Professor Lunn OT Final

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Practice Test



168 Terms
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occupational therapy
therapy based on engagement in meaningful activities of daily life (as self-care skills, education, work, or social interaction) especially to enable or encourage participation in such activities despite impairments or limitations in physical or mental functioning
occupational science
an academic discipline that offers support, reason, and scientific data that legitimizes the work that is done within that profession
direct, observable aspects of occupation objects and tools used steps involved environmental factors
human development health quality of life adaptation
looks at how people think, feel, and experience what they do discovered through qualitative measures such as interview encompasses the personal and cultural significance of occupations looks at how it influences choice through occupation we develop a sense of competence, self-esteem, and identity
the focus of occupation therapy and the unit of measure for occupational science
clinical reasoning
process used by practitioners to plan, direct, perform, and reflect on client care
William Rush Dunton
father of OT
Eleanor Clarke Slagle
mother of OT
George Edward Barton
leader of Arts and Crafts Movement
Susan cox Johnson
showed occupation can be positive for health
Thomas Bessel Kidner
established OT in Vocational Rehab.
Phillipe Pinel
conceived Moral Treatment Movement
Adolf Meyer
physch. who developed basis of OT
provided a motivation to the concept of OT (crafts, habit training)
provided more functional activities to enhance return of daily life; goal was rehab.
Biomechanical Frame of Reference (FOR)
emerged (Medical Model)
OT as a profession
seeks to improve the quality of life for individuals who are experiencing or are at risk for physical, cognitive mental, or psychosocial impairments
OT as art
it is different for every person - the therapist must learn to enter a client's life to understand
client-centered practice
the client determines what is meaningful and important for therapy
occupational-based practice
separates us from other allied health professionals; we use occupation as an end as well as a means
evidence-based practice
the use of research to guide clinical reasoning
thinking about the client
OT understanding their motivation, goals, developmental level, and personal expectations; OT needs to be realistic, ask Qs, and seek support
thinking about the family
the OT needs to perceive family members as listeners , supporters, motivators, and adaptable when necessary
OT role
respecting family values, beliefs, and routines not judging comm. with clean goals, expectations, and education to promote health, safety, and independence listening and trying not to fix everything being realistic HIPAA advocating for client/family establishing a professional relationship being human
thinking about the team
comm. with each other, the client, and the family everyone needs to be on the same page educate the family and client about outcomes, illness, disability, comm. resources, etc. provide necessary intervention/services
a set of basic principles/concepts underlying someone's practice or conduct
the Qs concerned with the nature of humankind
related to nature, origin, and limits of human knowledge; provides a base for understanding motivation, change, and learning; investigates how we know things and how do we know that we know?
examines the value of a profession and what's considered just and right; OT this = client-centered care, quality of life, ethics; explores Qs of desirability and ethics
reductionistic approach
humankind is reduced to separately functioning parts; successful in producing cures and technological advancements; inefficient and costly
holistic approach
emphasized the organic and functional relationship between parts and the whole being; core concept to our profession - this means that evaluations and intervention plans should reflect the needs of the whole person
active beings
how OT views humans; actively involved in controlling and determining their own behavior and are capable of changing behavior as desired; viewed as open systems in which there is continuous interaction between the person and environment
occupation as a means
the use of a specific occupation to bring about a change in the client's performance
occupation as an end
the desired outcome or product of intervention
a set of shared distinct beliefs, values, and behaviors that help individuals to recognize who belongs and who does not belong to the collective group
culture is...
learned - not inherited real - influence can be felt shared - be group individuals dynamic - changes over time in response to politics and economics invisible - taken for granted until a different culture makes our own visible NOT race or ethnicity
cultural sensitivity
cultural differences impact OT assessment and intervention; if we are not addressing important occupations - why would the client continue participating in OT treatment?
fundamental orientation in a persona's life; what inspires and motivates; may result in a connection with others; linked to hope, faith, coping, and self-transcendence; may imply religion
an organized and culturally shaped avenue for spiritual expression
social position
the differences and inequalities among people or groups of people; can shape one's values, beliefs, and view of the world as they participate in it
social/material qualities
resources such as education, jobs, housing, food, sources, and health care
socioeconomic status
the occupational, educational, and income achievements by individuals or groups
lack of material resources that are necessary to live
working poor
people who work full time but still live within the poverty line
new poor
when an unplanned life change occurs and effects the resources required to meet basic needs
when medicare and medicaid are established
for people 65+, disabled of any age, and end-stage renal disease part A: inpatient hospitalization SNFs HHC hospice part B: physician and outpatient services HHC DME
insurance for all who are unable to afford health care (requirements) federally and state funded varies by state with coverage/usage
SCHIP (State Children's Health Insurance Program)
established in 1997 to provide health care to uninsured children of working families who earn too little to afford private insurance but too much to be eligible for medicaid.
