated. Seventy-two participants at four stages of education (on entry, on completion of university-based studies, on completion of fieldwork and one year following graduation) completed the Cultural Awareness and Sensitivity Questionnaire. The findings indicate that occupational therapy students graduated with an understanding of cultural diversity and the realization that cultural awareness and sensitivity are essential to culturally competent practice. The findings suggest that there is not enough exposure to cultural issues in both university-based education and in fieldwork. This study was limited to one state university and to most students aged < or =24 years and predominantly female. It did not explore the factors that influence the development of cultural competence and the methods to develop it. Future studies should monitor actual culture-related exposures to determine how learning experiences are organized and the ways culture influences the learning process and clinical competence.

Development of a Chinese version of the Modified Barthel Index-- validity and reliability.

OBJECTIVE: To establish the structural validity of the Chinese version of the Modified Barthel Index and to estimate its inter-rater reliability for use with patients who have had a stroke. DESIGN: Prospective study. SETTING: A regional general hospital and a day hospital in Hong Kong. SUBJECTS: One hundred and sixteen older people who had had a stroke (mean age 76.0; SD 7.6) were involved in the establishment of evidence of the structural validity and item quality. Another 15 older people with stroke (mean age 78.0; SD 7.1) participated in estimating the reliability of the instrument. METHODS AND RESULTS: The Modified Barthel Index was translated into Chinese. Factor analyses revealed a two-factor structure that explained 75.7% of the total variance. Factor 1 was found to consist of eight items relating to patients' functional performance. Factor 2 consisted of the two items that focused on patients' ;physiological needs'. The test-retest reliability of the Chinese version at the item level was comparable with that of the original version, with kappa statistics ranging from 0.63 to 1.00 (P < 0.001). CONCLUSION: The Chinese version of the Modified Barthel Index (MBI-C) seems to be valid and reliable for use with older people with stroke. Changes were made to the item content and the rating criteria that were specific to Chinese culture. The structural validity and the reliability of the Chinese version were shown to be robust across the original and Chinese groups.

Performance on figure ground perception following stroke induced hemiplegia: a compairson of pre-and post-rehabilitation with the neurologically unimpaired.

This article compares performance times on the Figure Ground Perception (FGP) of the Sensory Integration and Praxis Tests (SIPT) in persons with stroke-induced hemiplegia and unimpaired older persons. Two hundred and twelve right dominant persons with hemiplegia on admission and discharge from comprehensive rehabilitation and 321 neurologically unimpaired persons in the community were evaluated on the FGP subtests of the SIPT. There were significant differences in performance between unimpaired persons and those with hemiplegia following a stroke. Among the persons with stroke-induced hemiplegia, performance on discharge was significantly better than on admission across all five FGP subtests. Age, sex, and severity of hemiplegia also affected performance on specific subtests; the influence of laterality was significant in persons with right hemispheric lesions; and persons with Wernicke's aphasia performed more poorly. Although further investigation is clearly needed, the association of increasing age (particularly males 75 years and over), severity of hemiplegia, and presence of aphasia on FGP performance suggest that these factors should be considered in the development of rehabilitation programs for stroke patients.

Teacher stress and coping strategies used to reduce stress.

This pilot study investigated teachers' symptoms of stress and their coping strategies. Measurements of 'stress levels' and 'coping strategies' used were acquired by constructing a questionnaire made up of four individual standardized questionnaires. The data were analysed by a series of correlational analyses that highlighted significant relationships between ways of coping and levels of distress. Differences between the stress-related areas were measured using the Friedman test and Wilcoxon signed rank test for hierarchy. The findings implied that 'escape avoidance', 'accepting responsibility' and 'uncontrolled aggression' were used as negative coping strategies and only one strategy, 'exercise', was indicated to be an effective way of coping. The teachers' strategies were examined for similarities and differences with those recommended by occupational therapists. This pilot study was limited to two schools and it is recommended that it be extended to better generalize the results. Furthermore, ways of coping, as measured by psychological measures, do not seem to reduce stress so it is possible that the activity-based Stress Management Questionnaire, as advocated by Stein et al. (2003), might be more advantageous.