Professional expertise of occupational therapists in community practice: results of an Ontario survey.

This paper presents findings of a study, The Community Practice Project, that examined the situation of occupational therapists practising in community based settings in the province of Ontario, Canada in 1992. In addition to providing a profile of the typical community based therapist, the study considered issues relating to: the principal roles in places of employment; specific job skills and areas of professional expertise utilized in the community; and how well occupational therapists; formal training prepared them for their community oriented roles and tasks. Results indicate that great opportunities exist and job satisfaction is high in community settings.

Native Canadians relocating for renal dialysis. Psychosocial and cultural issues.

Objective: To examine the effects of relocation from remote Native communities for dialysis treatment and explore the receptiveness of patients, caregivers, and their communities to establishing a local satellite dialysis unit. Second, to examine the methodological issues inherent in a qualitative, cross-cultural study.

Design: Qualitative descriptive survey using semistructured interviews.

Stability of functional outcomes following transitional living programme participation: 3-year follow-up.

The functional status and perceived problems of 21 persons with severe brain injury were reported at admission, and at 1 and 3 years post-discharge from a community-based post-acute rehabilitation programme. Functional status was measured by participation in productive activity, financial support, place of residence and level of supervision required. Improvements observed at 1-year follow-up remained stable or had improved at 3-year follow-up.

Community-based rehabilitation cadres: their motivation for volunteerism.

Volunteer workers, or cadres, are critical to the successful implementation of community-based rehabilitation (CBR) programmes. To date, relatively little research has examined the importance of motivation in health volunteers in general, and especially CBR workers. This paper reports the major findings of a field study in rural Indonesia.

Incorporation of ethnographic methods in occupational therapy assessment.

Many constructs of interest to occupational therapists can only be studied through qualitative methods. Such constructs include meaning of activity or the illness experience and the context in which these occur. The purpose of this paper is to describe how ethnographic methods used in research can be generalized and applied to clinical practice.

"Doing battle": a metaphorical analysis of diabetes mellitus among Navajo people.

Effective communication with patients and their family members forms the foundation of a therapeutic relationship. This is particularly important when the occupational therapist, other health professionals, and the patient are from different cultural backgrounds. This paper describes one aspect of the findings of a ethnographic study of chronic diabetes among the Navajo people (referred to here as Dine').

Measuring long-term outcome after traumatic brain injury.

We report the results of the first stage of development of an instrument to measure long-term functional outcome after traumatic brain injury. The instrument focuses on both the person with a disability and the impact on the family caregiver. We illustrate the early stages of instrument development, focusing on one approach to standardized reviewer feedback to evaluate content validity.

Cognitive failure in patients with terminal cancer: a prospective study.

In a prospective open study, 61 consecutive patients with terminal cancer admitted to the hospital underwent cognitive assessment using the Mini-Mental State Questionnaire three times a week between admission and discharge or death. Mini-Mental State Questionnaire score upon admission was 28 +/- 1.5 in patients who were discharged (N = 14), and 25 +/- 3 in patients who died in the hospital (N = 47, P less than 0.

Incidence and prevalence of end-stage renal disease among Ontario's James Bay Cree.

End-stage renal disease (ESRD) and chronic renal failure (CRF) among Canadian natives is more common than among the general Canadian population. The results of this study show the James Bay Cree in Northern Ontario in 1989 experienced ESRD prevalence rates 3.2 times greater than the national rate.

Activity and post-polio fatigue.

Fatigue was studied in 12 subjects with post-polio sequelae (PPS). Results of the Fatigue Severity Scale (FSS) demonstrated a mean score of 4.8 +/- 1.

Leisure activities after a stroke: an ethnographic approach.

Ethnography is a qualitative research design that has relevance for clinical research in occupational therapy. The ethnographic approach is illustrated in the present paper through a description of how it could be used to investigate the effectiveness of an occupational therapy leisure intervention with stroke survivors. This paper contrasts ethnography with a randomized clinical trial design addressing the same question.

Rigor in qualitative research: the assessment of trustworthiness.

Despite a growing interest in qualitative research in occupational therapy, little attention has been placed on establishing its rigor. This article presents one model that can be used for the assessment of trustworthiness or merit of qualitative inquiry. Guba's (1981) model describes four general criteria for evaluation of research and then defines each from both a quantitative and a qualitative perspective.

Double bind and disability: the case of traumatic head injury.

This paper presents ethnographic data to support the double bind model of communication most recently described by Alexander. Using traumatic head injury as an example, an interactive view of paradoxical communication was taken focusing on the disabled, the family, and service providers. A brief discussion of head injury in the U.