IDEA (Individuals with Disabilities Education Act)
a school-based program that focuses on care in school systems; highest % of OTs work in school-based programs; partnerships between state and federal gov. and school systems
workman's compensation
state-run; pays for healthcare related to a work injury; pays for medical services, salaries, vocational training, and for disability if determined by an MD; uninsured
JCAHO (Joint Commission on Accreditation of Healthcare Organizations)
evaluates an organization's compliance with the standards established; organization being evaluated must comply with essential standards in order to receive Medicare reimbursement; hospitals utilize this organization by choice
NCQA (National Committee for Quality Assurance)
assesses and reports on the quality of managed care plans; voluntary service for MCO's; standards relate to member satisfaction, quality of care, access., and services provided
CARF (Commission on Accreditation of Rehab Facilitates)
a voluntary organization for rehab providers
NBCOT (National Board for Certification in Occupational Therapy)
credentials OT's and COTA's to be able to work within the profession; and examination in taken after a master's education and 6 of fieldwork
State Regulatory Board
after passing the certification exam (NBCOT) an OT/COTA can apply for licensure within the state in which they want to practice; each state has specific criteria regarding the duties and responsibilities of the OT/COTA.
advances the profession within the state; provides continuing education opportunities independent from AOTA, but they collaborate
certified hand therapist
certified professional ergonomist
specialty certification in low vision
depends on skill, knowledge, and experience; promotes learning, autonomy, and professional growth; includes respect and trust; comm. needs and type of supervision
service competency
demonstration and verification of skills and knowledge of treatment; this can be done by: - co-treatment - observation - individual education
respect, understanding, clear expectations, dependability
team members have shared responsibility for providing services and support one another's goals for treatment. Separate assessments, then shared results to develop integrated and coordinated care
team members work side-by-side one another. Roles are clearly defined and team members are aware of each others' scope of practice
team members work together to develop goals, and carry out patient care. Family interacts with a primary provider, based on patient needs
clinical decisions based on professional judegment
involves personal and social morals and values; not a right/wrong answer
OT code of ethics
(AOTA 2000) common set of values/principles that promote high standards of behavior and professional responsibility
demonstrates concern and well-being for the recipients of services
do no harm to the recipients of service
autonomy and confidentiality
respect the right of the individual to self determination; collab with all, inform recipients of potential risks of intervention, respect decisions, HIPAA
social justice
providing service in a fair/equitable manner
procedural justice
compliance with laws/policies
the duty to tell the truth
treating colleagues and others with fairness, discretion, and integrity
OT values
Altruism Equality Freedom Justice Dignity Truth Prudence
process of ethical reasoning
- identify the ethical dilemma - gather relevant facts about the case - apply ethical theories and guiding principles to analyze the case - problem solve practical alternatives - decide on an action - act on that choice - evaluate how to prevent or cope with the dilemma should you encounter it again
professional reasoning
used by practitioners to plan, direct, perform, and reflect on client care; complex' multifaceted; effected by the amount of experience one has
thinking about thinking
building up a representation of what to expect based on experience
rules to guide thinking (initial treatment to discharge)
scientific reasoning
focuses on the diagnosis of the illness or condition; guided by theory; considers evidence from research to guide practice; does not consider the patient on a personal level
narrative reasoning
personal; includes info from the patient and family; focuses on the patient's history and story; considers the patient's culture; helps the therapist make sense of the patient's circumstances
pragmatic reasoning
practical; considers scheduling options, payment, equipment needed/available, therapist's skills, organizational policies; not focused on the client's condition, but the realities of providing services
ethical reasoning
a systematic approach to a moral conflict; analyzes the dilemma; helps generate alternative solutions; determines actions needed
interactive reasoning
thinking that helps the therapist build a positive relationship with the patient; uses positive communicative skills; allows for collaboration in treatment; identify and solve problems
OT process
involves the interaction between the practitioner and the client; collaborative; dynamic process with the focus on
evaluation process
to find out what the client wants/needs; based on age, diagnosis, developmental level, education, socioeconomic status, cultural background, and abilities
starts the OT process; a request for service for a particular client is made from a medical prof.
OT practitioners gather prelim. info about the client and determine whether further evaluation and intervention are needed; involves interview, screen test, observation, discussion, and referral
occupational profile
gather basic demographics: age, gender, diagnosis, reason for referral, etc.; provides OT with a history of the client's background and functional performance with which is to design interventions
occupational performance analysis
uses the occupational profile to provide a direction to the practitioner to the areas that need further examination; involved analyzing all aspects of the occupation to determine the client factors, patterns, skills, and behaviors required to be successful
the means of gathering info about a person or an environment by watch/notice; ex: posture, dress, social skills, voice, behavior, physical abilities, etc.
structured observation
watching the client perform a predetermined activity
working with the client through therapy to reach client goals
occupational justice
to develop an understanding of the political potential of OT to create situations in which all individuals, regardless of race, ethnicity, socioeconomics, class, or disability status, can engage in meaningful occupations by choice that support their participation in everyday life
occupational dysfunction
impaired or disordered occupations
occupational apartheid
segregation of groups of people through restriction or denial of participation in occupations if daily life; can be based on race, color, disability, sexual preference, political beliefs, etc.
occupational injustice
alienation, deprivation, marginalization, imbalance
a period of undefined time when a person is disconnected from others, lacks a clear identity, and cannot find meaning in his/her life
prevention of participation in meaningful occupation - control is outside of the individual; ex: Lavin's curfew in Bethlehem
the lack of choice/control which limits participation (invisible force); ex: homeless population
being "under/over-occupied" which causes the individual to lose meaning or empowerment in their other daily occupations
occupational analysis
a person's values, beliefs, interests, habits, routines, and goals are taken into account; the use of narrative reasoning; incorporate a person's natural context
occupational-based activity analysis
person/their goals are central; who are they? what do they wanna do? what are the demands of the activity within the person's context and how to relate to their current skill level; how OT bridges the gap between skills and demands
activity analysis
thought processes OT's use when they are thinking about activities in general; examining properties of an activity such as potential demands, range of skills, and meanings; thinking about therapeutic potential of an activity
activity analysis format
-identifies activity demands: objects, space, social -performance skills: motor, process, communication -required steps -required body functions -safety hazards
performance skills
what able to do; observable; actions have purpose; occur within the intersection of the person, demands of an activity, within a context -motor, process, communication
motor skills
skills in moving and interacting with tasks, objects and environment; observe as persons moves and interacts with objects and the environment; involves posture, movement, strength, etc.
process skills
skills used in managing and modifying actions during task performance; mental processing is focus rather than only physical activity; maintaining attention, choosing appropriate tools and using them correctly, etc.
communication/interaction skills
refers to conveying intentions and needs and coordinating social behavior to act together with people; these skills are those that enable people to get along with others, make their needs known, ask Qs, etc.
to improve the patient's capabilities (function) to participate in occupation by increasing or decreasing the demands in a sequential order; a variable
process of changing the demands of an activity so that the client in capable of performing it through changes in the occupation of environment; the goal is to allow the person continual involvement in a valued occupation that can no longer be pursued based on their functional capacity
OT in early intervention
promoting the functions and engagement of infants and toddlers and their families in everyday routines by addressing occupations; enhancing a family's capacity to care for their child and promote his/her development and participation
early intervention patients
infants 0-3
why early intervention?
the infant is not reaching certain milestones in their first years of life
OT in hospital acute care
secondary healthcare for those who have a severe injury or illness; treatment is quick and effective
hospital acute care patients
all ages, critical conditions, trauma, new diagnoses, worsening condition, etc.
hospital acute care stay time
less than 30 days
OT in home health
when a medical professional provides someone with medical care but goes to them
OT in mental health
the goal is to promote quality of life, independence, social interactions/participation, improving behavior, self-care, homemaking, etc.
mental health patients
PTSD, bipolar, depression, autism, mental health recovery, etc.
why mental health?
some are incapable of functioning in normal life, need help engaging with others, accomplishing tasks, etc.
OT in pediatric outpatient
teaching the patients to engaging in activities that allow them to learn, develop life skills, be creative, and have positive relationships with others
pediatric outpatient patients
0-18YO, ADHD, autism, premature, behavioral disorders, etc.
OT in outpatient
where patients can receive medical care without having to stay overnight at the facility
outpatient patients
patients can be any age but can only be admitted with a referral from a DR or specialist
outpatient stay time
2wks - 6mths
OT in schools
goal is to provide the children in their care with the tools and skills necessary for them to independently perform tasks
school stay time
varies according to IEP (individualized education plan)
OT in hospice
when the professional works to make the patient as comfy as possible before death when there is no further treatment for the illness
OT in hospital inpatient
a basic hospital visit; rooms vary from semi-private to full with meals and nurse service provided
OT in skilled nursing facilities
a facility that often houses the elderly, those suffering from traumatic injury, mental or physical disability, or something similar; cannot discriminate
skilled nursing facilities setting
patient's rooms can be adapted for their needs (ex: kitchen, office, gym, etc.)
SaMol's story
suffered from a brain injury and died; son-in-law took over; his OT was invited to the funeral; learning how other cultures cope with death
Mary Weber's story
successful, play-write/tv star and engaged women who got in a car accident and suffered from a brain injury; problems communicating, coordination, etc. she started to paint to express herself with the help of her OT, Anna
Alex's story
went to UNH; didn't want to stop living his "normal" life because of is cerebral palsy
Minnie Mae's story
suffered from Parkinson's Disease; 1st Doctor was not helpful; poor therapeutic rapport; didn't LISTEN; she found a new doctor; husband is Don: a UNH professor-retired (love story)
John Banks's Story
an African American who wanted technology to benefit him while his white OT believed in play and leisure; gender and racial differences
bipolar teenager; trouble getting to school on time but mostly get to school on time now behavior issue; therapy; therapeutic day school
MS; neuroscientist; wheelchair; enjoys painting
ATV head injury; coma for 6wks; impaired speech and balance
78YO; weakness on right side; transient ischemic attack (TIA) was diagnosed; flat effect, motor deficit, farsightedness, wheelchair dependent, loss of communication, etc.
Susan Tracy
first occupational therapist; a nurse who was involved in the arts and crafts movement and in the training of nurses in the use of occupations; wrote first book on OT
habit training
a re-education program designed to overcome disorganized habits, to modify other habits, and to construct new ones, with the goal of restoring and maintaining health
an educational program designed to teach a person to overcome a disability through training and education
intristic motivation
a desire to perform a behavior for its own sake and to be effective
March 1917
birth of OT
April 1921
name changed to AOTA
routine supervision
face to face contact at least every 2 weeks at the site of work, with interim supervision through methods of telecommunication
close supervision
daily, direct contact at the site of work
general supervision
initial direction and face to face contact with the supervising therapist at least once a month, interim supervision as needed by telecommunication
an allied health paraprofessional who under the direction of an OT, directs and individuals participation in selected tasks to restore, reinforce, and enhance performance, and promote to maintain health
William Tuke
leisure therapy advocate, created the moral treatment and occupation movement
Helen Willard
co created the the "bible" of OT, Willard and Spackman's Occupational Therapy
Herbert Hall
developed the arts and crafts movement for medical purposes
AOTA (American Occupational Therapy Association)
the nationally recognized professional association for occupational therapy practitioners
AOTF (American Occupational Therapy Foundation)
purpose is to serve public interest by supporting OT research and education the public about occupation's important relationship to health; they accomplish this with grants, scholarships, programs, and publications
ACOTE (Accreditation Council for Occupational Therapy Education)
recognizes education institutions and professional programs to ensure that integrity and quality performance is being received by the public community
Balanced Budget Act
1997: drastic cuts in Medicare reimbursement, including areas of occupational therapy service 2000: restoration of some Medicare benefits due to patient, family, and provider pressure
aspect of meaning vs. spirituality, aspect of two areas
3 divisions of OT process
evaluation, intervention, outcomes
5 intervention approaches
create/promote, establish/restore, maintain, modify, prevent
components of the evaluation process
purpose, procedures, referral, screening, OP, OPA, Interview, observation, formal assessment,
Jodie Heath
-Owner of Swing for the Stars Pediatric Therapy Center -Went to UNH -Worked at Adam's Camp Some Challenges of working with kids: -they don't always want to play what/when you want to play -having difficult conversations with families/parenting styles/home carryover and how it impacts progress -Behaviors, behaviors, behaviors!
Alicia Wood
-Worked in skilled nursing/long term care for 20+ years -Now works in home care -Went to Utica College of Syracuse in 2001 -Worked at Genesis Hackett Hill Center with Prof Lunn -Initially worked under a temp license until taking the NBCOT exam